Standardization of the Korean version of Mini‐Mental Adjustment to Cancer (K‐Mini‐MAC) scale: factor structure, reliability and validity

Abstract

Mental adjustment and coping affect the physical outcome and survival as well as quality of life in cancer patients. The Mini-Mental Adjustment to Cancer (Mini-MAC) scale is a new refined, economical and reliable self-rating instrument measuring cognitive and behavioral responses to cancer. The aim of this study was to evaluate the psychometric properties of the Mini-MAC in Korean cancer patients. A total of 208 cancer patients recruited from the Yonsei Cancer Center were assessed with the Mini-MAC and the Hospital Anxiety and Depression Scale (HADS). Principal component analysis with varimax rotation for the Korean version of Mini-MAC (K-Mini-MAC) confirmed four factors. Three had psychometric properties similar to Helpless-Hopeless (HH), Anxious Preoccupation (AP) and Cognitive Avoidance (CA) of the original Mini-MAC. A novel factor, named Positive Attitude, included items of both Fatalism (FA) and Fighting Spirit (FS) from the original version. The five subscales from the original version (AP, HH, FS, FA and CA) and Positive Attitude had acceptable internal reliabilities in our sample (Cronbach's alpha coefficient 0.50-0.86; correlation coefficient of test-retest 0.68-0.88). For the validity, significant interscale correlation was observed in the original five subscales and Positive Attitude. Each subscale including Positive Attitude was also significantly related to Depression and Anxiety of HADS. As a whole, the K-Mini-MAC was a reliable, valid and acceptable tool for Korean cancer patients. These findings can provide information about the cross-cultural validity of Mini-MAC scale's factor structure. Cultural differences were also discussed.

Studying the Relation between Mental Adjustment to Cancer and Health-Related Quality of Life in Breast Cancer Patients

“…These findings are coordinate with researches done by Anagnostopoulos et al (23), Grassi et al (29) and Akechi et al (30) that identified helplessness/hopelessness and anxiety preoccupation styles as maladaptive coping styles. Also, it coordinate with Cayrou's study (31) that explains helplessness/hopelessness and anxiety preoccupation as negative coping styles and Kang (9) that suggests the combination of these styles as negative emotion subscales. Given the large role of helplessness/hopelessness coping style in explaining the variance in HRQoL, it can be said that the feeling of helplessness, lack of disease control and knock off the face of the disease play important roles in determining the physical and mental health of patients.…”

“…In addition, some researches show that anxious reoccupation and helplessness/hopelessness strategies must be as negative emotion factor combined (9). According to the studies by Watson (10), Bredal (11) and Hulbert-Williams (12), and Wang (13), helplessness/hopelessness and anxious preoccupation, and cognitive avoidance are specified as a maladaptive coping styles.…”

“…They believe that both styles of fighting spirit and fatalism are involved in a positive attitude for the Chinese (8,30). Also, Kang et al (9) showed that fatalism was negatively related with helplessness/hopelessness style in Korean patients with cancer. But according to Yeung and Lu (33), fatalism is negatively related to QOL in Chinese patients with cancer.…”

“…In most studies on coping styles conducted in the East, the fighting spirit and fatalism are classified as positive attitudes (8,9). In addition, some researches show that anxious reoccupation and helplessness/hopelessness strategies must be as negative emotion factor combined (9).…”

Effects of educational versus peer discussion interventions on perceived competence in adolescents with medulloblastoma

“…Interestingly, children with cancer had a more negative judgment of themselves in all the other subscales at baseline (T0), except in scholastic performance, because this is a relatively more objective construct than the other subscales. 25 Other studies found social skills training and cognitive behavioral methods can improve psychosocial adjustment and coping in these situations. Curiously, in our research, peer discussion exhibited a more potent effect on physical appearance than educational intervention did.…”