Faculty of Medicine, University of Kelaniya, Ragama, Sri Lanka.
Faculty of Medicine, University of Peradeniya, Peradeniya, Sri Lanka.
Acad Psychiatry. 2021 Dec;45(6):716-724. doi: 10.1007/s40596-021-01446-7. Epub 2021 Apr 9.
Among the scales developed for assessing medical students' attitudes regarding psychiatry, "attitude towards psychiatry-30" (ATP-30) is probably the most widely used. Although this scale was originally deemed to form a unitary dimension without any meaningful subscales, the authors sought to re-examine its factor structure and the viability of subscales.
Secondary data from a survey of 743 final-year medical students from nine medical schools in Sri Lanka were analyzed using exploratory factor analysis (EFA) with promax rotation and confirmatory factor analysis (CFA), to assess the underlying factor structure of ATP-30. Parallel analysis was used in determining the number of factors to retain. Items conceptually external to the emerging factors were discarded.
Three models based on literature (one-, five-, and eight-factor) were disproved by CFA. A six-factor solution encompassing 18 items was supported by EFA and CFA and was gender-invariant. These factors were, namely, the image of psychiatrists, psychiatric patients and mental illness, the efficacy of treatment, psychiatric teaching, career choice, and psychiatry as an evidence-based discipline. While "the image of psychiatrists" formed the most consistent subscale (ω = 0.71), the internal consistencies of the other subscales were modest (ω = 0.55-0.67). The overall 18-item scale showed good internal consistency (ω = 0.78).
The findings provide evidence of a multi-dimensional structure in medical students' attitudes towards psychiatry, endorsing six meaningful subscales of the ATP-30. Future researchers and educators can utilize these subscales in identifying specific areas where students' attitudes are more stigmatized, to be intervened during undergraduate training.
在评估医学生对精神病学态度的量表中，“精神病学态度量表-30 项”（ATP-30）可能是使用最广泛的。尽管该量表最初被认为是一个没有任何有意义子量表的单一维度，但作者试图重新检验其因子结构和子量表的可行性。
对来自斯里兰卡 9 所医学院的 743 名应届医学生进行调查的二手数据，采用 promax 旋转的探索性因子分析（EFA）和验证性因子分析（CFA），评估 ATP-30 的潜在因子结构。平行分析用于确定保留的因子数量。与新兴因子概念上不相关的项目被丢弃。
基于文献的三个模型（单因子、五因子和八因子）均被 CFA 否定。EFA 和 CFA 支持六因子（包含 18 个项目）解决方案，且性别不变。这些因子包括精神科医生形象、精神科患者和精神疾病、治疗效果、精神病学教学、职业选择和精神病学作为循证学科。虽然“精神科医生形象”构成了最一致的子量表（ω=0.71），但其他子量表的内部一致性较低（ω=0.55-0.67）。整个 18 项量表显示出良好的内部一致性（ω=0.78）。
研究结果提供了医学生对精神病学态度存在多维结构的证据，支持 ATP-30 的六个有意义的子量表。未来的研究人员和教育工作者可以利用这些子量表来识别学生态度更具污名化的特定领域，以便在本科培训期间进行干预。
