Rao Deepa, Choi Seung W, Victorson David, Bode Rita, Peterman Amy, Heinemann Allen, Cella David
Center on Outcomes, Research and Education, Evanston Northwestern Healthcare, Evanston, IL, USA.
Qual Life Res. 2009 Jun;18(5):585-95. doi: 10.1007/s11136-009-9475-1. Epub 2009 Apr 25.
Most measures of stigma are illness specific and do not allow for comparisons across conditions. As part of a study of health-related quality of life for people with neurological disorders, our team developed an instrument to assess the stigma for people with chronic illnesses.
We based item content on literature review, responses from focus groups, and cognitive interviews. We then administered the items to people with neurological disorders for psychometric testing.
Five hundred eleven participants completed items of the stigma scale. Exploratory factor analysis produced two factors that were highly correlated (r = 0.81). Confirmatory factor analysis produced high standardized loadings on an overall stigma factor (0.68-0.94), with poorer loadings on the two sub-domains (-0.12 to 0.53). These results demonstrated a sufficiently unidimensional scale that corresponded with the bifactor model. Item response theory modeling suggested good model fit, and differential item functioning analyses indicated that the 24-item scale showed potential for measurement equivalence across conditions.
Our efforts produced a stigma scale that had promising psychometric properties. Further study can provide additional information about the SSCI and its benefit in measuring the impact of stigma across conditions.
大多数耻辱感测量方法是针对特定疾病的，无法在不同疾病间进行比较。作为一项针对神经系统疾病患者健康相关生活质量研究的一部分，我们的团队开发了一种工具来评估慢性病患者的耻辱感。
我们依据文献综述、焦点小组的反馈以及认知访谈来确定项目内容。然后，我们将这些项目应用于神经系统疾病患者进行心理测量测试。
511名参与者完成了耻辱感量表的项目。探索性因素分析产生了两个高度相关的因素（r = 0.81）。验证性因素分析在总体耻辱感因素上产生了较高的标准化载荷（0.68 - 0.94），而在两个子领域的载荷较低（-0.12至0.53）。这些结果表明该量表具有足够的单维性，符合双因素模型。项目反应理论建模显示模型拟合良好，差异项目功能分析表明，这个24项量表在不同疾病情况下具有测量等效性的潜力。
我们的努力产生了一个具有良好心理测量特性的耻辱感量表。进一步的研究可以提供关于该量表及其在测量不同疾病情况下耻辱感影响方面益处的更多信息。
