Development Of The Stroke Stigma Scale

Background and ObjectiveStigma is a negative feeling of doubting one's own value and worrying about poor evaluation from others because of existent illness,and is the manifestation of stereotypes.Stroke is a common cerebrovascular disease.Patients with stroke properly may have visual changes and functional disorders.These changes or disorders are usually hard to conceal,resulting in dependent life,lower self-care ability and decreased social communication.Feeling difficult to accept or adapt to the change of roles from a healthy individual to a patient and worrying about bringing burdens to family or friends,patients with stroke might generate self-denial and self-depreciation.UsLually,they have special performances,including low social participation,self'avoidance,fear of losing respect from others and expose of discrimination,therefore,patients generate stigma.Due to the unclear generation progress of'stigma and the lack of measurement,our study was to develop a novel and special scale on measuring stroke stigma and to examine its psychometric propertied based on the theoretical framework,which may be used as a scientific stigma measurement.MethodsAfter reviews of literature and existing perceived stigma theoretical frameworks,we proposed stroke perceived stigma theoretical framework.With the framework and the results of semi-structured interviews,the item pool was accomplished.We also analyzed and selected the standardized items by multiple selection methods.Eventually,the stroke stigma scale with four dimensions and sixteen items was developed.During the preliminary investigation,we conveniently interviewed two hundred and eighty-eight stroke patients by using general information questionnaire,Stroke Stigma Scale with sixteen items.Stigma Scale for Chronic Illness and Self-rating Depression Scale.The Stroke Stigma Scale was assessed through reliability(split half reliability,internal consistency reliability and test-retest reliability)as well as validity(content validity,construct validity,criterion validity and converge validity).Results1.After item selection,sixteen items were included in the four dimension stroke stigma scale.2.About the split half reliability,all the Cronbach's Alpha of the two sub-scales were more than 0.8.About the internal consistency reliability,the Cronbach's Alpha of the total scale was 0.916,and Cronbach's Alpha of all the sub-scales were 0.771?0.864.About the test-retest reliability,the test-retest coefficient reached 0.924(P<0.01).3.About content validity,the item content validity index was 0.910?1.00 and scale content validity index was 0.989.About the construct validity,it was assessed by exploratory factor analysis.The principle component analysis with varimax rotation was used to detect the structure.Finally,Four components with eigenvalues>1 emerged,and they accounted for 68.051%of the variance in the set of variables,including internalized stigma,physical impairment,discrimination experience and social isolation.The correlation coefficient between the Stroke Stigma Scale and the Stigma Scale for Chronic Illness was 0.890(P<0.001),while the correlation coefficient between the Stroke Stigma Scale and Self-rating Depression Scale was 0.727(P<0.001).Conclusions1.The construction of the Stroke Stigma Scale was scientific and rigorous.Detailed schemes,scientific development processes and rigorous screening methods resulted in stroke stigma items.2.The Stroke Stigma Scale was a reliable and valid measure.After the preliminary application,we found that the Stroke Stigma Scale reached the criteria in split half reliability,internal consistency reliability,test-retest reliability as well as content validity,construct validity,criterion validity and converge validity,showing that it could measure the stigma status exactly and effectively.