Abstract
BACKGROUND: This study describes the development and assessment of the reliability and validity of the Dental Care Attitudes Scale (DCAS), a new instrument for the measurement of attitudes towards dental care services. METHODS: Scale development employed qualitative and quantitative research methods. The initial set of items was developed from the transcripts of semi-structured interviews conducted with 16 dental patients. The psychometric properties of the DCAS were refined using an initial sample of 132 adults, and then a second sample of 744 participants (non-clinical sample of adults, dental students, and dentists). The five-factor structure was confirmed via CFA in the adult non-clinical sample (n = 527). Reliability was assessed by Cronbach's alpha values. Validity was assessed by examining the correlation coefficients of DCAS scores with established dental health scales, including the Dental Fear Survey, Dental Anxiety Scale, and Dental Belief Survey. Group differences were assessed by Mann-Whitney U and Kruskal-Wallis tests. RESULTS: The final measure was found to have 17 items, and five factors: Environment, Anesthesia, Delay, Social Status, and System-Related Dissatisfaction. CFA showed good fit (CMIN/DF = 2.11; CFI = 0.94; RMSEA = 0.046), and Cronbach's alpha ranged from 0.66 to 0.78. The association of the DCAS subscales with other measures were all in line with theoretical expectations, indicating good convergent and divergent validity. CONCLUSION: The Dental Care Attitudes Scale is a reliable and valid instrument for assessing attitudes towards dental care. The DCAS identified several attitudes that may hinder dental care attendance and dentist-patient cooperation. By understanding these attitudes, which the DCAS can measure, dentists can address potential issues in clinical practice and improve patient care.