Objectives: To elaborate and validate a scale which can be used as an instrument to find the attitudes towards primary health care of doctors at the first care level.
Design: Validation study and questionnaire on attitudes.
Setting: The first care level in the Murcia region. Subjects were 155 doctors (27 family and 128 general doctors) in fixed and provisional posts working in the out-clinics and health centres.
Measurements and results: A Likert-type attitudes scale was designed with five reply options. After the pilot-study on the initial scale and the full item-item correlation, the definitive 46-item survey was elaborated. Selection of subjects was through two-stage stratified randomised sampling, by specialty (general/family medicine) and health district. Reliability was high. Contents validity was reached through various consensus methods. To test validity of construction, a factorial analysis of the main components was performed, with 7 factors isolated: overall patient care, team-work, guidance on health problems, doctor's interest in in-work training, professional role, concern for the psychosocial aspects of the illness and inclusion of second level professionals.
Conclusions: The scale designed is a valid instrument, both a reliable way of identifying PHC doctors' attitudes and the attitudes, which could be improved.