| Objectives1. To develop the Self-Stigma of Disability Scale, and to provide a valid measurement tool for understanding the self-stigma of hearing-impaired people.2. To explore the positive rate and disclose the affecting factors of self-stigma of hearing-impaired middle-school students by applying an epidemiological investigation of the status quo of hearing-impaired middle-school students self-stigma in Hubei Province.3. To measure the implicit self-stigma of hearing-impaired middle-school students by Implicit Association Test, and to investigate the relationship between explicit and implicit self-stigma.Methods1. According to Moses (2010), to form the English version source Self-Stigma of Disability Scale by modifying the Internalized Stigma of Mental Illness Scale developed by Ritsher et al,(2003).Through scale translation process, translate the English version self-stigma of disability to original Chinese version.182hearing-impaired middle-school students from the Second Deaf School in Wuhan city were convenient sampled and asked to fill the original Chinese version of Self-Stigma of Disability. A revised Chinese version of Self-Stigma of Disability scale of23items (contains4common factors) was developed after item analysis of the original items.2. A cross-sectional design was performed in this study.503hearing-impaired middle-school students from thirteen special schools in eight regions in Hubei Province were investigated. The involved regions included:Wuhan, Yichang, Shiyan, Ezhou, Huanggang, Xianning and Enshi.The questionnaires included general data questionnaire, revised Self-Stigma of Disability Scale, Simplified Coping Style Questionnaire, Perceived Social Support Scale, and The Resilience Scale for Chinese Adolescent were applied to investigate and collect data. The reliability of the revised Self-Stigma of Disability Scale was tested by test-retest reliability, homogeneity reliability and split-half reliability, and the validity of the scale was tested in terms of content validity, and criterion validity. Independent samples t test, one-way ANOVA, Pearson analysis and multivariable linear regression model were used to explore the affecting factors of self-stigma.3. Implicit Association Test and Single Target Implicit Association Test were used to explore the implicit self-stigma of hearing-impaired middle-school students.76hearing-impaired middle-school students from the First and Second Deaf Schools were sampled. Each subject also needs to complete revised Self-Stigma of Disability Scale to explore the relationship between explicit and implicit self-stigma.Results1. The development and validation of the Self-Stigma of Disability Scale. The revised Self-Stigma of Disability Scale consists of23items covering four common factors (Devaluation-Discrimination, Alienation, Social Withdrawal, and Stigma Resistance). The homogeneity reliability coefficients of common factors and the scale ranged from0.50to0.88. The test-retest reliability coefficients ranged from0.68to0.88. The split-half reliability coefficient of scale was0.84. The correlations between the self-stigma of disability scale scores and its four common factors scores ranged from0.50to0.92, which were statistical significance (P<0.001). All above suggested the scale has good content validity. The confirmatory factor analysis showed the factor loading of four factors of23-item are all greater than or close to0.4. The goodness-of-fit test of modeling was fine indicated bydf, RMR, and GFI. All above showed the revised Self-Stigma of Disability Scale has robust construct reliability.2. The epidemiological study of self-stigma of disability.(1) There were87hearing-impaired middle-school students being found to high self-stigma using a cutoff criterion. So the detection rate was18.24%.(2) The multiple linear regressions indicated: the scores of resilience, perceived social support and parenting style were significant, negatively correlated with self-stigma levels (P<0.05), while school location and the scores of negative coping style were positively associated with self-stigma levels(P<0.001); School location and the scores of negative coping style were significantly positive associated with the levels of "Alienation"(P<0.001) while resilience was negatively associated with the levels of "Alienation"(P<0.001); Age and resilience were significant, negatively associated with the levels of "Stigma Resistance"(P<0.001), while school location was positively associated with the levels of "Stigma Resistance"(P<0.05); Resilience and peer relationship were significant, negatively associated with the levels of "Social Withdrawal"(P<0.01), while negative coping style and school location were significant, positively associated with the levels of "Social Withdrawal"; Resilience, perceived social support, positive coping style, and parenting style were significant, negatively associated with the levels of "Devaluation-Discrimination", while negative coping style and school location were positively associated with the levels of "Devaluation-Discrimination"(P<0.05).3. The study of implicit self-stigma of disability. The result of implicit association test indicated that hearing-impaired middle-school students’implicit attitude toward self and hearing-impaired were both positive. The D scores for IAT and ST-IAT were significantly greater than zero (P<0.05).The detection rate for implicit self-stigma was O.Pearson correlation analysis indicated the explicit self-stigma was not significantly associated with the D score for IAT and ST-IAT, respectively (P>0.05).Conclusions1. The revised self-stigma of disability scale had good reliability and validity, which can meet the requirements of psychological measurement.2. The detection rate for high self-stigma was18.24%in hearing-impaired middle-school students. The factors affecting the level of self-stigma of hearing-impaired middle-school students include age, school location, parenting style, peer relationship, social support, resilience and coping style.3. Hearing-impaired students’implicit attitude toward self and hearing-impaired were both positive. The detection rate for implicit self-stigma was0. Pearson correlation analysis indicates implicit and explicit stigmas were two different structures.HighlightsHighlights of our study: Firstly, this research is the first to study the self-stigma of hearing-impaired students in China. Secondly, our research successfully developed the first Self-Stigma of Disability Scale for the Chinese hearing-impaired students, which is a great action in China. Using the Implicit Association Test to explore implicit self-stigma of hearing-impaired students, the results enrich the existing research results from the research contents and measuring tools. |
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