Review Article

Psychological Adjustment Measures for Chronic Illness: A Narrative Review

Abstract

Objective: Chronic illnesses carry substantial psychological implications, emphasizing the critical nature of psychological adaptation to these conditions. Adequate assessment tools are essential for gauging adaptation levels within this context. Thus, this study aims to conduct a thorough review of psychological adaptation instruments designed for chronic illnesses.

Method: This narrative review scrutinizes articles published from 1990 to November 2024 in both Persian and English languages, focusing on psychological adaptation to chronic illnesses. The search encompassed prominent scientific databases, including "SID", "Irandoc", "Web of Science", "PubMed", and "Scopus". Relevant keywords were employed to retrieve articles discussing adaptation tools for chronic illnesses. Subsequently, the "consensus-based standards for the selection of health measurement instruments" were applied to assess the psychometric properties of the identified tools.

Results: Within this study, the exploration identified 8 instruments tailored to measure psychological adaptation to chronic illnesses. These instruments encompass measures for psychological adaptation to cancer (Mini-Mac), adaptation to ostomy (OAS), adaptation to type 1 diabetes (DAS_1), adaptation to drug-resistant tuberculosis (AS_DRTBP), adaptation to type 2 diabetes (DAAS), psychosocial adaptation to Parkinson's disease (Psychosocial Adaptation in PD), psychosocial adaptation to HIV infection (MAHIVS), and adaptation to breast cancer (AIMI-IBC). However, comprehensive reporting of psychometric properties was often lacking for the majority of these instruments.

Conclusion: The outcomes of this study underscore the significance of employing valid and dependable instruments tailored to the unique requirements of individuals grappling with chronic illnesses. Given the pivotal role of psychological adaptation, the careful formulation and implementation of specialized measures are recommended to facilitate the design and psychometric evaluation of adaptation measurement tools pertinent to diverse chronic illnesses in Iran.

