Development of a questionnaire measure of adjustment to cancer: the MAC scale

Watson, Maggie; Greer, Steven; Young, James P.; Inayat, Qulsoom; Burgess, Caroline; Robertson, B.

doi:10.1017/s0033291700002026

Cited by 580 publications

(517 citation statements)

References 18 publications

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“…The possible responses to each statement are: (1) 'definitely does not apply to me', (2) 'does not apply to me', (3) 'applies to me' and (4) 'definitely applies to me'. Previous studies have suggested that the MAC scale has adequate validity and reliability (Watson et al, 1988Greer et al, 1989). Our previous study also disclosed that the Japanese version of the MAC scale is valid and reliable (Akechi et al, 1997).…”

Section: Methodsmentioning

confidence: 55%

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Predictors of patients' mental adjustment to cancer: patient characteristics and social support

Akechi

Okamura²,

Yamawaki³

et al. 1998

Br J Cancer

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Because being diagnosed with cancer is considered to be extremely stressful, cancer patients' mental adjustment has been widely studied. Previous studies have revealed that cancer patients' mental adjustment is correlated with the quality of life and the degree of psychological distress and have suggested that one of the most adaptive adjustments is 'fighting spirit' whereas one of the most maladaptive is 'helplessness/hopelessness'. However, little is known about the association between patients' mental adjustment to cancer and their spouses characteristics or social support network. This paper describes a study of cancer patients' characteristics and social support factors as predictors of the patients' responses to having cancer. A total of 455 ambulatory cancer patients completed the Mental Adjustment to Cancer (MAC) scale and participated in a structured interview about their characteristics and social support. The results of multiple regression analysis suggested that size of household, performance status, support from physicians and satisfaction with support were predictive of patients' fighting spirit, whereas age, education, size of household, performance status and satisfaction with support were predictive of helplessness/hopelessness.

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Section: Methodsmentioning

confidence: 55%

“…The MAC scale is a self-rating scale developed in the United Kingdom (Watson et al, 1988). The scale consists of five subscales: fighting spirit, anxious preoccupation, fatalism, helplessness/hopelessness and avoidance.…”

Section: Methodsmentioning

confidence: 99%

Predictors of patients' mental adjustment to cancer: patient characteristics and social support

Akechi

Okamura²,

Yamawaki³

et al. 1998

Br J Cancer

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“…Although the original version of the MAC scale had only been validated in UK population (Watson et al, 1988), it has undergone assessment and validation among patient populations of other ethnicities and countries (Akechi et al, 2000;Cayrou et al, 2003;Ho et al, 2003;Mystakidou et al, 2004). In each case the internal consistency was found to be similar to that of the original version and concurrent validity and correlation was established with other frequently used tools.…”

Section: Methodsmentioning

confidence: 98%

“…Both are wellvalidated tools used to measure coping and distress in cancer patients. The MAC is a 40-item questionnaire, which incorporates five subscales to measure fighting spirit, helpless/hopelessness, anxious preoccupation, fatalism and avoidance/denial (Watson et al, 1988). Recent work suggests that the construct of denial is addressed by three questions (questions 5, 21 and 38) on the MAC scale rather than the originally proposed single item (question 38) (Nordin et al, 1999).…”

Section: Methodsmentioning

confidence: 99%

The use of denial in an ethnically diverse British cancer population: a cross-sectional study

et al. 2005

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A total of 82 Asian and 117 randomly selected white Caucasian patients at the Leicestershire Cancer Centre were assessed using measures of coping and adaption to cancer. On the Mental Adjustment to Cancer (MAC) scale, Asian patients were more fatalistic ( P <0.0001) and had more significant hopeless/helpless scores ( P =0.007). The two ethnic groups answered the three questions thought to assess denial differently. Caucasians were more likely not to dwell on their illness (73 vs 55.5%, P <0.0001) and agree with the statement ‘I have difficulty believing this is happening to me' (73 vs 60.5%, P <0.0001). However, Asian patients were more likely to agree with the statement ‘I don't really believe I have cancer' (48.2 vs 31.3%, P =0.019). Within both groups there was an association with denial and anxious preoccupation ( P <0.001). On the Hospital Anxiety and Depression (HAD) scale, there was no difference in anxiety scores between either sexes or between the Asian and Caucasian groups. However, Asian patients were more depressed ( P =0.001). Although denial was significantly related to the presence of both depression ( P <0.0001) and anxiety ( P =0.001) in the entire patient population, there were different predictors of denial in each subgroup. On multiple regression analysis depression was linked with denial in Caucasians, whereas Fighting Spirit (minus helplessness/hopelessness) was linked with denial in Asian patients. There are definite differences in coping styles in British cancer patients according to ethnicity. While significant numbers in both groups employ denial in some form, Caucasian patients appear to adapt to the psychological pressures of cancer more successfully than Asian patients at a particular point in time. Further work is required to elucidate longitudinal relationships between denial and adaption to cancer.

