The medical condition regard scale: measuring reactions to diagnoses

To develop a non-condition-specific scale to capture biases, emotions, and expectations generated by medical condition descriptors. An 18-item pilot scale was developed from the literature on physicians' responses to patients they like and dislike, stigma definitions, and discussions with primary care faculty. Exploratory factor analysis was conducted after 440 medical students rated one of 12 diverse conditions. Confirmatory factor analysis was performed after 163 medical students rated two psychiatric conditions. Validity was evaluated by the scale's ability to meaningfully stratify the 12 conditions and identify changes in attitudes toward psychiatric conditions after a psychiatry clerkship. Exploratory factor analysis supported an 11-item unidimensional solution (all factor loadings >.40, coefficient alpha =.87). The final scale, the Medical Condition Regard Scale (MCRS), taps the degree to which medical students find patients with a given medical condition to be enjoyable, treatable, and worthy of medical resources. The unidimensional model also was supported by the confirmatory factor analyses for the two psychiatric conditions (both comparative fit indices =.98). The scale stratified the 12 conditions as expected: straightforward medical conditions rated highest, somatoform conditions rated lowest. Students showed greater regard for patients with major depression after the psychiatry clerkship, and students who rotated through an addiction treatment program showed a greater increase in regard for patients with alcoholism than did students not exposed to addiction treatment. MCRS scores are reliable, and the scale appears to be a valid instrument for assessing regard for any medical condition.