Illness Identity and Well-Being in Congenital Heart Disease: Directionality of Effects and Developmental Trajectories

• Published in: Health psychology 2024-03, Vol.43 (3), p.203-213
• Main Authors: Campens, Sara, Van Laere, Elise, Vanderhaegen, Janne, Van Bulck, Liesbet, Moons, Philip, Luyckx, Koen
• Format: Article
• Language: English
• Subjects: Acceptance; Adult; Adults; Bidirectionality; Cardiovascular disease; Cardiovascular diseases; Congenital diseases; Congenital heart disease; Emerging Adulthood; Ethnicity; Female; Health Sciences; Heart Defects, Congenital - psychology; Heart Disorders; Human; Humans; Hälsovetenskaper; Identity; Illness Behavior; Illnesses; Individual differences; Insight; Interpersonal Relationships; Latent growth curve models; Longitudinal Studies; Male; Mental depression; Psychology; Psykologi; Quality of Life; Well Being; Young Adult
• ISSN: 0278-6133; 1930-7810; 1930-7810
• DOI: 10.1037/hea0001330

Objective: This longitudinal study explores the relationship between illness identity and well-being in emerging adults with congenital heart disease (CHD), aiming to understand the factors contributing to well-being in individuals with CHD. Method: Dutch-speaking emerging adults with CHD (N = 254, age range = 24-28 years) participated in a three-wave study, which is part of the I-DETACH 2 project. Cross-lagged analyses examined the directionality of effects between illness identity and well-being. Multivariate latent class growth analysis identified developmental trajectory classes of illness identity. Multigroup latent growth curve modeling investigated differences in the development of well-being among these classes. Results: Bidirectional associations were uncovered between illness identity and well-being. For instance, acceptance predicted better quality of life and less depressive symptoms over time. Three trajectory classes of illness identity were identified: high (i.e., as compared to the sample mean) acceptance and enrichment with low rejection and engulfment (Class 1), high rejection with low levels in the other dimensions (Class 2), and high rejection and engulfment along with high enrichment and low acceptance (Class 3). Individuals in Class 3 experienced the worse well-being. In addition, individuals with complex heart defects were strongly represented in this class. Conclusions: This study demonstrates the significance of illness identity in understanding individual differences in well-being among emerging adults with CHD. Additionally, this study provided valuable insight in the development of illness identity and its longitudinal relationship with well-being. Objetivo: Este estudio longitudinal explora la relación entre la identidad de la enfermedad y el bienestar en adultos emergentes con cardiopatía congénita (CHD), con el objetivo de comprender los factores que contribuyen al bienestar en personas con CHD. Método: Los adultos emergentes de habla holandesa con CHD (N = 254, rango de edad = 24-28 años) participaron en un estudio de tres fases, que forma parte del proyecto I-DETACH 2. Los análisis cruzados examinaron la direccionalidad de los efectos entre la identidad de la enfermedad y el bienestar. El Análisis Multivariado de Crecimiento de Clases Latentes identificó clases de trayectoria de desarrollo de identidad de enfermedad. El Modelo de Curva de Crecimiento Latente Multigrupo investigó las diferencias en el desarrollo del bienesta