Effect of an Educational Nursing Intervention on the Mental Adjustment of Patients with Chronic Arterial Hypertension: An Interventional Study

The objective of this analytical and interventional prospective quantitative study was to assess the effect of an educational intervention performed by nurses for mental adjustment to chronic disease in patients with hypertension. A convenience sample was studied, composed of 329 participants with chronic hypertension, followed in a primary healthcare unit in the Central Region of Portugal. Data collection was carried out by applying the Mental Adjustment to Disease Scale (MADS) before and 1 month after the educational nursing intervention between September 2017 and February 2018. Prior to the application of the educational intervention, 43.5% of the participants were classified as “unadjusted” in at least one of the subscales of MADS. After the educational intervention, 21.3% of the participants classified as “unadjusted” became “adjusted” in all MADS subscales. The success rate of the intervention varied from 26.9% (in the fatalism subscale) to 44.6% (for the anxious concern subscale). Participants were more likely to be mentally “unadjusted” to hypertension if they lived with other family members, had an active professional situation before the diagnosis of hypertension, still had an active professional situation now, were under 65 years old, had a shorter time to diagnosis (1–2 years), and measured blood pressure less regularly. The educational intervention performed by nurses is relevant for the mental adjustment of hypertensive patients, contributing to increased knowledge, as well as improvement in preventive and self-care practices, facilitating the experience of the health/disease transition process.

Cancer coping self-efficacy mediates the relationship between mental adjustment to cancer and health-related quality of life in persons with cancer

Individuals with cancer experience significant levels of distress. Improving health-related quality of life of persons with cancer is a major focus in cancer treatment. This study investigated the mediating role of self-efficacy for coping with cancer in the relationship between mental adjustment to cancer and health-related quality of life among individuals with cancer. Two hundred and fourteen persons with cancer (male = 74, female = 140, mean age = 50.57) were recruited from a University Teaching Hospital, in South-West Nigeria. Participants responded to the measures of psychological responses to cancer (mental adjustment to cancer), self-efficacy for coping with cancer (Cancer Behaviour Inventory [CBI]), and health-related quality of life (Functional Assessment of Cancer Therapy–General). Mediation analysis and structural equation modelling were carried out using IBM AMOS software version 23. Domains of mental adjustment to cancer significantly predicted health-related quality of life, helplessness/hopelessness, and anxious preoccupation had a negative association with health-related quality of life; whereas fighting spirit, cognitive avoidance, and fatalism were positively associated with health-related quality of life. Self-efficacy had a positive association with health-related quality of life. Mediation analysis showed that self-efficacy for coping with cancer partially mediated the association between four domains of mental adjustment to cancer (helplessness/hopelessness, fighting spirit, cognitive avoidance, and fatalism) and health-related quality of life. The findings demonstrated the need for improved coping mechanisms while undergoing cancer treatment. The study has important clinical implications for psycho-oncology practice, particularly with respect to self-efficacy for coping with cancer. Psychosocial therapies aimed at enhancing the self-efficacy of persons with cancer should be incorporated as part of cancer treatment to improve their health-related quality of life.

Self-Esteem as a Predictor of Mental Adjustment in Patients with Breast Cancer

This study aimed to explore the relationship between self-esteem and mental adjustment and examine the directional effects in patients with breast cancer using path modeling. This was a cross-sectional, descriptive, and correlational study. A total of 128 patients with breast cancer were selected through convenience sampling at a medical center in northern Taiwan. They completed a basic characteristics questionnaire, the Memorial Symptom Assessment Scale short form, the Rosenberg Self-Esteem Scale, and the mini-Mental Adjustment to Cancer Scale. Descriptive statistics, regression analysis, and path analysis were used to analyze the data. The results showed that higher self-esteem was associated with better mental adjustment (β = 0.9, 95% confidence interval 0.6~1.3, p < 0.001). Age, religious beliefs, employment, cancer stage, and symptom distress were correlated with mental adjustment. Path modeling demonstrated that self-esteem, cancer stage, performance status, and symptom distress directly affected mental adjustment in patients with breast cancer. These findings suggest that health professionals should evaluate self-esteem, performance status, and symptom distress in patients with breast cancer immediately upon admission. This can facilitate early implementation of relevant nursing interventions and, consequently, improve self-esteem and symptom distress and increase mental adjustment in these patients.

The Effect of Uncertainty-Tolerance-based Intervention in Couples on the Mental Adaptation to Disease in Women With Breast Cancer: a Randomized Clinical Trial

Purpose: The aim of this study was to evaluate the effect of a couple-coping intervention aiming to improve uncertainty tolerance in women diagnosed with breast cancer and their spouses on the patients’ mental adaption to their disease. Methods: The present study was conducted on 90 women with breast cancer referred to educational, medical and research centers in Urmia, IRAN, which 45 patients were randomly assigned to each treatment and control groups. Outcome measures were assessed at baseline and 6 weeks using short form mental adjustment to cancer (Mini-MAC) questionnaire. The intervention was performed in 6 group-based sessions consisting of patients and their spouses. Results: comparing the change from before to after intervention revealed that the effect of the intervention was significant in reducing hopeless-helpless (-5.42 ± 2.42 in intervention group VS -0.13 ± 0.46 in control group, P<0.001) and anxious preoccupation (-6.80 ± 2.87 VS -0.16 ± 0.82, P<0.001). It has also been significant in increasing fatalism (4.89 ± 2.09 VS 0.22 ± 1.24) and fighting spirit (3.58 ± 2.05 VS 0.11 ± 1.61). The effect of intervention on changing avoidance scale was not significant (P = 0.83).Conclusion: Couple-centered intervention program based on increasing uncertainty tolerance can be used to improve the situation in order to increase the patients' adjustment and it has an effective support for breast cancer patients in helping to cope with cancer. Trial registration number: IRCT20150125020778N21.Date of registration: 2020-12-13.

