Evaluation of a model of adjustment to an iatrogenic hepatitis C virus infection

Objective: The aim of this study was to evaluate a model of adjustment to an iatrogenic hepatitis C(HCV) infection in a cohort of women. Participants: Eighty‐three women diagnosed with an iatrogenic HCV infection were recruited; 49 women had chronic infection (PCR positive) and the remaining 34 women were considered to have a self‐limiting HCV infection (PCR negative). Measures: The Hepatitis C Survey Questionnaire (HCSQ; Coughlan, Sheehan, Carr, & Crowe, unpublished) and the General Health Questionnaire (GHQ30; Goldberg & Williams, 1988) were used in this study. Results: Structural equation modelling (SEM) was carried out to evaluate and modify a recursive path model using Moos and Schaefer's (1984) model of coping with illness as the basis for developing a multivariate model of adjustment to an iatrogenic HCV infection. The final model fit, χ 2 (30) = 21.9 p = .86, CFI = 1.00, RMSEA = 0.000, was judged to be theoretically acceptable, indicating that positive illness appraisal, ability to work and negative behaviour as a consequence of feelings of anger and blame are directly related to adjustment. Conclusion: This model has provided support for the following general relationships, namely that, adjustment to an iatrogenic HCV infection is related to:1 illness and social factors; 2 cognitive appraisals; 2 adaptive tasks; and 2 coping skillsthus emphasizing the need to develop a biopsychosocial model of treatment.