title: Mental Adjustment to Cancer Scale: psychometric properties in a large cancer cohort.
abstract: OBJECTIVE
  The Mental Adjustment to Cancer (MAC) Scale is widely used to assess psychological response to cancer. There have been several attempts to replicate independently the original factor structure of the MAC. Evidence from these replication studies is reviewed. A re-analysis of the MAC Scale was conducted on a substantial new cohort in order to clarify the factor structure.
  
  
  METHODS
  1255 patients with various cancer diagnoses completed the MAC Scale.
  
  
  RESULTS
  Two results emerged: first, that the original MAC dimension of Helplessness/Hopelessness is extremely stable and robust; second, that the original factors can be subsumed within two overarching (first order) factors relating to positive and negative adjustment scores.
  
  
  CONCLUSIONS
  The original MAC Scale remains a satisfactory measure of psychological outcome. Two-higher order factors representing global adjustment are now available to provide an overall summary measure alongside the original specific sub-scales.
authors.affiliation: The Royal Marsden NHS Foundation Trust, Sutton, Surrey, UK. maggie.Watson@rmh.nhs.uk
authors.forename: M
authors.initials: M
authors.lastname: Watson
authors.forename: J
authors.initials: J
authors.lastname: Homewood
mesh_terms: D000223:Adaptation, Psychological; D001007:Anxiety / Q000175:diagnosis / Q000523:psychology; D015331:Cohort Studies; D003674:Defense Mechanisms; D003863:Depression / Q000175:diagnosis / Q000523:psychology; D006801:Humans; D009369:Neoplasms / Q000523:psychology*; D010555:Personality Inventory / Q000706:statistics & numerical data*; D011379:Prognosis; D011594:Psychometrics / Q000706:statistics & numerical data; D015203:Reproducibility of Results; D055500:Resilience, Psychological; D012803:Sick Role