The mediating role of coping in the relationship between perceived health and psychological wellbeing in recurrent urinary tract infection: the rUTI Illness Process Model

Abstract

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