The Mental Adjustment to Cancer (MAC) Scale: 
replication and refinement in 632 breast cancer 
patients

Background. Assessment of adjustment of patients in cancer treatment trials is becoming more common and increasingly regarded as a useful outcome measure. The widely used Mental Adjustment to Cancer (MAC) Scale was designed to measure Fighting Spirit (FS), Anxious Preoccupation (AP), Helpless–hopelessness (HH) and Fatalism.Methods. Questionnaire responses from 632 breast cancer patients were randomly divided into two groups, one for exploratory analyses and possible scale refinement, and the other for validation purposes.Results. Estimates of reliability (Cronbach's α) were satisfactory for two scales, FS (α = 0·85) and HH (α = 0·81), but lower for AP (α = 0·65) and Fatalism (α = 0·64). Exploratory factor analysis suggested that the MAC Scale might be measuring six independent constructs including two related to Fighting Spirit (Positive Orientation to the Illness, Minimizing the Illness), two related to Fatalism (Fatalism-revised, Loss of Control), a construct we have named Angst, and an unchanged HH construct. Scales developed to measure these constructs were satisfactorily replicated in confirmatory analyses but some reliabilities were lower than desirable. The general structure of the MAC Scale remained little changed despite the division of two scales and the suggested removal of six items. The refined scales correlated with the Hospital Anxiety and Depression scale and the Medical Coping Modes Questionnaire, indicating good concurrent validity.Conclusions. While reasonable reliability of the original scales persists through analyses of the MAC Scale, the original factor structure could not be reproduced. Six refined constructs with strong construct validity were identified within the overall domain of mental adjustment to cancer.

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Examination of the construct validity of the Swedish version of Hospital Anxiety and Depression Scale in breast cancer patients

Quality of Life Research ◽

10.1007/s11136-013-0407-8 ◽

2013 ◽

Vol 22 (10) ◽

pp. 2849-2856 ◽

Cited By ~ 10

Author(s):

Fredrik Saboonchi ◽

Agneta Wennman-Larsen ◽

Kristina Alexanderson ◽

Lena-Marie Petersson

Keyword(s):

Breast Cancer ◽

Construct Validity ◽

Cancer Patients ◽

Depression Scale ◽

Anxiety And Depression ◽

Breast Cancer Patients ◽

Hospital Anxiety ◽

Swedish Version

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Anxiolytic Effect of Aromatherapy Massage in Patients with Breast Cancer

Evidence-based Complementary and Alternative Medicine ◽

10.1093/ecam/nem073 ◽

2009 ◽

Vol 6 (1) ◽

pp. 123-128 ◽

Cited By ~ 45

Author(s):

Jiro Imanishi ◽

Hiroko Kuriyama ◽

Ichiro Shigemori ◽

Satoko Watanabe ◽

Yuka Aihara ◽

...

Keyword(s):

Breast Cancer ◽

Cancer Patients ◽

Control Period ◽

Depression Scale ◽

Comparative Trial ◽

Anxiolytic Effect ◽

Anxiety And Depression ◽

Breast Cancer Patients ◽

Hospital Anxiety ◽

Massage Treatment

We examined how aromatherapy massage influenced psychologic and immunologic parameters in 12 breast cancer patients in an open semi-comparative trial. We compared the results 1 month before aromatherapy massage as a waiting control period with those during aromatherapy massage treatment and 1 month after the completion of aromatherapy sessions. The patients received a 30 min aromatherapy massage twice a week for 4 weeks (eight times in total). The results showed that anxiety was reduced in one 30 min aromatherapy massage in State-Trait Anxiety Inventory (STAI) test and also reduced in eight sequential aromatherapy massage sessions in the Hospital Anxiety and Depression Scale (HADS) test. Our results further suggested that aromatherapy massage ameliorated the immunologic state. Further investigations are required to confirm the anxiolytic effect of aromatherapy in breast cancer patients.

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Would women with breast cancer prefer to receive an antidepressant for anxiety or depression from their oncologist?

Journal of Clinical Oncology ◽

10.1200/jco.2015.33.29_suppl.219 ◽

2015 ◽

Vol 33 (29_suppl) ◽

pp. 219-219

Author(s):

Daniel Curtis McFarland ◽

Megan Johnson Shen ◽

Kirk Harris ◽

Amy Tiersten ◽

John Mandeli ◽

...

