title: 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.
authors.affiliation: Psychology Department, Bowmere Hospital, Liverpool Road, Chester, UK. julia.boot@cwp.nhs.uk
authors.forename: Julia S
authors.initials: JS
authors.lastname: Boot
authors.forename: Christopher
authors.initials: C
authors.lastname: Holcombe
authors.forename: Peter
authors.initials: P
authors.lastname: Salmon
mesh_terms: D000223:Adaptation, Psychological; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000554:Ambulatory Care Facilities; D001007:Anxiety / Q000209:etiology* / Q000523:psychology; D001943:Breast Neoplasms / Q000150:complications / Q000175:diagnosis / Q000523:psychology* / Q000628:therapy; D003430:Cross-Sectional Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008875:Middle Aged; D011594:Psychometrics; D015203:Reproducibility of Results; D012917:Social Adjustment; D012959:Socioeconomic Factors; D013315:Stress, Psychological; D011795:Surveys and Questionnaires; D013997:Time Factors; D014930:Women / Q000523:psychology*