Self-concept as a "BMT patient", illness intrusiveness, and engulfment in allogeneic bone marrow transplant recipients.

OBJECTIVE

The experience of cancer and its treatment by bone marrow transplantation (BMT) can enhance the salience of one's status as a patient in the evolution of self-concept. Illness and the patient role can come to dominate the sense of self, resulting in feelings of hopelessness, helplessness, and distress ("engulfment"). Illness-induced lifestyle disruptions ("illness intrusiveness") introduce adaptive demands, challenging preexisting conceptions of self. Illness intrusiveness and engulfment may interact, leading affected individuals to construe themselves as highly similar to a prototypical "BMT patient".

METHODS

Ninety allogeneic BMT outpatients completed the Illness Intrusiveness Ratings Scale, Modified Engulfment Scale, and a semantic differential measure of self-concept as a BMT patient in an interview context.

RESULTS

Illness intrusiveness correlated significantly with engulfment (r=.58, P<.0001) and with self-concept as a BMT patient (r=.27, P<.016). Engulfment did not correlate significantly with self-concept as a BMT patient (r=.15). Multiple regression analysis, controlling for relevant covariates, indicated a significant Illness Intrusiveness x Engulfment interaction effect on self-concept as a BMT patient [F(1,84)=4.93, P<.029].

CONCLUSIONS

Self-concept as a BMT patient increases as cancer and its treatment introduce increasing lifestyle disruptions (illness intrusiveness). These effects are amplified when self-experience is dominated by disease and treatment and patients feel helpless, hopeless, and distressed (engulfment).