Department of Primary and Community Care, Research Institute for Medical Innovation, Radboud University Medical Center, Nijmegen, Netherlands.
Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, United Kingdom.
J Psychosom Res. 2024 Jun;181:111689. doi: 10.1016/j.jpsychores.2024.111689. Epub 2024 Apr 30.
Persistent somatic symptoms (PSS) describe recurrent or continuously occurring symptoms such as fatigue, dizziness, or pain that have persisted for at least several months. These include single symptoms such as chronic pain, combinations of symptoms, or functional disorders such as fibromyalgia or irritable bowel syndrome. While stigmatisation by healthcare professionals is regularly reported, there are limited measurement instruments demonstrating content validity. This study develops a new instrument to measure stigmatisation by healthcare professionals, the Persistent Somatic Symptom Stigma scale for Healthcare Professionals (PSSS-HCP).
Development was an iterative process consisting of research team review, item generation and cognitive interviewing. We generated a longlist of 60 items from previous reviews and qualitative research. We conducted 18 cognitive interviews with healthcare professionals in the United Kingdom (UK). We analysed the relevance, comprehensibility and comprehensiveness of items, including the potential for social desirability bias.
After research team consensus and initial feedback, we retained 40 items for cognitive interviewing. After our first round of interviews (n = 11), we removed 20 items, added three items and amended five items. After our second round of interviews (n = 7), we removed four items and amended three items. No major problems with relevance, comprehensibility, comprehensiveness or social desirability were found in remaining items.
The provisional version of the PSSS-HCP contains 19 items across three domains (stereotypes, prejudice, discrimination), demonstrating sufficient content validity. Our next step will be to perform a validation study to finalise item selection and explore the structure of the PSSS-HCP.
持续性躯体症状（PSS）描述反复发作或持续存在的症状，如疲劳、头晕或疼痛，至少持续数月。这些症状包括慢性疼痛等单一症状、症状组合或功能性障碍，如纤维肌痛或肠易激综合征。尽管医疗保健专业人员经常受到污名化，但目前用于测量这种污名化的工具十分有限，其内容效度也有待验证。本研究开发了一种新的工具来测量医疗保健专业人员对持续性躯体症状的污名化，即医疗保健专业人员持续性躯体症状污名量表（PSSS-HCP）。
该研究的开发过程是一个迭代过程，包括研究团队的审查、项目生成和认知访谈。我们从之前的综述和定性研究中生成了一份包含 60 个项目的长清单。我们在英国（UK）对医疗保健专业人员进行了 18 次认知访谈。我们分析了项目的相关性、可理解性和全面性，包括潜在的社会期望偏差。
经过研究团队的共识和初步反馈，我们保留了 40 个项目进行认知访谈。在第一轮访谈（n=11）后，我们删除了 20 个项目，增加了 3 个项目，并修改了 5 个项目。在第二轮访谈（n=7）后，我们删除了 4 个项目，并修改了 3 个项目。剩余项目在相关性、可理解性、全面性或社会期望偏差方面没有发现重大问题。
PSSS-HCP 的暂定版本包含三个领域（刻板印象、偏见、歧视）的 19 个项目，具有足够的内容效度。我们的下一步将是进行验证研究，以最终确定项目选择并探索 PSSS-HCP 的结构。
