A Self-Regulatory Model of Coping in Women With Interstitial Cystitis/Bladder Pain Syndrome (IC/BPS)
Pain , Disability , Mental health , Interstitial Cystitis/Bladder Pain Syndrome , Structural equation modeling , Self-regulation , Coping , Illness perceptions , Emotion regulation
Interstitial Cystitis /Bladder Pain Syndrome (IC/BPS) is a chronic and refractory medical condition that is characterized by chronic pelvic pain along with abnormal urinary frequency and urgency. There is no widely accepted etiology or efficacious cure for IC/BPS, thus treatment often relies on pain and symptom management. IC/BPS is associated with a complex array of psychological, behavioural, cognitive and emotional issues, and as such examining these relationships within a comprehensive model is warranted. Current perspective on the biopsychosocial framework has introduced models of self regulation, which help to explain how individuals cope with chronic illness. The literature reviewed in this dissertation examines the interconnection between impairments (pain and symptoms), illness perceptions, coping (illness-focused, wellness-focused and emotion regulation) and outcomes (mental health and physical disability). Many of these relationships have yet to be investigated within samples of IC/BPS. Thus, the primary aim of this dissertation was to evaluate a self-regulation model of coping with IC/BPS through a series of model building methodologies. Female patients diagnosed with IC/BPS by a urologist in tertiary care hospitals were recruited across centres in North America (n=217). Steps 1 and 2 evaluated the measurement models to determine the structure and composition of the main constructs. Step 3 evaluated the model fit and specified hypotheses in the proposed IC-Self Regulation Model, and step 4 evaluated alternative models. The results support the structural model of the IC-Self Regulation Model that demonstrates relationships amongst impairments, illness perceptions, coping and outcomes. In particular, physical disability was modeled through negative illness perceptions, illness-focused coping and emotion regulation, and mental health was modeled through illness self-efficacy perceptions, wellness-focused coping and adaptive emotion regulation. The specified relationships are discussed in relation to the literature along with theoretical and clinical implications, study limitations and areas for future research.