Mental Adjustment to Cancer Scale: psychometric properties in a large cancer cohort.
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.
Watson
M
M
The Royal Marsden NHS Foundation Trust, Sutton, Surrey, UK. maggie.Watson@rmh.nhs.uk
Homewood
J
J
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