The Stroke Stigma Scale: a reliable and valid stigma measure in patients with stroke

Abstract

Objective: The objective of the study is to analyse the psychometric properties of the Stroke Stigma Scale, a novel scale to assess perceived stigma of patients with stroke. Design: This is a psychometric study. Setting: Neurology or rehabilitation units in three hospitals in China. Subjects: A total of 288 patients with stroke. Interventions: None. Measures: The content validity of the Stroke Stigma Scale was assessed through expert consultation. Criterion validity was evaluated based on the scale’s relationships with the Stigma Scale for Chronic Illness and the Self-rating Depression Scale. Construct validity was assessed using exploratory factor analysis, and internal consistency was tested with Cronbach’s α. Results: The final version Stroke Stigma Scale consists of 16 items. It showed strong positive correlations with both the Stigma Scale for Chronic Illness ( ρ = 0.89, P < 0.001) and the Self-rating Depression Scale ( ρ = 0.82, P < 0.001). The exploratory factor analysis revealed four components of the Stroke Stigma Scale: internalized stigma, physical impairment, discrimination experience, and social isolation, which were strongly associated with our perceived stroke stigma model. Cronbach’s α for the total scale was 0.92, and that of each subscale was 0.77–0.86. The test–retest reliability with intra-class correlation coefficients of the total scale was 0.92 ( P < 0.001), and intra-class correlation coefficients of each subscale were 0.74–0.89 ( P < 0.001). Conclusions: The Stroke Stigma Scale is a reliable and valid measure of perceived stigma in patients with stroke, which may be useful in stigma prevention and stroke rehabilitation.

The effect of stigma on social participation in community-dwelling Chinese patients with stroke sequelae: A cross-sectional study

“…This study showed a moderate level of stigma among patients with stroke sequelae in the community, which is similar to Zhu et al’s study, which explored the stigma of Chinese patients during stroke rehabilitation, 33 and Sarfo et al’s study, which investigated stroke-related stigma among West Africans. 34 It can be concluded that stigma is prevalent in stroke patients regardless of sequelae, and stroke patients experience higher levels of felt stigma than enacted stigma.…”

“…The reason may be that stroke patients with more sequelae and severe disability experience more discrimination from the outside world and tend to consider themselves a significant burden, internalizing enacted stigma into felt stigma. 33 Furthermore, this also explains the reason why the felt-stigma level was higher than the enacted stigma level.…”

Validation of the Italian translation of the perceived stigma scale and resilience assessment in inflammatory bowel disease patients

“…The psychometric evaluation of the Italian PSS version showed an excellent Cronbach alpha coefficient, item internal consistency, and test-retest reliability. Our results are in line with previous literature validating stigma scales in different settings[ 4 , 10 , 26 , 27 ], showing that our translation is reliable and offers a tool to assess stigma in Italian IBD patients. In our cohort, the main concern is the high floor effect recorded, especially in the HP domain.…”

Why Me?: A Qualitative Study on the Experiences of Young Stroke Survivors in the Accra Metropolis of Ghana, West Africa

“…As a result, there were also some indications, however small, about feelings of been stigmatized because of the social perceptions that were attributed to stroke among young adults. Studies assert that in order to avoid been stigmatized most stroke sufferers were likely not to disclose their condition because of the likelihood of been viewed in a negative manner (49)(50)(51)(52)(53) by members of a social group.…”