Positive adjustment to breast cancer: Development of a disease-specific measure and comparison of women diagnosed from 2 weeks to 5 years

Abstract

Objective: Many women describe 'positive adjustment' as a consequence of having breast cancer. It is unclear whether positive experiences reflect the absence of anxiety and depression or are part of a separate process of adjustment. Existing measures are not specific to breast cancer and may lack validity. Our aims were as follows: (1) to develop a valid questionnaire to measure positive adjustment after breast cancer; (2) to clarify whether it measures aspects distinct from anxiety and depression and (3) to suggest when positive adjustment typically emerges. Methods: A new measure, the Positive Adjustment Questionnaire (PAQ), was developed and completed by 156 women with breast cancer, allocated to three groups: 2-4 weeks; 6 months-2 years and 2-5 years post-diagnosis. Other questionnaires were used to assess anxiety and depression and test the validity of the PAQ. Results: Principal components analysis of the PAQ identified four domains of positive adjustment; Fulfilment, Re-evaluation, New ways of living and Valuing Life. Women questioned 2-5 years after diagnosis reported more fulfilment, re-evaluation of life and new ways of living than those asked shortly after diagnosis. Differences in these aspects of positive adjustment remained after controlling for anxiety and depression. Conclusions: This study (1) provides a measure specific to positive adjustment following breast cancer; (2) suggests that positive adjustment is different from anxiety and depression and (3) indicates that positive adjustment is seen in women assessed 2-5 years after diagnosis. Psychological therapies that promote positive adjustment could enhance existing interventions that focus on reducing anxiety and depression. Copyright © 2010 John Wiley & Sons, Ltd.