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February 25, 2016

Measuring patient motivation in cancer therapy

Studies have shown cancer patients will select a treatment based on factors besides full recovery. New criteria designed by a CiRA researcher and scientists from other institutes provide a method to recognizing such patients for alternative options.

It is a dreaded diagnosis - cancer - but one which touches almost every family. Surprisingly, Japan used to have a tradition of not informing the patient the true diagnosis when cancer is found, instead providing other reasons for the treatment. The country has since become more progressive, but the declaration of cancer does not always result in full cooperation from the patient. There exists evidence that some patients may actually be less inclined to participate in the therapy if aware of their status. This reaction has implications on the recommended treatment strategy, but there remains no reliable way to identify which patients will eagerly participate from those who will withdraw.

To develop criteria that distinguish such patients, several Japanese researchers have collaborated to prepare the Achievement Motive Index for Medical Treatment (AMI-MeT). A new study, first authored by Taichi Hatta of the Uehiro Division for iPS Cell Ethics at CiRA, outlines the application of AMI-Met to cancer patients.

To examine the validity of AMI-MeT, the authors looked at three Japanese populations: cancer patients themselves, people who take regular health checks, and university students. The AMI-MeT consists of 10 questions, which can be broken down into two categories of equal size. The first describes Self-derived Achievement Motivation (AMS). AMS only assesses the self and ignores any implications on the wider community. On the other hand, Achievement Motivation Derived from Other (AMO) assesses factors like how one's own treatment could benefit others: for example, motivation to collect data that would help medical care practitioners decide which cancer therapy is best in which circumstances.

The study shows that AMS does not differ between the three groups, but that AMO is lower in the university students than in the other two. These results did not surprise Hatta, since university students are generally healthy and do not need medication. The value, he believes, is that the data could provide a baseline for recognizing patients who need more encouragement and support to undergo therapy. "Less motivated patients have other priorities. They want to live as they always did. On the other hand, highly motivated patients are ready to discuss all treat options in detail. AMI-MeT should be useful for physicians to make a strategy for communicating with their patients", he said.

Hatta T, Narita K, Yanagihara K et al. (2016)
Measuring motivation for medical treatment: confirming the factor structure of the Achievement Motivation Index for Medical Treatment (AMI-MeT).
BMC Med Inform Decis Mak 16(1)
DOI: 10.1186/s12911-016-0260-0
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