Purpose: The Mini-Mental Adjustment to Cancer Scale (Mini-MAC) is widely used to evaluate cancer patients' psychological responses. Validation studies of the scale have shown methodological shortcomings and inconsistency in the factor solutions. The aim of this study was to examine the factor structure and psychometric properties of the Mini-MAC.
Methods: A large sample of 364 Chinese patients with breast or colorectal cancer completed the Mini-MAC and psychosocial measures (general health, perceived stress, anxiety, and depression). Exploratory factor analyses examined the relative fit of two- to six-factor models using robust weighted least square estimation and oblique target rotation. Convergent validity was evaluated via correlations between the Mini-MAC factor scores and the psychosocial outcomes.
Results: The five-factor model showed the best model fit and largely replicated the original Mini-MAC's helpless/hopeless (HH), anxious preoccupation (AP), fighting spirit (FS), fatalism (FA), and cognitive avoidance (CA) subscales. The five factors had acceptable reliability (Cronbach's α = 0.67-0.88) and 4-month test-retest reliability (r = 0.45-0.64). HH, AP, and CA were positively associated with the psychosocial outcomes (r = 0.19-0.60). Modest and negative correlations were found between the psychosocial outcomes and FS and FA.
Conclusions: The results support the Mini-MAC's original five-factor structure with satisfactory reliability and convergent validity. The results demonstrate that the Mini-MAC is a valid measure for assessing psychological responses in cancer patients.