TY - JOUR
T1 - Psychometric properties of a brief measure of autonomy support in breast cancer patients Clinical decision-making, knowledge support systems, and theory
AU - Shumway, Dean
AU - Griffith, Kent A.
AU - Jagsi, Reshma
AU - Gabram, Sheryl G.
AU - Williams, Geoffrey C.
AU - Resnicow, Ken
N1 - Funding Information:
This work was funded by P01 CA163233 from the National Cancer Institute to the University of Michigan. We thank Steven Katz, MD, MPH and Rose Juhasz, PhD for the scientific and administrative leadership of the P01 and the Research Management Team for their efforts in supporting this project. The authors wish to acknowledge Monica Morrow, MD and Imelda Burgan for facilitating data collection at Memorial Sloan Kettering Cancer Center, and Mackenzie Crawford, MPH and Kevin Ward, PhD at Emory University.
Publisher Copyright:
© 2015 Shumway et al.
PY - 2015/7/9
Y1 - 2015/7/9
N2 - Background: The Health Care Climate Questionnaire measures patient perceptions of their clinician's autonomy supportive communication. We sought to evaluate the psychometric properties of a modified brief version of the Health Care Climate Questionnaire (mHCCQ) adapted for breast cancer patients. Methods: We surveyed 235 women aged 20-79 diagnosed with breast cancer within the previous 18 months at two cancer specialty centers using a print questionnaire. Patients completed the mHCCQ for their surgeon, medical oncologist, and radiation oncologist separately, as well as the overall treatment experience. Exploratory factor analysis (EFA) using principal components was used to explore the factor structure. Results: One hundred sixty out of 235 (68.1 %) women completed the survey. Mean age was 57 years and time since diagnosis was 12.6 months. For surgeon, medical oncologist, and radiation oncologist ratings separately, as well as overall treatment, women rated 6 dimensions of perceived physician autonomy support. Exploratory factor analysis indicated a single factor solution for each clinician type and for the overall experience. Further, all six items were retained in each clinician subscore. Internal consistency was 0.93, 0.94, 0.97, and 0.92 for the overall, surgeon, medical oncologist, and radiation oncologist scales, respectively. Hierarchical factor analysis demonstrated that a summary score of the overall treatment experience accounts for only 52 % of the total variance observed in ratings of autonomy support for the three provider types. Conclusions: These results describe the first use of the mHCCQ in cancer patients. Ratings of the overall treatment experience account for only half of the variance in ratings of autonomy support, suggesting that patients perceive and report differences in communication across provider types. Future research is needed to evaluate the relationship between physician communication practices and the quality of decision making, as well as other outcomes among cancer patients.
AB - Background: The Health Care Climate Questionnaire measures patient perceptions of their clinician's autonomy supportive communication. We sought to evaluate the psychometric properties of a modified brief version of the Health Care Climate Questionnaire (mHCCQ) adapted for breast cancer patients. Methods: We surveyed 235 women aged 20-79 diagnosed with breast cancer within the previous 18 months at two cancer specialty centers using a print questionnaire. Patients completed the mHCCQ for their surgeon, medical oncologist, and radiation oncologist separately, as well as the overall treatment experience. Exploratory factor analysis (EFA) using principal components was used to explore the factor structure. Results: One hundred sixty out of 235 (68.1 %) women completed the survey. Mean age was 57 years and time since diagnosis was 12.6 months. For surgeon, medical oncologist, and radiation oncologist ratings separately, as well as overall treatment, women rated 6 dimensions of perceived physician autonomy support. Exploratory factor analysis indicated a single factor solution for each clinician type and for the overall experience. Further, all six items were retained in each clinician subscore. Internal consistency was 0.93, 0.94, 0.97, and 0.92 for the overall, surgeon, medical oncologist, and radiation oncologist scales, respectively. Hierarchical factor analysis demonstrated that a summary score of the overall treatment experience accounts for only 52 % of the total variance observed in ratings of autonomy support for the three provider types. Conclusions: These results describe the first use of the mHCCQ in cancer patients. Ratings of the overall treatment experience account for only half of the variance in ratings of autonomy support, suggesting that patients perceive and report differences in communication across provider types. Future research is needed to evaluate the relationship between physician communication practices and the quality of decision making, as well as other outcomes among cancer patients.
KW - Autonomy support
KW - Breast cancer
KW - Health Care Climate Questionnaire
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U2 - 10.1186/s12911-015-0172-4
DO - 10.1186/s12911-015-0172-4
M3 - Review article
C2 - 26155944
AN - SCOPUS:84936140599
VL - 15
JO - BMC Medical Informatics and Decision Making
JF - BMC Medical Informatics and Decision Making
SN - 1472-6947
IS - 1
M1 - 51
ER -