The mediating role of coping in the relationship between perceived health and psychological wellbeing in recurrent urinary tract infection: the rUTI Illness Process Model
Background: Recurrent urinary tract infection (rUTI) is associated with significant symptom and quality of life burden. Given the unique challenges in diagnostics and management, healthcare disillusionment and stigmatisation which distinguish rUTI from other urological conditions, specific identific...
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| Format: | Article |
| Language: | English |
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Taylor & Francis Group
2024-12-01
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| Series: | Health Psychology and Behavioral Medicine |
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| Online Access: | https://www.tandfonline.com/doi/10.1080/21642850.2024.2420806 |
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| author | Abigail F. Newlands Melissa L. Kramer Kayleigh Maxwell Jessica L. Price Katherine A. Finlay |
| author_facet | Abigail F. Newlands Melissa L. Kramer Kayleigh Maxwell Jessica L. Price Katherine A. Finlay |
| author_sort | Abigail F. Newlands |
| collection | DOAJ |
| description | Background: Recurrent urinary tract infection (rUTI) is associated with significant symptom and quality of life burden. Given the unique challenges in diagnostics and management, healthcare disillusionment and stigmatisation which distinguish rUTI from other urological conditions, specific identification of the key illness processes experienced by this patient population is required. This study aimed to identify the unique illness processes and perceptions that contribute to quality of life in rUTI, through perceived health status, psychological wellbeing, and coping.Methods: An international sample of adults living with rUTI (N = 389, 96.9% female) completed a cross-sectional survey comprising the following standardised questionnaires: the EuroQoL EQ-5D-5L, Patient Health Questionnaire 9 (PHQ-9), Generalised Anxiety Disorder 7 (GAD-7), Connor-Davidson Resilience Scale–10 (CD-RISC-10), Pain Catastrophising Scale (PCS). Sociodemographic characteristics were also assessed. Structural equation modelling was conducted to identify the underlying constructs which contributed to psychological wellbeing in rUTI, establishing the ‘rUTI Illness Process Model’.Results: The positive relationship between ‘perceived health status’ and ‘psychological wellbeing’ was partially mediated by ‘rUTI coping’, after controlling for the impact of household income and age (p < .001). The model demonstrated a large effect size (R2 = .81) and good local and global fit. Overall, rUTI coping skills, boosted by resilience and weakened by pain catastrophising, contribute to a significant proportion of the positive relationship between perceived health status and psychological wellbeing in rUTI. A uniquely vulnerable patient phenotype emerges from this new research, with patients who are younger and/or of lower socioeconomic status at greater risk of poorer rUTI health outcomes and psychological wellbeing, potentially requiring further support.Conclusions: The rUTI Illness Process Model establishes the crucial need to clinically characterise the individualised illness perceptions and metacognitive strategies held by people living with rUTI, revealing that patient-centred interventions targeting illness perceptions and coping strategies require prioritisation to enhance patient outcomes and the patient experience of living with rUTI. |
| format | Article |
| id | doaj-art-62f6f6c55aeb44579bcfe40ba5954dc7 |
| institution | OA Journals |
| issn | 2164-2850 |
| language | English |
| publishDate | 2024-12-01 |
| publisher | Taylor & Francis Group |
| record_format | Article |
| series | Health Psychology and Behavioral Medicine |
