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Children with medically unexplained symptoms (MUS) represent a challenge for paediatricians and typically undergo extensive in-patient investigations for symptoms such as abdominal pain. This can delay access to psychological services. This study aims to develop and evaluate a scale to assess the attitudes of paediatric staff to caring for children with MUS and to explore factors influencing those attitudes.In this cross-sectional survey, 118 health professionals at one UK hospital with experience of caring for children with MUS completed an attitude questionnaire developed for the study.Factor analysis identified four factors that explained significant variance in staff perceptions of care: rewarding nature of care; demanding nature of care; parental influence; children's need for skilled support. The combined subscales formed the MUS-Q.Paediatric staff found caring for children with MUS difficult and would welcome more support from CAMHS. The MUS-Q proved a reliable tool to evaluate staff attitudes.