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This paper presents the details of the development of a scale designed to measure adjustment to ostomy surgery. A total of 53 ostomates responded to a mail questionnaire used for instrument development. Thirty of these also completed a retest. A 34-item scale comprised of items to be responded to on a 6-point Likert scale was developed. The scale was found to be reliable (α = .85, test-retest r = .72). Discriminant validity from measures of self-esteem and social desirability was demonstrated. Scores on the scale were related to time since surgery, return to work, and the amount of choice and preparation given a patient regarding the surgery. The scale also discriminated between actual ostomy patients and college students asked to simulate ostomy patients' responses. Factor analysis of the scale and the development of two short forms are also discussed. The scale appears to be a tool that will be useful in clinical practice with ostomates and in further research on adjustment to ostomy surgery.