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 The Hepatitis C Survey Questionnaire (HCSQ; Coughlan, Sheehan, Carr & Crowe, unpublished) and the General Health Questionnaire (GHQ30; Goldberg & Williams, 1988) were used in this study.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, chi(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; (3) adaptive tasks; and (4) coping skills thus emphasizing the need to develop a biopsychosocial model of treatment.