Keyword(s):

Breast Cancer ◽

Mental Health ◽

Health Professional ◽

Cancer Patients ◽

Mental Health Professional ◽

Depression Scale ◽

Patient Treatment ◽

Anxiety And Depression ◽

Breast Cancer Patients ◽

To Receive

219 Background: Patient treatment preferences for the management of anxiety and depression influence adherence and treatment outcomes, yet breast cancer patient preferences for provider-specific pharmacologic management of anxiety and depression is unknown. This study examined breast cancer patients’ antidepressant prescriber preferences and their preferences for treatment by a mental health professional. Methods: Breast cancer patients (Stage 0-IV) were asked two questions: 1) “Would you be willing to have your oncologist treat your depression or anxiety with an antidepressant medication if you were to become depressed or anxious at any point during your treatment?”; and 2) “Would you prefer to be treated by a psychiatrist or mental health professional for problems with either anxiety or depression?” Additionally, the Distress Thermometer and Problem List, Hospital Anxiety and Depression Scale, Risky Families Questionnaire, and demographic information were assessed. Results: One hundred twenty-five participants completed the study. 60.4% were willing to accept an antidepressant from an oncologist and 26.3% preferred treatment by a mental health professional. 77.3% who were willing to receive an antidepressant from their oncologist reported either no preference or that treatment by a mental health professional didn’t matter (p = 0.01). Participants taking antidepressants (p = 0.02) or reporting high chronic stress (p = 0.03) preferred a mental health professional. Conclusions: The majority of patients accepted antidepressant prescribing by their oncologist; only a minority preferred treatment by a mental health professional. These findings suggest the benefit for promoting education of oncologists to assess psychological symptoms and manage anxiety and depression as a routine part of an outpatient visit.

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The effect of a pathology clinic on the mental state and adjustment of patients with breast cancer

Palliative & Supportive Care ◽

10.1017/s1478951515000395 ◽

2015 ◽

Vol 13 (6) ◽

pp. 1615-1621

Author(s):

Miyuki Nagashima-Nishimaki ◽

Kiyomi Taniyama ◽

Hanae Minami ◽

Minoru Takebayashi

Keyword(s):

Breast Cancer ◽

Cancer Patients ◽

Mental State ◽

Medical Information ◽

Depression Scale ◽

Breast Cancer Patients ◽

Patient Anxiety ◽

Short Term ◽

Mental Adjustment ◽

Before And After

AbstractObjective:In this study, we examine whether a pathology clinic, conducted by pathologists, a novel medical tool that provides an explanation for the diagnosis of a cancer, can influence the mental state and adjustment of breast cancer patients.Method:We created a paper-based questionnaire and interviewed targeted breast cancer patients, who had undergone radical surgery, before and after they visited the clinic.Results:We found that there may be increased motivation for treatment, a greater sense of reassurance, and reduced anxiety (as indicated by the Hospital Anxiety and Depression Scale (HADS)) in the group that attended the clinic.Significance of Results:Our results suggest that visiting the pathology clinic may reduce anxiety over the short term. On the other hand, Mental Adjustment to Cancer (MAC) Anxious Preoccupation scores were significantly higher in this group as well, both before and after attendance, compared to the group that did not attend. The attending group may have reduced anxiety by such actions as collecting medical data on the cause of their anxiety and adopting healthier behaviors. Our findings suggest that appropriate emotional support and provision of medical information are very important in dealing with patient anxiety.

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Depression and Fatigue of Breast Cancer Patients Receiving Chemotherapy during the Covid-19

Indonesian Journal of Global Health Research ◽

10.37287/ijghr.v3i3.510 ◽

2021 ◽

Vol 3 (3) ◽

pp. 297-304

Author(s):

Dwi Retnaningsih ◽

Roudhotul Auliyak ◽

Mariyati Mariyati ◽

Enggar Nurnaningsih

Keyword(s):

Breast Cancer ◽

Data Analysis ◽

Cancer Patients ◽

Depression Scale ◽

Fear Of Death ◽

Anxiety And Depression ◽

P Value ◽

Breast Cancer Patients ◽

Increased Risk ◽

The Relationship

Depression in breast cancer patients includes mental shock, inability to accept reality, hopelessness, fear of death, and fear of the future. Depression creates long periods of sadness and worry, usually accompanied by feelings of worthlessness. Fatigue is a symptom that often appears in cancer patients undergoing chemotherapy. Associated with the conditions of the COVID-19 pandemic, cancer patients have an increased risk of transmitting COVID-19 because they have decreased endurance. This study aims to determine the relationship between depression and fatigue in breast cancer patients undergoing chemotherapy at Hospital Sultan Agung Semarang Indonesia. The instruments used in this study were questionnaire of the hospitals anxiety and Depression Scale (HADS) and questionnaire of fatigue, 30 female respondents who suffer from breast cancer and have undergone chemotherapy. Rank Spearman data analysis. P value = 0.000 and correlation coefficient value r = 0.671. There is a relationship between depression and fatigue in breast cancer patients undergoing chemotherapy which has an impact on adherence to chemotherapy for breast cancer patients. The higher the level of depression is, the more severe the level of fatigue in cancer patients.

