Modified Health Care Climate Questionnaire for Breast Cancer Treatment

The Modified Health Care Climate Questionnaire (mHCCQ) for Breast Cancer Treatment measures patients’ perceptions of the degree to which their physician(s) provided autonomy-supportive (as opposed to controlling) breast cancer care. Modified from the original Health Care Climate Questionnaire (Williams et al., 1996), the mHCCQ contains six items that target the evaluation of specific physicians (as opposed to a more general impression of the clinic that may include other staff).  Respondents complete the instrument for each physician separately and are asked to respond to each item on a seven-point Likert scale where 1 is “not at all true”, 4 is “somewhat true”, and 7 is “very true”.

Piloting in a sample of 235 breast cancer patients indicated that patients report differences in communication across provider types (surgeon, medical oncologist, and radiation oncologist vs. “my breast cancer treatment doctors”); we therefore recommend that physicians be evaluated separately when possible. Note that the response scale can be reduced to a more compact five-point scale if survey space or participant burden is a concern.

mHCCQ - English
mHCCQ - Spanish

Scoring instructions:

All questions use a seven-point Likert scale with endpoints as marked. Response values increase left to right (1-7). To determine the mHCCQ score for a particular physician, calculate the average rating across all six items.  For all items, a higher score indicates more autonomy supportive care.

To cite this instrument, please use the following reference:

Shumway D, Griffith KA, Jagsi R, Gabram SG, Williams GC, Resnicow K. Psychometric properties of a brief measure of autonomy support in breast cancer patients. BMC medical informatics and decision making. 2015; 15:51.

Please note that this instrument has not been psychometrically validated and may change over time.

To cite the original Health Care Climate Questionnaire:

Williams GC, Grow VM, Freedman ZR, Ryan RM, Deci EL. Motivational predictors of weight loss and weight-loss maintenance. Journal of personality and social psychology. Jan 1996;70(1):115-126.