| 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. |
