The Communication-Distress Scale for Physicians (CDS-P): Development and Validation

Description

Sonalipa Chatterjee¹, Moumita Mukherjee², and Atanu Kumar Dogra³ (Department of Psychology, SoHMS, Adamas University Kolkata, West Bengal¹, Research and Development, Adamas University Kolkata, West Bengal², Department of Psychology, University of Calcutta, West Bengal³)

Effective physicianpatient communication is essential for quality care, whereas communication breakdowns can create “communication distress”; manifesting as emotional strain, anxiety, and reduced trust among doctors and patients arising from emotional, cognitive, relational, temporal or environmental stressors before, during or after clinical interaction. This study developed and validated the Communication-Distress Scale for Physicians (CDS-P), a 30-item self-report measure assessing perceived communication-related distress among physicians. All the necessary steps for scale construction, i.e., item generation, identifying CVI from expert’s evaluation, item analysis, then EFA, CFA, reliability (Cronbach’s alpha) and finally for validation convergent validity was conducted. First, initial items pool was generated from literature review and expert input, then refined via content validity (expert panel CVI > .80) and pilot testing. A sample of 153 physicians from suburban government hospitals in West Bengal completed the CDS-P. Exploratory factor analysis supported a seven-factor structure (Emotional Labor & Empathic Fatigue, Lack of Clarity, & Interpretive ambiguity, Emotional & Physiological Reactivity, Fear of negative evaluation, Anticipatory Communication Anxiety, Post-interaction Reflection & Rumination, Communication fatigue due to External constraints) explaining 64% of variance. Confirmatory factor analysis on the 7-factor model demonstrated acceptable fit (RMSEA = .059, CFI = .936, TLI = .925) consistent with conventional cutoffs. All the domains showed adequate internal consistency (Cronbach’s α ≥ .77). The CDS-P is a reliable and valid instrument for assessing communication-related distress in physicians, with potential to inform interventions to reduce burnout and improve doctorpatient relationships.