2013 Volume 27 Issue 3 Pages 24-32
Abstract
This study has three purposes：（1）To create a questionnaire that will become an index for evaluating psychological adjustment of adult allogeneic hematopoietic cell transplantation survivors；（2）To assess the state of psychological adjustment of subjects using the questionnaire；（3）To clarify how psychological adjustment relates to physical condition and emotional condition. A draft questionnaire was created based on a review of literature and interviews with allogeneic hematopoietic cell transplantation survivors. The draft comprised a total of 27 questions from the 4 subordinate concepts of self‒esteem, self‒affirmative feeling, stability and satisfaction. The draft questionnaire was then used to conduct a study on 69 survivors up to three years after adult allogeneic hematopoietic cell transplantation. As the first step, psychological adjustment questionnaire draft item analysis and factor analysis were conducted. Based on the results of these analyses, the questionnaire was then refined to 16 questions comprising the 4 subordinate concepts of self‒esteem, self‒affirmative feeling, stability and satisfaction. Cronbach’s α coefficient of the refined questionnaire was between 0.72 and 0.88, confirming reliability by internal consistency. A significant correlation was seen between the psychological adjustment questionnaire and SF‒36v2 （r＝0.63，p＜0.01）, confirming concurrent validity. Regarding the relationship between physical condition and the adjustment score obtained by summing the scores of the refined questionnaire, subjects with chronic graft versus host disease （GVHD） had significantly lower psychological adjustment scores（p＝0.026）. In addition, there was a negative correlation between high scores for physical symptoms such as fatigue and low scores for psychological adjustment（r＝－0.58，p＜0.01）. In conclusion, evaluations of the questionnaire developed in this study suggested that, for allogeneic hematopoietic cell transplantation survivors, even in the situation of physical condition or lifestyle change after transplantation, assessing the situation with a sense of self‒affirmation can put them in a psychologically stable state of adjustment. The results have shown that there is correlation between psychological adjustment and QOL.
