The Development of a Scale Measuring Medical Mistrust Among Medical and Healthcare Students and Providers

Hung-Chang Liao,1,2 Ya-Huei Wang3– 5 1Department of Health Policy and Management, Chung Shan Medical University, Taichung, Taiwan; 2Department of Medical Management, Chung Shan Medical University Hospital, Taichung, Taiwan; 3Department of Applied Foreign Languages, Chung Shan Medical University, Taichung, Taiwan; 4Department of Medical Humanities, School of Medicine, Chung Shan Medical University, Taichung, Taiwan; 5Department of Medical Education, Chung Shan Medical University Hospital, Taichung, TaiwanCorrespondence: Ya-Huei Wang, Chung Shan Medical University, Department of Applied Foreign Languages, 110, Sec. 1, Jian-Koa N. Road, Taichung, 402, Taiwan, Tel +886-4-24730022 ext. 12003, Email [email protected]: Lack of medical trust among healthcare providers may result in delayed decision-making, repeated medical examinations, or increased medical errors. Hence, the study intends to develop and validate a medical mistrust scale (MMtS-MHC-SP) grounded in the Taiwanese cultural and healthcare context’s perspective of healthcare students and providers to provide a reference framework for administrators and healthcare policymakers.Methods: Following an in-depth review of existing literature and expert consultations through panel discussions, the researchers utilized SPSS to conduct an exploratory factor analysis (EFA) on data collected from a sample of 322 participants. This analytical process was designed to uncover the underlying factors of the MMtS-MHC-SP and to rigorously examine its psychometric soundness. To confirm the factor structure and validate the identified factor structure, the researchers subsequently performed a confirmatory factor analysis (CFA) using AMOS software on a separate sample of 233 individuals to assess the observed factor structure. Tests were also performed on goodness-of-fit indexes, convergent and discriminant validities, and internal consistency.Results: The EFA reduced the original 59 items to 31 items, grouped into five factors: provider trustworthiness (8 items), healthcare accessibility (6 items), institutional integrity (7 items), treatment justifiability (6 items), and system reliability (4 items). These five factors accounted for 41.578% of the total variance in responses. Subsequent CFA validated this five-factor, 31-item structure. The EFA and CFA models demonstrated adequate convergent and discriminant validities. The Cronbach’s alphas, composite reliability values, and McDonald’s ω Coefficients ranged from 0.853 to 0.982 across factors, indicating good internal consistency.Conclusion: The results validated the developed MMtS-MHC-SP as a valid tool for assessing the medical mistrust among medical and healthcare students and providers. Hence, it can serve as a valuable tool to guide educational interventions, policy-making, and administrative strategies to foster trust within healthcare systems.Keywords: medical mistrust, healthcare providers, scale development, psychometric validation