Normalization of the Mini-MAC (Mental Adjustment to CanCer) Questionnaire among Cancer Patients

Cancer is associated with discomfort and many changes in patients’ lives to which they must adapt. The main objective of the study was to assess the use of the mini-MAC questionnaire scale among persons diagnosed with malignant cancer and to develop standards allowing differentiation of patients with diagnosed cancer in terms of their style of adjustment to the disease. The mini-MAC questionnaire is a widely used tool in assessing coping strategies among cancer patients. Sten standards have been developed to determine the level of results on the questionnaire scales in the low–average–high categories. The study included 1187 patients diagnosed with malignant cancer who are covered by outpatient care at the Maria Sklodowska-Curie Institute—Oncology Center in Warsaw. The questionnaire concerning mental adjustment to cancer was used (mini-MAC). Patients with cancer most often adopt strategies of fighting spirit and positive reevaluation. The variables that differentiate the results most significantly include gender, presence of metastasis, and the state of undergoing chemotherapy. The mini-MAC questionnaire should be a tool for psycho-oncological diagnosis of patients’ attitudes towards cancer. The obtained results indicate that cancer patients are characterized by their constructive style of adjustment to the disease.

Implementation of Mental adjustment to cancer scale in psycho-oncology practice in Bulgaria

Background Theoretically there are several insufficiently confirmed statements based on evidences that underline the important role of psychological assistance to patients with malignant neoplasms. Since April, 2021, Mental Adjustment to Cancer Scale (MAC) is translated into Bulgarian and it was introduced to psycho-oncologic practice in Bulgaria. Methods The concise variant of MAC - Mini Mental Adjustment to Cancer Scale (Mini-MAC) has been implemented evaluating the degree when the patients perceive their adaptation to the diagnosis and cancer treatment. It comprises 29 items and measures four inner scales: determination, helplessness, anxiety, cognitive negligence and fatalism. It has been applied in compliance with strict confidentiality, voluntary principle and objectivity to 30 patients - 14 male and 16 female. Results MAC scales have good consistency - alpha coefficient from 0.56 to 0.74. The age correlates moderately with disease type (r=.35, p = 0.05). Helplessness is in positive relation to anxiety (r=.63, p = 0.000) and fatalism (r=.30, p = 0.05), and in negative one to determination (r=-.35, p = 0.05). The determination is in statistic positive relation to cognitive negligence (r=.44, p = 0.02). Conclusions The malignant disease type does not influence the scale results. They are influenced by inner factors as morbid experience, sensitivity to the disease, psychological protections that are frequently demonstrated by cognitive negligence and determination. MAC has been successfully implemented in the clinical psychological counseling in Bulgaria. Key messages Mental Adjustment to Cancer Scale identifies patients' adaptation to cancer and is introduced in Bulgaria. The methodology shows the established cognitive mechanisms for personal understanding and behavior in the course of treatment.

The Physical and Mental Regulating Effect of Tai Chi Chuan Traditional Health Sports Based on Two-Sift Methods

Objectives: The research on the physical and mental regulation of college students based on two-screen Tai Chi style traditional health sports can help to improve the teaching process of Tai Chi Chuan and help students to obtain better adjustment of their physical and mental state. Methods: In this study, based on the understanding of related theories, and then the author compares the physical and mental status of a college student before and after Tai Chi Chuan training, and finally uses two algorithms to analyze the physical and mental adjustment role of Tai Chi Chuan to college students. Results: The results show that Tai Chi can play a positive and positive role in regulating the physical and mental health of college students to some extent. Conclusion: The research aims to provide reference for the physical and psychological development of Chinese college students.

Validation of Mini-Mental Adjustment to Cancer scale in a Moroccan sample of breast cancer women

Background The Mini-Mental Adjustment to Cancer Scale (Mini-MAC) instrument is commonly used worldwide by professionals of oncology, but the scale has not, up to date, been validated in Arabic and Moroccan context, and there is an absence of data in the Moroccan population. This study aims to validate the Mini-MAC, translated and adapted to the Arabic language and Moroccan culture, in women with breast cancer. Methods Data were analyzed in two successive phases. First, exploratory factor analysis (EFA) was used to assess the factor structure in the pilot sample (N = 158). Then, this structure was confirmed in the validation sample (N = 203) using confirmatory factor analysis (CFA). Results Confirmatory factor analysis confirmed Watson’s original structure underlying the Mini-MAC items: Helpless/Hopeless, Anxious Preoccupation, Fighting Spirit, Cognitive Avoidance, and Fatalism. Absolute, incremental, and parsimonious fit indices showed a highly significant level of acceptance confirming a good performance of the measurement model. The instrument showed sufficient reliability and convergent validity demonstrated by acceptable values of composite reliability (CR =0.93–0.97), and average variance extracted (AVE = 0.66–0.93), respectively. The square roots of AVE were higher than factor-factor pairs correlations, and the Heterotrait-Monotrait ratio of correlations values were lesser than 0.85, indicating acceptable discriminant validity. Conclusions reliability; and both convergent and discriminant validity tests indicated that the Arabic version of the Mini-MAC had a good performance and may serve as a valid tool measuring psychological responses to cancer diagnosis and treatment.