Division of Pediatric Infectious Diseases, Department of Pediatrics, Warren Alpert Medical School of Brown University, Providence, RI, Center for International Health Research, Rhode Island Hospital, Providence, RI.
Department of Global Health and Social Medicine, Harvard Medical School, Boston, MA, USA.
Int J Tuberc Lung Dis. 2023 Oct 1;27(10):754-760. doi: 10.5588/ijtld.23.0104.
TB-related stigma contributes to poor clinical outcomes and reduced wellbeing for affected individuals. Adolescents may be particularly susceptible to TB-related stigma due to their heightened sensitivity to peer acceptance, yet few studies have evaluated TB-related stigma in this group. Without a validated scale, it remains challenging to measure TB-related stigma in adolescents. We adapted and validated the Van Rie TB Stigma Scale (VTSS) for adolescents on treatment for rifampicin-susceptible TB in Lima, Peru. The modified stigma scale was administered within a larger survey, which measured other psychosocial factors, including depression, adverse childhood experiences (ACEs), and social support. Data analysis included factor analysis, internal consistency, and convergent validity. From October 2020 to September 2021, 249 adolescents (individuals aged 10-19 years) completed the survey. Preliminary confirmatory factor analysis led to removal of two items. The final 10-item scale demonstrated good internal consistency (Cronbach's α = 0.82) and adequate model fit (χ²/df = 2.0; root mean square error of approximation: 0.06; comparative fit index: 0.94; Tucker-Lewis Index: 0.92: standardized root mean square residual: 0.05). Stigma was positively correlated with ACEs (γ = 0.13), depression (γ = 0.39), and suicidal ideation (γ = 0.27), and negatively correlated with social support (γ = -0.19). This adolescent TB stigma scale may serve as a practical tool to measure TB-related stigma and evaluate the impact of stigma-reduction interventions in adolescents.
与结核病相关的耻辱感会导致受影响个体的临床结局恶化和幸福感降低。由于青少年对同伴接纳更加敏感,他们可能更容易受到与结核病相关的耻辱感的影响,但很少有研究评估过这一群体的与结核病相关的耻辱感。由于缺乏经过验证的量表,因此在青少年中衡量与结核病相关的耻辱感仍然具有挑战性。我们在秘鲁利马对接受利福平敏感结核病治疗的青少年进行了 Van Rie 结核病耻辱量表(VTSS)的改编和验证。在一项更大的调查中,对修改后的耻辱量表进行了评估,该调查还测量了其他社会心理因素,包括抑郁、不良童年经历(ACEs)和社会支持。数据分析包括因子分析、内部一致性和收敛有效性。2020 年 10 月至 2021 年 9 月,共有 249 名青少年(年龄在 10-19 岁之间)完成了调查。初步验证性因子分析导致删除了两个项目。最终的 10 项量表具有良好的内部一致性(Cronbach's α = 0.82)和适度的模型拟合(χ²/df = 2.0;近似均方根误差:0.06;比较拟合指数:0.94;Tucker-Lewis 指数:0.92;标准化均方根残差:0.05)。耻辱感与 ACEs(γ = 0.13)、抑郁(γ = 0.39)和自杀意念(γ = 0.27)呈正相关,与社会支持(γ = -0.19)呈负相关。该青少年结核病耻辱感量表可用作衡量与结核病相关的耻辱感并评估减少耻辱感干预措施对青少年影响的实用工具。