title: Psychometric properties of a brief measure of autonomy support in breast cancer patients.
abstract: 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.
authors.affiliation: University of Michigan, School of Medicine, 2800 Plymouth Road, Ann Arbor, MI, 48109, USA. dshumway@med.umich.edu.
authors.forename: Dean
authors.initials: D
authors.lastname: Shumway
authors.affiliation: University of Michigan, School of Medicine, 2800 Plymouth Road, Ann Arbor, MI, 48109, USA.
authors.forename: Kent A
authors.initials: KA
authors.lastname: Griffith
authors.affiliation: University of Michigan, School of Medicine, 2800 Plymouth Road, Ann Arbor, MI, 48109, USA.
authors.forename: Reshma
authors.initials: R
authors.lastname: Jagsi
authors.affiliation: Emory University, School of Medicine, 69 Jesse Hill Jr. Drive SE, Atlanta, GA, 30303, USA.
authors.forename: Sheryl G
authors.initials: SG
authors.lastname: Gabram
authors.affiliation: University of Rochester, School of Medicine, 500 Joseph C. Wilson Blvd, Rochester, NY, 14611, USA.
authors.forename: Geoffrey C
authors.initials: GC
authors.lastname: Williams
authors.affiliation: University of Michigan, School of Public Health, 109 Observatory Street, Ann Arbor, MI, 48109-2029, USA.
authors.forename: Ken
authors.initials: K
authors.lastname: Resnicow
mesh_terms: D000328:Adult; D000368:Aged; D001943:Breast Neoplasms / Q000523:psychology* / Q000628:therapy; D003142:Communication; D003657:Decision Making; D005260:Female; D006801:Humans; D008875:Middle Aged; D026684:Personal Autonomy; D010817:Physician-Patient Relations; D011594:Psychometrics / Q000295:instrumentation*; D011795:Surveys and Questionnaires / Q000592:standards*; D055815:Young Adult