Department of Sociology and Centre for Longitudinal and Life Course Studies, University of Antwerp, Antwerp, Belgium; Centre for Health Systems Research and Development, University of the Free State, Bloemfontein, South Africa.
Department of Sociology and Centre for Longitudinal and Life Course Studies, University of Antwerp, Antwerp, Belgium.
Int J Tuberc Lung Dis. 2017 Nov 1;21(11):19-25. doi: 10.5588/ijtld.16.0749.
Recent evidence indicates that human immunodeficiency virus (HIV) and tuberculosis (TB) related stigma act as a key barrier to the utilisation of associated occupational health services by South African health care workers (HCWs). It also highlights a dearth of appropriate tools to measure HIV and TB stigma among HCWs.
To test four scales measuring different aspects of stigma: respondent's external stigma (RES) and others' external stigma (OES) towards TB as well as HIV across different professional categories of HCWs.
The current study employs data from a study on HIV and TB stigma among HCWs, a cluster randomised controlled trial for the collection of data among 882 HCWs in the Free State Province of South Africa. Confirmatory factor analyses and structural equation modelling were used to assess the validity and reliability of the scales.
All four scales displayed adequate internal construct validity. Subsequent analysis demonstrated that all four scales were metric-invariant, and that the OES scales were even scalar-invariant across patient and support staff groups. The scales displayed good reliability and external construct validity.
Our results support the use of the scales developed to measure TB and HIV stigma among HCWs. Further research is, however, needed to fine tune the instruments and test them across different resource-limited countries.
最近的证据表明，艾滋病毒（HIV）和结核病（TB）相关的污名是南非卫生保健工作者（HCWs）利用相关职业健康服务的一个主要障碍。它还突出表明缺乏衡量 HCWs 中 HIV 和 TB 污名的适当工具。
测试四个衡量不同方面污名的量表：TB 对 HCWs 不同职业类别的受访者的外部污名（RES）和其他人的外部污名（OES）以及 HIV。
本研究利用了一项针对 HCWs 中 HIV 和 TB 污名的研究的数据，这是一项在南非自由州收集 882 名 HCWs 数据的集群随机对照试验。验证性因子分析和结构方程模型用于评估量表的有效性和可靠性。
四个量表都显示出足够的内部结构有效性。随后的分析表明，所有四个量表在不同的患者和支持人员群体中都是度量不变的，而 OES 量表甚至是标度不变的。这些量表显示出良好的可靠性和外部结构有效性。
我们的结果支持使用开发的量表来衡量 HCWs 中的 TB 和 HIV 污名。然而，需要进一步的研究来调整这些工具，并在不同资源有限的国家进行测试。
