Psychometric evaluation of a new drug-resistant tuberculosis stigma scale

Lisa Redwood; Ellen M H Mitchell; Thu Anh Nguyen; Kerri Viney; Viet Nhung Nguyen; Greg J Fox

doi:10.1016/j.jclinepi.2021.01.007

Psychometric evaluation of a new drug-resistant tuberculosis stigma scale

J Clin Epidemiol. 2021 May:133:101-110. doi: 10.1016/j.jclinepi.2021.01.007. Epub 2021 Jan 19.

Authors

Lisa Redwood¹, Ellen M H Mitchell², Thu Anh Nguyen³, Kerri Viney⁴, Viet Nhung Nguyen⁵, Greg J Fox³

Affiliations

¹ The University of Sydney Central Clinical School, The Faculty of Medicine and Health, The University of Sydney, 92-95 Parramatta Road, Camperdown, New South Wales 2050, Australia; The Woolcock Institute of Medical Research, Apartment 203, Building 2G, Van Phuc Diplomatic Compound 298 Kim Ma Street Ba Dinh District, Hanoi, Vietnam. Electronic address: lred9798@uni.sydney.edu.au.
² Department of Public Health, Institute for Tropical Medicine, Kronenburgstraat 43, 2000 Antwerp, Belgium.
³ The University of Sydney Central Clinical School, The Faculty of Medicine and Health, The University of Sydney, 92-95 Parramatta Road, Camperdown, New South Wales 2050, Australia; The Woolcock Institute of Medical Research, Apartment 203, Building 2G, Van Phuc Diplomatic Compound 298 Kim Ma Street Ba Dinh District, Hanoi, Vietnam.
⁴ Research School of Population Health, Australian National University, Building 62 Mills Rd, Acton ACT 2601, Australia; Department of Global Public Health, Karolinska Institutet, SE-171 77 Stockholm Sweden; School of Public Health, The Faculty of Medicine and Health, The University of Sydney, Science Road, Camperdown, New South Wales 2050, Australia.
⁵ National Tuberculosis Program, 463 Hoang Hoa Tham, Vinh Phu, Ba Dinh, Hanoi, Vietnam.

PMID: 33476766
DOI: 10.1016/j.jclinepi.2021.01.007

Abstract

Objectives: Stigma contributes to diagnostic delay, disease concealment, and reduced wellbeing for people with multidrug-resistant tuberculosis (MDR-TB) and their communities. Despite the negative effects of stigma, there are no scales to measure stigma in people with MDR-TB. This study aimed to develop and validate a scale to measure stigma in people affected by MDR-TB in Vietnam.

Study design and setting: People with rifampicin-resistant (RR)-MDR-TB who had completed at least 3 months of treatment were invited to complete a survey containing 45 draft stigma items. Data analysis included exploratory factor analysis, internal consistency, content, criterion and construct validity, and test-retest reliability.

Results: A total of 315 people with RR/MDR-TB completed the survey. Exploratory factor analysis revealed a 14 item RR/MDR-TB stigma scale with four subscales, including guilt, social exclusion, physical isolation, and blame. Internal consistency and test-retest reliability were good (Cronbach's Alpha = 0.76, ICC = 0.92). Construct validity was adequate with moderate correlations with related constructs.

Conclusion: Our RR/MDR-TB Scale demonstrated good psychometric properties in Vietnam. This scale will assist in the measurement of stigma in people with RR/MDR-TB. It will also aid in the evaluation of stigma reduction interventions in people with RR/MDR-TB.

Keywords: Multidrug-resistant tuberculosis; Psychometrics; Social stigma; Validation; Vietnam/epidemiology.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Adult
Antibiotics, Antitubercular / therapeutic use*
Cross-Sectional Studies
Female
Humans
Male
Middle Aged
Psychometrics / standards*
Quality of Life / psychology*
Reproducibility of Results
Rifampin / therapeutic use*
Social Stigma*
Surveys and Questionnaires
Tuberculosis, Multidrug-Resistant / drug therapy*
Tuberculosis, Multidrug-Resistant / epidemiology
Tuberculosis, Multidrug-Resistant / psychology*
Vietnam / epidemiology

Substances

Antibiotics, Antitubercular
Rifampin