Priority Research Centre for Health Behaviour, School of Medicine & Public Health, University of Newcastle & Hunter Medical Research Institute, Newcastle, NSW, Australia.
Health Qual Life Outcomes. 2012 May 20;10:55. doi: 10.1186/1477-7525-10-55.
The mini-Mental Adjustment to Cancer Scale (mini-MAC) is a well-recognised, popular measure of coping in psycho-oncology and assesses five cancer-specific coping strategies. It has been suggested that these five subscales could be grouped to form the over-arching adaptive and maladptive coping subscales to facilitate the interpretation and clinical application of the scale. Despite the popularity of the mini-MAC, few studies have examined its psychometric properties among long-term cancer survivors, and further validation of the mini-MAC is needed to substantiate its use with the growing population of survivors. Therefore, this study examined the psychometric properties and dimensionality of the mini-MAC in a sample of long-term cancer survivors using Rasch analysis.
RUMM 2030 was used to analyse the mini-MAC data (n=851). Separate Rasch analyses were conducted for each of the original mini-MAC subscales as well as the over-arching adaptive and maladaptive coping subscales to examine summary and individual model fit statistics, person separation index (PSI), response format, local dependency, targeting, item bias (or differential item functioning -DIF), and dimensionality.
For the fighting spirit, fatalism, and helplessness-hopelessness subscales, a revised three-point response format seemed more optimal than the original four-point response. To achieve model fit, items were deleted from four of the five subscales - Anxious Preoccupation items 7, 25, and 29; Cognitive Avoidance items 11 and 17; Fighting Spirit item 18; and Helplessness-Hopelessness items 16 and 20. For those subscales with sufficient items, analyses supported unidimensionality. Combining items to form the adaptive and maladaptive subscales was partially supported.
The original five subscales required item deletion and/or rescaling to improve goodness of fit to the Rasch model. While evidence was found for overarching subscales of adaptive and maladaptive coping, extensive modifications were necessary to achieve this result. Further exploration and validation of over-arching subscales assessing adaptive and maladaptive coping is necessary with cancer survivors.
Mini-Mental Adjustment to Cancer Scale（Mini-MAC）是一种广为人知的、流行的心理肿瘤学应对措施，评估了五种癌症特异性应对策略。有人提出，这五个分量表可以组合成一个总体的适应性和适应性应对分量表，以方便对量表的解释和临床应用。尽管 Mini-MAC 很受欢迎，但很少有研究在长期癌症幸存者中检验其心理测量特性，为了证实其在不断增长的幸存者群体中的应用，需要进一步验证 Mini-MAC。因此，本研究使用 Rasch 分析在长期癌症幸存者样本中检验了 Mini-MAC 的心理测量特性和维度。
使用 RUMM 2030 分析 Mini-MAC 数据（n=851）。对原始 Mini-MAC 分量表以及总体适应性和适应性应对分量表分别进行 Rasch 分析，以检查总结和个体模型拟合统计、个体分离指数（PSI）、反应格式、局部依赖性、目标定位、项目偏差（或差异项目功能-DIF）和维度。
对于斗志、宿命论和无助-无望分量表，修订后的三点反应格式似乎比原始的四点反应格式更优。为了达到模型拟合，从五个分量表中的四个分量表中删除了项目-焦虑关注项目 7、25 和 29；认知回避项目 11 和 17；斗志项目 18；无助-无望项目 16 和 20。对于那些有足够项目的分量表，分析支持单维性。将项目组合成适应性和适应性分量表的方法得到了部分支持。
原始的五个分量表需要删除项目和/或重新调整，以提高对 Rasch 模型的拟合度。虽然发现了适应性和适应性应对的总体分量表，但要达到这一结果需要进行大量修改。需要进一步探索和验证评估适应性和适应性应对的总体分量表，以癌症幸存者为对象。