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“…Cancer-Related Coping: the Mini-Mental Adjustment to Cancer Scale (short form) (MAC) 16 The MAC is a 29-item self-report questionnaire designed to assess patients' strategies for handling their cancer and is a short-form version of the original MAC, with 5 subscales: fighting spirit, helpless/hopeless, anxious preoccupation, fatalism, and cognitive avoidance. "At the moment I take one day at a time.…”

Section: 67mentioning

confidence: 99%

Electronic support groups for breast carcinoma

Lieberman

Golant

Giese‐Davis

et al. 2003

Cancer

231

140

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BACKGROUNDA recent Pew Charitable Trust study found that 52,000,000 individuals used the Internet to obtain health/medical information. Clinical trials of face‐to‐face breast carcinoma support groups show evidence of 1) improvement in quality of life, 2) reduction of psychologic symptoms, 3) improvement in coping responses, and 4) a reduction in pain. To the authors' knowledge, a few studies published to date have investigated Internet‐delivered electronic support groups (ESGs) for cancer. The most sophisticated is the Comprehensive Health Enhancement Support System (CHESS) program, which provides integrated information, referral, and a newsgroup‐based social support program. However, to the authors' knowledge, no studies published to date have examined the impact of a breast carcinoma ESG in a clinical trial.METHODSSixty‐seven women completed the initial baseline questionnaires, 32 of whom accepted the authors' invitation and began the groups. With regard to geographic location, 49% lived in rural/small towns, 41% lived in medium‐sized cities, and 10% lived in large cities. Diagnostic stages of disease were: Stage I, 22%; Stage II, 56%; Stage III, 12%; and other forms, 10%. There were 4 intervention groups, of which 8 participants led by trained Wellness Community (TWC) (a national agency) leaders met for 1.5 hours once a week for 16 weeks. Student t tests for paired outcome data were computed using baseline and postgroup scores.RESULTSThe results of the current study indicated that breast carcinoma patients significantly reduced depression (Center for Epidemiologic Studies‐Depression [CES‐D] scale) and Reactions to Pain. They also demonstrated a trend toward increases on The Posttraumatic Growth Inventory (PTGI) in two subscales: New Possibilities and Spirituality. Counterintuitively, breast carcinoma patients appeared to demonstrate an increase in emotional suppression. Postinterview results indicated that approximately 67% of patients found the group to be beneficial. Those who withdrew from the groups (20%) demonstrated low scores in their ability to contain anxiety and appeared to be more likely to suppress their thoughts and feelings regarding their illness.CONCLUSIONSThe findings of the current study are encouraging, particularly because it was conducted through TWC, a national agency willing to make this type of intervention readily available at no cost. A limitation of the current study was the lack of randomization and a control group comparison. Although the authors were not able to demonstrate effectiveness without the addition of a control condition, the analysis of pregroup and postgroup outcomes suggests that a randomized trial is worthwhile. Women with a devastating disease will join and commit themselves to an online support group. In addition, because a large percentage of these women were from rural locations, this type of intervention may hold promise for those who have limited access to support groups. Cancer 2003;97:920–5. © 2003 American Cancer Society.DOI 10.1002/cncr.11145

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Development of a questionnaire measure of adjustment to cancer: the MAC scale

Cited by 580 publications

References 18 publications

Predictors of patients' mental adjustment to cancer: patient characteristics and social support

Predictors of patients' mental adjustment to cancer: patient characteristics and social support

The use of denial in an ethnically diverse British cancer population: a cross-sectional study

Electronic support groups for breast carcinoma

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