Styles of coping with cancer: The Italian version of the Mini-Mental Adjustment to Cancer (Mini-MAC) scale

Abstract

Mental adjustment to cancer has been explored in a large body of the literature by using the Mental Adjustment to Cancer (MAC) scale. Problems in the factor structure of the scale and the need for refining the instrument have determined the development of the Mini-MAC. The aim of this study was to validate, according to a test-oriented approach, the Italian version of the Mini-MAC. Four hundred and thirty cancer patients in five centres in Northern Italy completed the Mini-MAC and the Brief Symptom Inventory (BSI). A subgroup of 153 patients filled out the instruments again within 3 months of the first assessment. The five original subscales (Fighting Spirit, Hopeless, Fatalism, Anxious Preoccupation and Cognitive Avoidance) showed acceptable levels of reliability (Cronbach alpha coefficients ranging from 0.55 to 0.80) although alphas were lower for the scales Fighting Spirit and Fatalism. Factor analysis (Varimax rotation) identified the same five factors with minor variations from the original version. Again, alpha coefficients were less robust for the factors Fighting Sprit and Fatalism. Hopeless and Anxious Preoccupation were significantly related to all the BSI psychological stress symptoms, including the Global Stress Index (GSI). Test-retest reliability showed no differences in the sub-scales scores between assessments.

Psychological distress and coping in nasopharyngeal cancer: an explorative study in Western Europe

“…The short version of the Mental Adjustment to Cancer Scale (Mini-MAC) was administered to measure the following coping strategies: helplessness/hopelessness, anxious preoccupation, fighting spirit, cognitive avoidance, and fatalism (Grassi et al, 2005;Wang, Tu, Liu, Yeh & Hsu, 2013). It is a self-report scale of 29 items, each question rated on a 4-point Likert scale, from 1 ("definitely does not apply to me"), to 4 ("definitely applies to me").…”

Mini-mac - escala de ajustamento mental para o câncer: estrutura fatorial

“…Estudos clínicos realizados antes da criação da MAC demonstravam, segundo Watson et al (1988), que, do ponto de vista psicológico, mulheres com câncer de mama respondiam ao tratamento lutando ou negando a doença. O aspecto de luta apareceu em alguns estudos fatoriais da MAC (Ross et al, 1994;Watson et al, 1988) e da Mini-MAC (Grassi et al, 2005;Watson et al, 1994), mas com confiabilidade bastante variada (de 0,55 a 0,84). O aspecto de negação ou evitação foi outro fator encontrado em mais de um estudo (Grassi et al, 2004b;Nordin et al, 1999;Ross et al, 1994, Watson et al, 1994, mas também com índices de fidedignidade insuficientes.…”

“…Os autores atribuíram a diferença nas estruturas fatoriais a fatores culturais. Grassi et al (2005) validaram e testaram os índices de validade da Mini-MAC para 430 pacientes com câncer de cinco regiões do Norte da Itália. A análise fatorial com rotação Varimax identificou os mesmos cinco fatores da escala original, com Alpha de Cronbach variando de 0,55 a 0,80, sendo os α mais baixos para "espírito de luta" e "fatalismo".…”

Adjustment as process and outcome: Measuring adjustment to HIV in Uganda

“…From research in adjustment to cancer, fatalistic type factor should correlate with age, with greater fatalism at older age (Grassi et al, 2005).…”