Psychological adjustment to chronic disease and rehabilitation - an exploration.
OBJECTIVE
Psychological adjustment has a major impact on chronic disease health outcomes. However, the classification of psychological adjustment is unclear in the current version of the International Classification of Functioning, Disability and Health (ICF). We aim (i) to characterize the process of psychological adjustment to chronic disease, and (ii) to analyze how various categories of the psychological adjustment process could be incorporated into the ICF.


METHODS
We provide a summary of models of psychological adjustment to chronic disease. We also evaluate various options for incorporating categories of psychological adjustment into the ICF.


RESULTS
Acute and ongoing illness stressors; emotional, cognitive and behavioral responses; personal background; and social and environmental background are major categories in the adjustment process. These categories could, in principle, be integrated with various components of the ICF. Any future revision of the ICF should explicitly incorporate psychological adjustment and its (sub)categories.


CONCLUSIONS
The ICF could incorporate categories of psychological adjustment to chronic disease, although several adaptations and clarifications will be required. Implications for Rehabilitation In the context of an ageing society and large numbers of people living with chronic diseases, it is essential to understand psychological adjustment to chronic disease. However, the classification of psychological adjustment to chronic disease is unclear in the current version of the International Classification of Functioning, Disability and Health (ICF). We demonstrate that the ICF could incorporate categories of psychological adjustment to chronic disease, although several adaptations and clarifications would first be required. We suggest that these adaptations and clarifications should be considered in any future revision of the ICF.
a Department of Psychiatry , VU University Medical Center, EMGO Institute for Health and Care Research , Amsterdam , the Netherlands.|b Department of Rehabilitation Medicine , VU University Medical Center, EMGO Institute for Health and Care Research , Amsterdam , the Netherlands.
Joost
J
Dekker
b Department of Rehabilitation Medicine , VU University Medical Center, EMGO Institute for Health and Care Research , Amsterdam , the Netherlands.
Vincent
V
de Groot
D000203:Activities of Daily Living; D002908:Chronic Disease / Q000523:psychology / Q000534:rehabilitation; D006233:Persons with Disabilities / Q000523:psychology / Q000534:rehabilitation; D000066498:Emotional Adjustment; D006801:Humans; D064702:International Classification of Functioning, Disability and Health; D008960:Models, Psychological; D000073278:Self-Management / Q000523:psychology*
Chronic disease; ICF; Rehabilitation; psychological adjustment