1. Bonomi AE, Wagner EH, Glasgow RE, VonKorff M. Assessment of chronic illness care (ACIC): a practical tool to measure quality improvement. Health Serv Res. 2002;37(3):791-820.
2. Ambrosio L, Portillo MC, Rodríguez-Blázquez C, Rodriguez-Violante M, Castrillo JCM, Arillo VC, et al. Living with chronic illness scale: international validation of a new self-report measure in Parkinson's disease. NPJ Parkinsons Dis. 2016;2:16022.
3. Brunner LS. Brunner & Suddarth's textbook of medical-surgical nursing: Lippincott Williams & Wilkins; 2010.
4. Conroy T, Feo R, Alderman J, Kitson A. Building nursing practice: The fundamentals of care framework. InPotter & Perry’s Fundamentals of Nursing: Australia and New Zealand 6th Edition 2021 (pp. 19-33). Elsevier Australia.
5. Forestier B, Anthoine E, Reguiai Z, Fohrer C, Blanchin M. A systematic review of dimensions evaluating patient experience in chronic illness. Health Qual Life Outcomes. 2019;17(1):19.
6. Falvo D, Holland BE. Medical and psychosocial aspects of chronic illness and disability: Jones & Bartlett Learning; 2017.
7. Izadi-avanji FS, Hasani P, Rakhshan M, Alavi Majd H. Structure of resilience in older adults with chronic conditions. Journal of Qualitative Research in Health Sciences. 2017;6(4):314-25.
8. Vahidi A, Shaker Dioulagh A. The role of caregiver burden, marital stress, and mindfulness in predicting psychosocial adjustment to illness in people with coronary artery disease. J Cardiovasc Nurs. 2018;7(1):50-9.
9. Memarian R. The application of nursing concepts and theories. Tehran: Tarbiat Modarres University. Office of Publishing Scientific Works; 1999.
10. Yoder LH, Cengiz A, Hinkley T, Hertel RA, Gallagher‐Ford L, Koshy Thomas B. Medical‐surgical nurses' EBP beliefs and competencies. Worldviews on Evidence‐Based Nursing. 2022 Apr;19(2):149-59.
11. Feghhi H, SAADATJOO SA, Dastjerdi R. Psychosocial adaptation in patients with Type 2 diabetes referring to Diabetes Research Center of Birjand in 2013. 2013.
12. Yousefy A, Nekouei ZK. Basis of Cognitive-Behavioral Trainings and its Applications in Recovery of Chronic Diseases. J Med Educ.2011;10(5):792-800.
13. Samadzade N, Poursharifi H, Babapour J. The effectiveness of cognitive-behavioral therapy on the psycho-social adjustment to illness and symptoms of depression in individuals with type II diabetes. Clinical Psychology Studies. 2014;5(17):77-96.
14. Hassani SN, Tabiee S, Saadatjoo S, Kazemi T. The effect of an educational program based on Roy adaptation model on the psychological adaptation of patients with heart failure. Modern Care Journal. 2013;10(4).
15. Aghakhani N, Hazrati Marangaloo A, Vahabzadeh D, Tayyar F. The effect of Roy’s adaptation model-based care plan on the severity of depression, anxiety and stress in hospitalized patients with colorectal cancer. Hayat. 2019;25(2):208-19.
16. Halford J, Brown T. Cognitive–behavioural therapy as an adjunctive treatment in chronic physical illness. Adv Psychiatr Treat. 2009;15(4):306-17.
17. Sahranavard S, Ahadi H, Taghdisi MH, Kazemi T, Krasekian A. The role of psychological factors on the psychological and social adjustment through the mediation of ischemic heart disease hypertension. Hypertension. 2017;5(2):139-46.
18. Atik D, Karatepe H. Scale development study: adaptation to chronic illness. Acta Medica Mediterranea. 2016;32(1):135-42.
19. Nazari S, Foroughan M, Mohammadi Shahbolaghi F, Rassouli M, Sadegh Moghadam L, Farhadi A, et al. Analysis of the psychometric properties of the perceived social support scales in older adults. Iranian Journal of Ageing. 2016;10(4):210-8.
20. Calderon C, Lorenzo-Seva U, Ferrando PJ, Gómez-Sánchez D, Ferreira E, Ciria-Suarez L, et al. Psychometric properties of Spanish version of the Mini-Mental Adjustment to Cancer Scale. Int J Clin Health Psychol. 2021;21(1):100185.
21. Indrebø KL, Aasprang A, Olsen TE, Andersen JR. Psychometric Properties of New Subscales of the Ostomy Adjustment Scale: A Cross-Sectional Study. Patient Relat Outcome Meas. 2021;12:65-75.
22. Rivas T, Carreira M, Domínguez-López M, Ruiz de Adana MS, Anarte MT. Development and Preliminary Validation of a New Type 1 Diabetes Adjustment Scale (DAS-1). Front Psychol. 2020;11:533.
23. Liu H, Zhao J, Cao Y, Jiang H, Zhang S, Hua Z, et al. Developing and Validating an Adjustment Scale: The Adaptation Status Assessment of Drug-Resistant Tuberculosis Patients. Psychol Res Behav Manag. 2020;13:67-78.
24. Ebrahimi H, Karimi Moonaghi H, Asghari Jafarabadi M, Namdar Areshtanab H, Jouybari L. Development and Preliminary Validation of Diabetes Adjustment Assessment Scale (DAAS): a New Measure of Adjustment with Type 2 Diabetes. J Caring Sci. 2016;5(2):145-52.
25. Zhang T, Yin A, Sun X, Liu Q, Song G, Li L. Development, reliability and validity of the psychosocial adaptation scale for Parkinson's disease in Chinese population. Int J Clin Exp Med. 2015;8(10):19731-8.
26. Kelly B, Raphael B, Burrows G, Judd F, Kernutt G, Burnett P, et al. Measuring psychological adjustment to HIV infection. Int J Psychiatry Med. 2000;30(1):41-59.
27. Hajian S, Mehrabi E, Simbar M, Houshyari M, Zayeri F, Hajian P. Designing and Psychometric Evaluation of Adjustment to Illness Measurement Inventory for Iranian Women With Breast Cancer. Iran J Cancer Prev. 2016;9(4):e5461.
28. Antoniadis D, Giakoustidis A, Papadopoulos V, Fountoulakis KN, Watson M. Quality of life, distress and psychological adjustment in patients with colon cancer. Eur J Oncol Nurs. 2024;68:102467.
29. Rodríguez-González A, Velasco-Durántez V, Cruz-Castellanos P, Hernández R, Fernández-Montes A, Jiménez-Fonseca P, et al. Mental Adjustment, Functional Status, and Depression in Advanced Cancer Patients. Int J Environ Res Public Health. 2023;20(4).