| spelling | doaj-art-62f6f6c55aeb44579bcfe40ba5954dc72025-08-20T02:31:23ZengTaylor & Francis GroupHealth Psychology and Behavioral Medicine2164-28502024-12-0112110.1080/21642850.2024.2420806The mediating role of coping in the relationship between perceived health and psychological wellbeing in recurrent urinary tract infection: the rUTI Illness Process ModelAbigail F. Newlands0Melissa L. Kramer1Kayleigh Maxwell2Jessica L. Price3Katherine A. Finlay4School of Psychology and Clinical Language Sciences, University of Reading, Reading, UKSchool of Psychology and Clinical Language Sciences, University of Reading, Reading, UKDepartment of Psychology, Faculty of Natural Sciences, University of Stirling, Stirling, UKLive UTI Free Ltd, Dublin, IrelandSchool of Psychology and Clinical Language Sciences, University of Reading, Reading, UKBackground: Recurrent urinary tract infection (rUTI) is associated with significant symptom and quality of life burden. Given the unique challenges in diagnostics and management, healthcare disillusionment and stigmatisation which distinguish rUTI from other urological conditions, specific identification of the key illness processes experienced by this patient population is required. This study aimed to identify the unique illness processes and perceptions that contribute to quality of life in rUTI, through perceived health status, psychological wellbeing, and coping.Methods: An international sample of adults living with rUTI (N = 389, 96.9% female) completed a cross-sectional survey comprising the following standardised questionnaires: the EuroQoL EQ-5D-5L, Patient Health Questionnaire 9 (PHQ-9), Generalised Anxiety Disorder 7 (GAD-7), Connor-Davidson Resilience Scale–10 (CD-RISC-10), Pain Catastrophising Scale (PCS). Sociodemographic characteristics were also assessed. Structural equation modelling was conducted to identify the underlying constructs which contributed to psychological wellbeing in rUTI, establishing the ‘rUTI Illness Process Model’.Results: The positive relationship between ‘perceived health status’ and ‘psychological wellbeing’ was partially mediated by ‘rUTI coping’, after controlling for the impact of household income and age (p < .001). The model demonstrated a large effect size (R2 = .81) and good local and global fit. Overall, rUTI coping skills, boosted by resilience and weakened by pain catastrophising, contribute to a significant proportion of the positive relationship between perceived health status and psychological wellbeing in rUTI. A uniquely vulnerable patient phenotype emerges from this new research, with patients who are younger and/or of lower socioeconomic status at greater risk of poorer rUTI health outcomes and psychological wellbeing, potentially requiring further support.Conclusions: The rUTI Illness Process Model establishes the crucial need to clinically characterise the individualised illness perceptions and metacognitive strategies held by people living with rUTI, revealing that patient-centred interventions targeting illness perceptions and coping strategies require prioritisation to enhance patient outcomes and the patient experience of living with rUTI.https://www.tandfonline.com/doi/10.1080/21642850.2024.2420806Urinary tract infectionchronic illnessresiliencepain catastrophisingdepressionanxiety |
| spellingShingle | Abigail F. Newlands Melissa L. Kramer Kayleigh Maxwell Jessica L. Price Katherine A. Finlay The mediating role of coping in the relationship between perceived health and psychological wellbeing in recurrent urinary tract infection: the rUTI Illness Process Model Health Psychology and Behavioral Medicine Urinary tract infection chronic illness resilience pain catastrophising depression anxiety |
| title | The mediating role of coping in the relationship between perceived health and psychological wellbeing in recurrent urinary tract infection: the rUTI Illness Process Model |
| title_full | The mediating role of coping in the relationship between perceived health and psychological wellbeing in recurrent urinary tract infection: the rUTI Illness Process Model |
| title_fullStr | The mediating role of coping in the relationship between perceived health and psychological wellbeing in recurrent urinary tract infection: the rUTI Illness Process Model |
| title_full_unstemmed | The mediating role of coping in the relationship between perceived health and psychological wellbeing in recurrent urinary tract infection: the rUTI Illness Process Model |
| title_short | The mediating role of coping in the relationship between perceived health and psychological wellbeing in recurrent urinary tract infection: the rUTI Illness Process Model |
| title_sort | mediating role of coping in the relationship between perceived health and psychological wellbeing in recurrent urinary tract infection the ruti illness process model |
| topic | Urinary tract infection chronic illness resilience pain catastrophising depression anxiety |
| url | https://www.tandfonline.com/doi/10.1080/21642850.2024.2420806 |
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