Department of Psychiatry, School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung 80708, Taiwan.
Department of Psychiatry, Kaohsiung Medical University Hospital, Kaohsiung 80756, Taiwan.
Int J Environ Res Public Health. 2022 Oct 25;19(21):13877. doi: 10.3390/ijerph192113877.
Gay and bisexual men's experiences and worries of sexual stigma by health-care providers may delay them from seeking health-care assistance. Our study developed the Experienced and Anticipated Sexual Stigma Scale in Health-care Services (EASSSiHS) and examined its psychometric properties. The six-item EASSSiHS was first developed on the basis of the results of focus group interviews with 24 participants. Parallel analysis was used to determine the number of factors. Exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) were performed to examine the factor structure. The internal consistency was examined using McDonald's omega coefficient. Concurrent validity was examined using Pearson correlations with perceived sexual stigma from family and friends, depression, anxiety, and loneliness. The results of parallel analysis and EFA indicated that the factor structure of the EASSSiHS included two factors: experienced stigma and anticipated stigma. The result of CFA further confirmed the two-factor structure. The EASSSiHS had good internal consistency and acceptable concurrent validity. The anticipated stigma factor had stronger associations with perceived sexual stigma from family members and friends, depression, anxiety, and loneliness, when compared with the experienced stigma factor. The results of this study supported the psychometric properties of the EASSSiHS for assessing experienced and anticipated sexual stigma in health-care services among gay and bisexual men. The experience and worry of sexual stigma in health-care services were not rare among gay and bisexual men; therefore, interventions to enhance the cultural competency of health-care workers are urgently required.
男同性恋和双性恋者在医疗保健提供者处经历和担心性污名，可能会延迟他们寻求医疗保健帮助。我们的研究开发了医疗保健服务中经历和预期的性污名量表（EASSSiHS），并检验了其心理测量学特性。EASSSiHS 最初由 24 名参与者的焦点小组访谈结果开发了 6 个项目。平行分析用于确定因素的数量。进行探索性因素分析（EFA）和验证性因素分析（CFA）以检验因子结构。使用 McDonald 的ω系数检验内部一致性。使用与来自家人和朋友的感知性污名、抑郁、焦虑和孤独的 Pearson 相关性检验同时效度。平行分析和 EFA 的结果表明，EASSSiHS 的因子结构包括两个因子：经历性污名和预期性污名。CFA 的结果进一步证实了两因素结构。EASSSiHS 具有良好的内部一致性和可接受的同时效度。与经历性污名因子相比，预期性污名因子与来自家庭成员和朋友的感知性污名、抑郁、焦虑和孤独的相关性更强。本研究的结果支持了 EASSSiHS 在评估男同性恋和双性恋者医疗保健服务中经历和预期性污名的心理测量学特性。在医疗保健服务中经历和担心性污名在男同性恋和双性恋者中并不罕见；因此，迫切需要采取干预措施来增强医疗保健工作者的文化能力。