30. Siennicka A, Goscińska-Bis K, Waga K, Wójcik M, Błaszczyk R, et al. Derivation and Validation of a Scale Assessing Constructive and Destructive Styles of Mental Adjustment to Heart Failure Based on the Mini-MAC Scale Used in Psycho oncology: The Results of Multicenter Caps-Lock-HF (Complex Assessment of Psychological Status Located in Heart Failure) Study, Front Med Health Res, 2017,1(1):1-10.
31. Okati-Aliabad H, Ansari-Moghadam A, Mohammadi M, Kargar S, Shahraki-Sanavi F. The prevalence of anxiety and depression and its association with coping strategies, supportive care needs, and social support among women with breast cancer. Support Care Cancer. 2022;30(1):703-10.
32. Cao CH, Liao XL, Gamble JH, Li LL, Jiang XY, Li XD, et al. Evaluating the psychometric properties of the Chinese Depression Anxiety Stress Scale for Youth (DASS-Y) and DASS-21. Child Adolesc Psychiatry Ment Health. 2023;17(1):106.
33. Pontone GM, McDaniels B, Keener AM, Subramanian I. A Wellness Prescription for Parkinson's: Mid to Late-Stage Disease. Am J Geriatr Psychiatry. 2023;31(9):737-47.
34. Morgado FFR, Meireles JFF, Neves CM, Amaral ACS, Ferreira MEC. Scale development: ten main limitations and recommendations to improve future research practices. Psicol Reflex Crit. 2017;30(1):3.
35. Taghizadeh Z, Ebadi A, Montazeri A, Shahvari Z, Tavousi M, Bagherzadeh R. Psychometric properties of health related measures. Part 1: Translation, development, and content and face validity. Payesh (Health Monitor). 2017;16(3):343-57.
36. Vakili MM, Jahangiri N. Content validity and reliability of the measurement tools in educational, behavioral, and health sciences research. Journal of Medical Education Development. 2018;10(28):106-18.
37. Tabatabaei MS, Kamran F, Jalaei S. A Review of Assessment Tools for Oral Feeding in Term and Preterm Infants. Journal of Mazandaran University of Medical Sciences. 2019;29(172):160-9.
38. Shabankareh K, Hamidi A. Validity Assessment in the Knowledge & Information Science Researches. Iranian Journal of Information Processing and Management. 2019;34(3):1103-24.
39. Echevarría-Guanilo ME, Gonçalves N, Romanoski PJ. Psychometric properties of measurement instruments: conceptual bases and evaluation methods-part I. Texto & Contexto-Enfermagem. 2018;26.
40. Shirinabadi Farahani A, Rassouli M, Yaghmaei F, Alavi Majd H. Index for selecting an appropriate instrument to conduct research in health sciences: Introducing the COSMIN checklist. Journal of Health Promotion Management. 2015;4(4):1-13.
41. Nademi MS, Bahmani B, Maarefvand M, Motamedi SV, Mardani MA, Biglarian A. Psychometric properties of attitude questionnaire to prayer: construction, development, validity and reliability. 2018.
42. Boateng GO, Neilands TB, Frongillo EA, Melgar-Quiñonez HR, Young SL. Best Practices for Developing and Validating Scales for Health, Social, and Behavioral Research: A Primer. Front Public Health. 2018;6:149.
43. Abdollahpour I, Nedjat S, Noroozian M, Majdzadeh R. Performing content validation process in development of questionnaires. Iranian Journal of Epidemiology. 2011;6(4):66-74.
44. Zamanzadeh V, Ghahramanian A, Rassouli M, Abbaszadeh A, Alavi-Majd H, Nikanfar AR. Design and Implementation Content Validity Study: Development of an instrument for measuring Patient-Centered Communication. J Caring Sci. 2015;4(2):165-78.
45. Vakili MM. Assessment of construct validity questionnaires in psychological, educational and Health research: applications, methods, and interpretation of exploratory factor analysis. Journal of Medical Education Development. 2018;11(30):4-19.
46. Mohammadbeigi A, Mohammadsalehi N, Aligol M. Validity and reliability of the instruments and types of measurments in health applied researches. Journal of rafsanjan university of medical sciences. 2015;13(12):1153-70.
47. Tian L, Cao X, Feng X. Evaluation of psychometric properties of needs assessment tools in cancer patients: A systematic literature review. PLoS One. 2019;14(1):e0210242.
48. Ebadi A, Taghizadeh Z, Montazeri A, Shahvari Z, Tavousi M, Bagherzadeh R. Translation, development and psychometric properties of health related measures-Part 2: construct validity, reliability and responsiveness. Payesh (Health Monitor). 2017;16(4):445-55.
49. Huang FF, Yang Q, Wang AN, Zhang JP. Psychometric properties and performance of existing self-efficacy instruments in cancer populations: a systematic review. Health Qual Life Outcomes. 2018;16(1):241.
50. Caro-Bautista J, Martín-Santos FJ, Morales-Asencio JM. Systematic review of the psychometric properties and theoretical grounding of instruments evaluating self-care in people with type 2 diabetes mellitus. J Adv Nurs. 2014;70(6):1209-27.
51. Reneman MF, Dijkstra A, Geertzen JH, Dijkstra PU. Psychometric properties of Chronic Pain Acceptance Questionnaires: a systematic review. Eur J Pain. 2010;14(5):457-65.
52. Frei A, Svarin A, Steurer-Stey C, Puhan MA. Self-efficacy instruments for patients with chronic diseases suffer from methodological limitations--a systematic review. Health Qual Life Outcomes. 2009;7:86.
53. Yazdani N, Sharif F, Elahi N, Ebadi A, Hosseini SV. Psychometric properties of quality of life assessment tools in morbid obesity: a review of literature. Evidence Based Care Journal. 2018;7(4):7-21.
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IssueVol 20 No 2 (2025) QRcode
SectionReview Article(s)
Keywords
Chronic Diseases Chronic Illness Measure Psychological Adaptation Psychological Adjustment

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How to Cite
1.
Ebrahimgol F, Khanjani MS, Abdi K, Aarabi M, Latifian M. Psychological Adjustment Measures for Chronic Illness: A Narrative Review. Iran J Psychiatry. 2025;20(2):241-252.