Development and validation of the Psychological Adaptation Scale (PAS): Use in six studies of adaptation to a health condition or risk

Abstract

Objective We introduce The Psychological Adaptation Scale (PAS) for assessing adaptation to a chronic condition or risk and present validity data from six studies of genetic conditions. Methods Informed by theory, we identified four domains of adaptation: effective coping, self-esteem, social integration, and spiritual/existential meaning. Items were selected from the PROMIS “positive illness impact” item bank and adapted from the Rosenberg self-esteem scale to create a 20-item scale. Each domain included five items, with four sub-scale scores. Data from studies of six populations: adults affected with or at risk for genetic conditions (N=3) and caregivers of children with genetic conditions (N=3) were analyzed using confirmatory factor analyses (CFA). Results CFA suggested that all but five posited items converge on the domains as designed. Invariance of the PAS amongst the studies further suggested it is a valid and reliable tool to facilitate comparisons of adaptation across conditions. Conclusion Use of the PAS will standardize assessments of adaptation and foster understanding of the relationships among related health outcomes, such as quality of life and psychological well-being. Practice Implications Clinical interventions can be designed based on PAS data to enhance dimensions of psychological adaptation to a chronic health condition or risk.

Mothers’ psychological adaptation to Duchenne/Becker muscular dystrophy

“…Psychological Adaptation wsas measured with the 20-item Psychological Adaptation Scale (PAS), which is designed to measure adaptation to a chronic condition or disease risk by patients or caregivers. 17 Cronbach's alpha was 0.96.…”

“…16 Across patients and caregivers, factors reported to be associated with adaptation include personality traits such as optimism; economic resources; social support; cognitive and emotional appraisals of the condition, including disease impact and control; and coping strategies and efforts to make meaning of the disease experience. [16][17][18] Our choice of psychological adaptation to DBMD as the study outcome is consistent with the preferences expressed during community engagement (described below). Predictor variables were chosen based on the adaptation literature, studies of DBMD caregivers, and through community engagement.…”

Overlooked and underserved: Widowed fathers with dependent-age children

“…." Cronbach's alpha scores for the PAS have ranged from 0.83 to 0.97 (Biesecker et al, 2013). Finally, this module included 12 Likert-type questions assessing self-perceived parental competence.…”

Patient Perceptions of Telephone vs. In‐Person BRCA1/BRCA2 Genetic Counseling

“…However, this report did not evaluate participant perceptions of the content and delivery of TC versus UC. The assessment of such patient-reported quality of care measures in genetic counseling is becoming an increasingly key indicator of the potential benefits and value of such services (Biesecker et al, 2013; DeMarco, Peshkin, Mars, & Tercyak, 2004; Elliott, Chodirker, Bocangel, & Mhanni, 2014; McAllister & Dearing, 2015). Although TC and UC yield comparable psychosocial and decision making outcomes (Kinney et al, 2014; Schwartz et al, 2014), the current analysis focuses on participants’ views of these alternate approaches to pre-test genetic counseling.…”