Development and Validation of a Scale to Assess Barriers to Health Care Seeking Among Medical Students

Abstract

Evidence suggests that medical students often hesitate to seek formalized care for their health issues and concerns during training. Presently, there is no validated instrument to assess barriers to health care seeking among medical students. Hence, we attempted to develop and validate an English language questionnaire for assessment of self-reported barriers to physical and mental health care seeking among medical students. The questionnaire was developed at a medical college in India and was evaluated among the entire undergraduate medical student population of the college. Exploratory factor analysis was conducted to find the factor structure of the questionnaire. The 28-item final instrument comprised of 14 Likert-type items each pertaining to physical and mental health care separately. Higher scores on the scale reflect greater barriers to treatment. The test-retest reliability was found to be good. The factor analysis yielded an optimum five-factor solution explaining 44.8 % of the variance in the score on the scale. The five factors broadly encompassed the dimensions of “stigma and confidentiality,” “awareness of procedures,” “felt needs,” “avoidance of formalized care,” and “preference for alternative treatment.” The present valid and reliable instrument is likely to have institutional utility in assessing barriers to health care service utilization among medical students and thus planning corrective strategies.