Abstract
Objectives
One of the modifiable determinants of biopsychosocial well-being in patients admitted for haematopoietic cell transplantation (HCT) is the illness representation. To date, studies on illness representations have mainly been cross-sectional, treating the sample as homogeneous. We investigated distinct illness representation profiles (including illness consequences, timeline, personal control, treatment control, identity, illness concern, coherence, and emotional representation) in patients before HCT, as well as profile predictors (i.e., demographic and clinical factors) and outcomes (i.e., pre- and post-transplant biopsychosocial indicators of well-being).
Design
A longitudinal study.
Methods
Illness representations (B-IPQ), symptoms of depression (CES-D), anxiety (GAD), loneliness (RUCLA), psychological well-being (C-PTGI-SF), and health-related quality of life (EORTC QLQ-C30) were measured in 202 patients (57% male; mean age = 47.38 years; mean time since diagnosis = 19.05 months) after admission for HCT and 2 weeks after discharge (N = 119). Unconditional and conditional latent profile analyses were applied.
Results
Three latent illness representation profiles were identified: positive (27%), negative (19%), and ambivalent (54%). Women were more likely to belong to the negative or ambivalent profiles. Patients with more favourable illness representations reported fewer depressive, anxiety, and loneliness symptoms, both prior to and after HCT. The positive and negative profiles differentiated well between patients with greater positive psychological well-being and poorer post-transplant overall quality of life, respectively.
Conclusions
The results highlight the variation in pre-HCT illness representation and demonstrate how biopsychosocial well-being is related to different illness representation subgroups in a concurrent and short-term manner, indicating the practical implications of the study.