Development and psychometric validation of the medical dismissal scale

Some people living with long-term physical health conditions report feeling dismissed, disbelieved, or not taken seriously when they seek healthcare. Their symptoms may be downplayed, attributed to psychological causes without good reason, or deprioritised. These experiences are sometimes described as medical dismissal, medical gaslighting or medical invalidation. There is growing concern that these experiences are common and may affect people's willingness to seek care, their trust in healthcare professionals, and their physical and mental health over time. At present, there is no reliable questionnaire designed specifically to measure these experiences in UK healthcare. Without one, it is difficult to know how common medical dismissal is, who is most affected, or whether efforts to improve patient care are working. The aim of this study is to test a new questionnaire, the Medical Dismissal Questionnaire (MDQ). The MDQ has been developed from interviews with people who have used UK healthcare services and describes the range of ways in which patients can feel dismissed by the healthcare system. This study will examine whether the MDQ is a reliable and valid measure, and will look at how experiences of medical dismissal relate to people's health, wellbeing, and use of healthcare over six months. Approximately 1400 adults living in the UK who have used healthcare services at least five times in the past two years will be recruited. Participation is entirely online. People who are interested will be directed to a secure survey where they can read about the study, check their eligibility, and provide consent. Those who take part will be asked to complete four questionnaires over six months: At the start, participants will complete a baseline questionnaire (about 30 to 40 minutes). This asks about background information, long-term conditions, the new MDQ, and other questionnaires about trust in doctors, feeling invalidated, stigma, personality, social desirability, and health literacy. It also includes measures of mood, quality of life, pain, fatigue, and beliefs about health. One week later, participants will complete a shorter questionnaire (about 5 to 10 minutes) that repeats the MDQ and one other measure. This is to check whether MDQ scores are stable over a short period. Three months and six months after the start, participants will complete follow-up questionnaires including the MDQ and measures of mental and physical health. Findings from this study will be used to check whether the MDQ measures what it is intended to measure and whether scores relate to health outcomes over time. In the longer term, the MDQ may be used in research and in healthcare settings to better understand patient experiences and to evaluate efforts to improve patient care.