Yi Yaohui, Sun Meng, Lu Jiachen, Dou Xiaofeng, Yu Yingying, Zhou Ling
School of Public Health, Dalian Medical University, Dalian City, Liaoning Province, People's Republic of China.
Risk Manag Healthc Policy. 2024 Apr 5;17:815-826. doi: 10.2147/RMHP.S446068. eCollection 2024.
As future health workers, medical students' attitudes towards tuberculosis (TB) patients can impact TB control. However, in China, there is a lack of well-quantified assessment regarding the stigma among medical students towards TB patients. Therefore, this study aimed to validate the Chinese version of the Tuberculosis related-Stigma Scale (TSS) in medical students and to apply the scale to measure stigma and its determinants.
A total of 1035 eligible medical students participated in the cross-sectional questionnaire. Exploratory factor analyses (EFA) and confirmatory factor analyses (CFA) were first conducted to test Chinese version of the TSS construct validity, and then internal consistency was assessed using Cronbach's α. Finally, multiple linear regression analyses were conducted to identify predictors of stigma.
EFA extracted two factors ("Social distance" and "Exclusionary sentiments"). The CFA further confirmed the two-factor construct. The internal consistency, convergent and divergent validity of the adapted Chinese version of the TSS was acceptable. Furthermore, Whether one has received TB health education and whether know a person with TB are associated with all dimensions of TB stigma, while differences in sex and place of residence play different roles in influencing the different dimensions of stigma.
The adapted Chinese version of the TSS can be used to assess the level of stigma among medical students in China towards tuberculosis patients. When implementing future interventions to reduce stigma associated with TB, special attention should be given to medical students from urban areas, of male gender, who have not received TB health education, and no know a person with TB. However, these two dimensions ("Social distance" and "Exclusionary sentiments") are impacted by different determinants and should therefore be addressed separately when designing, implementing, and evaluating measures to reduce stigma.
作为未来的卫生工作者，医学生对结核病患者的态度会影响结核病控制。然而，在中国，对于医学生对结核病患者的污名化缺乏量化良好的评估。因此，本研究旨在验证医学生结核病相关污名量表（TSS）中文版的有效性，并应用该量表测量污名及其决定因素。
共有1035名符合条件的医学生参与了横断面问卷调查。首先进行探索性因素分析（EFA）和验证性因素分析（CFA）以检验TSS中文版的结构效度，然后使用Cronbach's α评估内部一致性。最后，进行多元线性回归分析以确定污名的预测因素。
EFA提取了两个因素（“社会距离”和“排斥情绪”）。CFA进一步证实了两因素结构。改编后的TSS中文版的内部一致性、收敛效度和区分效度是可接受的。此外，是否接受过结核病健康教育以及是否认识结核病患者与结核病污名的所有维度相关，而性别和居住地点的差异在影响污名的不同维度中发挥不同作用。
改编后的TSS中文版可用于评估中国医学生对结核病患者的污名化程度。在实施未来减少与结核病相关污名的干预措施时，应特别关注来自城市地区、男性、未接受过结核病健康教育且不认识结核病患者的医学生。然而，这两个维度（“社会距离”和“排斥情绪”）受不同决定因素的影响，因此在设计、实施和评估减少污名的措施时应分别加以解决。
