Mental Adjustment to Cancer Scale: psychometric properties in a large cancer cohort.

Objectives: 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. Copyright (C) 2008 John Wiley & Sons, Ltd.