Bergman Alanna J, McNabb Katherine, Farley Jason E
Johns Hopkins University School of Nursing, Center for Infectious Disease and Nursing Innovation.
Stigma Health. 2024 Feb;9(1):81-93. doi: 10.1037/sah0000328. Epub 2021 Jun 17.
Tuberculosis (TB) stigma is one barrier to TB testing, treatment uptake and treatment completion. Therefore, stigma measurement must be approached through rigorous scientific methodology in order to accurately and reliably estimate the impact of TB stigma on treatment outcomes. The aim of this systematic review is to evaluate the methods and instruments used to measure TB stigma and interrogate strategies used to culturally validate measures of TB stigma in global research. Two reviewers used the PRISMA method to extract and analyze the existing body of literature on TB stigma in Sub-Saharan Africa. A thorough search was performed using three data bases generating 2,302 independent studies. After systematic screening, this review includes 28 studies. Of those studies, 13 used a psychometrically validated instrument while 15 used informal questionnaires or proxy variables to measure stigma. Psychometric appraisal was limited due to the number of studies that measured stigma using unvalidated questionnaires or proxy variables. The validated by Van Rie et al. were the most commonly used instruments to measure TB stigma; additionally, many instruments were not culturally or linguistically validated in Sub-Saharan Africa. Our appraisal emphasizes the need for reliable and valid instruments to measure TB stigma in low- and middle-income countries most affected by TB.
结核病污名是阻碍结核病检测、治疗接受和治疗完成的一个因素。因此，必须通过严谨的科学方法来进行污名测量，以便准确可靠地估计结核病污名对治疗结果的影响。本系统评价的目的是评估用于测量结核病污名的方法和工具，并审视在全球研究中用于对结核病污名测量进行文化验证的策略。两名评审员使用PRISMA方法提取并分析了撒哈拉以南非洲地区关于结核病污名的现有文献。使用三个数据库进行了全面检索，共生成2302项独立研究。经过系统筛选，本评价纳入了28项研究。在这些研究中，13项使用了经过心理测量学验证的工具，15项使用了非正式问卷或替代变量来测量污名。由于使用未经验证的问卷或替代变量测量污名的研究数量较多，心理测量学评估受到限制。Van Rie等人验证的工具是最常用的测量结核病污名的工具；此外，许多工具在撒哈拉以南非洲地区没有经过文化或语言验证。我们的评估强调，在受结核病影响最严重的低收入和中等收入国家，需要可靠有效的工具来测量结核病污名。
