Development and psychometric validation of the Physician Occupational Stigma Perception Scale among Chinese physicians.

BACKGROUND: Occupational stigma is increasingly recognized as an important psychosocial concern for physicians, yet no instrument specifically measures how Chinese physicians perceive negative public evaluations of their profession. This study aimed to develop and psychometrically evaluate the Physician Occupational Stigma Perception Scale (POSPS) for Chinese physicians. METHODS: An exploratory sequential mixed-methods design was used. The POSPS was developed and administered in Chinese. Candidate items were generated from semi-structured interviews with 23 frontline physicians and relevant existing measures, and were subsequently refined through two rounds of Delphi consultation and target-population pretesting. A pilot survey of 193 physicians was used for exploratory factor analysis (EFA), with Horn's parallel analysis guiding factor retention. The resulting structure was examined in an independent sample of 312 physicians using confirmatory factor analysis (CFA). Internal consistency, convergent and discriminant validity, and nomological validity were also assessed. RESULTS: EFA yielded a six-item, two-factor solution comprising Medical Ethics Stigma Perception (ME) and Medical Skills and Services Stigma Perception (MSS). The correlated two-factor CFA model showed good fit. Cronbach's alpha was 0.849 for ME and 0.862 for MSS, and McDonald's omega was 0.851 and 0.862, respectively. Composite reliability values were 0.852 and 0.866, and average variance extracted values were 0.659 and 0.684. The latent correlation between ME and MSS was 0.496, supporting their related but distinct nature. Both dimensions were positively correlated with emotional exhaustion and ambivalent occupational identification and negatively correlated with job satisfaction, providing evidence of nomological validity. CONCLUSION: The six-item POSPS demonstrated acceptable psychometric properties for assessing occupational stigma perceptions among Chinese physicians. Its two subscales provide a concise, contextually grounded measure for research on physicians' occupational experiences and well-being in China.