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Hubungan Dukungan Sosial dengan Kecemasan dan Depresi pada Pasien Kanker Payudara di RSU Raden Mattaher Jambi

Jurnal Ilmiah Universitas Batanghari Jambi ◽

10.33087/jiubj.v20i1.786 ◽

2020 ◽

Vol 20 (1) ◽

pp. 1

Author(s):

Yuliana Yuliana ◽

Mustikasari Mustikasari ◽

Feri Fernandes

Keyword(s):

Breast Cancer ◽

Social Support ◽

Cancer Patients ◽

Depression Scale ◽

The United States ◽

Anxiety And Depression ◽

Bivariate Analysis ◽

Data Sampling ◽

Breast Cancer Patients ◽

The Impact

Breast cancer is the most common cancer in woman. In Europen there are approximately 175,000 cases found regarding breast cancer and more than 165,000 patients died if the cancer is not controlled, whereas in the United States 44,000 patients died of breast cancer. According to the Hospital Statistics in the Breast Cancer Hospital Information System, Indonesia is the first rank of the most breast cancer patients which can be found in almost every hospital in Indonesia. The impact of breast cancer on the aspects of bio- psycho- social- spritual in breast cancer patients include anxiety and depression.Unfortunately this study is not commonly carried aut by researchers. One effort to reduce anxiety and depression in breast cancer patients is to provide social support. This study aims to determine the relationship of social support with anxiety and depression in breast cancer patients. The method used is analytic cross- sectional study.Also this study is conducted at Raden Mattaher Hospital in Jambi, with 97 breast cancer patients were picked as participants. Data sampling that is utilised in this study was incidental sampling.The data were colleted by using several methods, such as the Multidemensional Scale of Perceived of Social Support (MSPSS) instrument, and the Hospital Anxiety and depression Scale (HADS), and later those data were analysed with Bivariate Analysis using the Chi Square test. The results showed that the average age of breast cancer patient is 46,57, length of diagnosis is 28,59 months, low education level patient is 68,0%, patient who has merried is 91,8%, unemployed patient is 78,4%, patient who reseived good social support is 54,6%, patient with anxiety is 49,5%, and patient with depression is 50,5%. There is relationship between social support and anxiety in breast cancer patients, with (p:0,000).

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Hair Loss Prevention by a Scalp Cooling Device in Early Breast Cancer Patients: The Poliambulanza Preliminary Experience

Reviews on Recent Clinical Trials ◽

10.2174/1574887113666181120111104 ◽

2019 ◽

Vol 14 (1) ◽

pp. 66-71 ◽

Cited By ~ 2

Author(s):

Tiziana Prochilo ◽

Alessandra Huscher ◽

Federica Andreis ◽

Mara Mirandola ◽

Elisabetta Zaina ◽

...

Keyword(s):

Breast Cancer ◽

Cancer Patients ◽

Hair Loss ◽

Depression Scale ◽

Hair Follicles ◽

Common Side Effect ◽

Scalp Cooling ◽

Breast Cancer Patients ◽

Cooling Device ◽

End Of Treatment

Background: The most effective agents in the treatment of breast cancer have a common side effect, the hair loss. Some studies reported a reduction of hair loss with the use of the scalp cooling device. Indeed, it decreases the drug accumulation in the hair follicles. We report our preliminary experience with a scalp cooling device in reducing chemotherapy-induced alopecia and related distress in breast cancer patients undergoing adjuvant chemotherapy. </P><P> Methods: Hair loss grading and treatment tolerability were evaluated during chemotherapy every 21 days and 3 weeks after the last cycle of chemotherapy via Dean’s scale by patients and operators and a comfort analogic scale by patients. We administered the Hospital Anxiety and Depression Scale questionnaire at the baseline and at the end of treatment to assess the distress related to chemotherapy- induced alopecia. Results: Among the 46 patients identified, 27 accepted the device. The eligible chemotherapy regimens included docetaxel+cyclophosphamide (TC), doxorubicin+cyclophosphamide (AC) and paclitaxel (P) weekly+trastuzumab (T). 24 pts (89%) completed the treatment; 3 pts (11%) treated with AC prematurely interrupted use of the scalp-cooling device due to inefficacy. After the last cycle of chemotherapy, the number of patient who perceived a HL < grade 2 was 16 (59%). The hair retention reported by operators has been higher (78%). 81.5% of patients well tolerated the treatment. Conclusion: In our study, the scalp-cooling device reduced chemotherapy-induced alopecia in taxane- based chemotherapy. Furthermore, it suggests a discordance in hair loss perception between patients and operators.

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