Measuring professionals' attitudes toward persistent somatic symptoms: Development, validation, and reliability of the professionals' Attitude to Persistent Somatic Symptoms Questionnaire (PAPSS)

Objective: The healthcare professional's attitude toward persistent somatic symptoms (PSS) seems to play an important role in access to and quality of care for patients with PSS. To encourage research on PSS attitude, we developed and validated the Professionals' Attitude to Persistent Somatic Symptoms Questionnaire (PAPSS).

Methods: A list of items was developed through theory and a focus group with PSS experts, with response categories on a 5-point Likert scale ranging from "strongly disagree" to "strongly agree". These items were then validated through a sample (N = 411) consisting of medical specialists, general practitioners, and psychologists. Subscales of the PAPSS were constructed using repeated factor analyses and reliability analyses.

Results: Exploratory factor analyses resulted in a 15-item questionnaire with four subscales: "Perceived burden" and "Affinity" showed good reliability rates; "Perceived professional competence" and "Openness to patient-centered care" had questionable reliability rates. In general, psychologists had the most pronounced scores on subscales compared to medical specialists and general practitioners.

Innovation: The PAPSS is the first questionnaire for exploring the role of the professional's attitude toward PSS; it offers opportunities for further research on the influence of attitude on treatment of PSS.

Conclusions: The PAPPS is a relatively short questionnaire that can be used in both quantitative research and clinical care. However, it requires further research on psychometric qualities, including the validation of the translated versions of this questionnaire.