Development of a scale to measure stigma related to podoconiosis in Southern Ethiopia

BMC Public Health

Gail Davey³  Ayalu A Reda¹  Kebede Deribe³  Abebayehu Tora²  Hannah Franklin³ 

[1] Department of Public Health, College of Health Sciences, Haramaya University, Harar, Ethiopia;Department of Sociology, Wolita Sodo University, Sodo, Ethiopia;Brighton and Sussex Medical School, Brighton, UK

关键词: Validity;    Ethiopia;    Neglected tropical disease;    Podoconiosis;    Measure;    Stigma;   

Others  :  1162382
DOI  :  10.1186/1471-2458-13-298

 received in 2012-07-22, accepted in 2013-03-18,  发布年份 2013

【 摘 要 】

Background

Health-related stigma adds to the physical and economic burdens experienced by people suffering from neglected tropical diseases (NTDs). Previous research into the NTD podoconiosis showed significant stigma towards those with the disease, yet no formal instrument exists by which to assess stigma or interventions to reduce stigma. We aimed to develop, pilot and validate scales to measure the extent of stigma towards podoconiosis among patients and in podoconiosis-endemic communities.

Methods

Indicators of stigma were drawn from existing qualitative podoconiosis research and a literature review on measuring leprosy stigma. These were then formulated into items for questioning and evaluated through a Delphi process in which irrelevant items were discounted. The final items formed four scales measuring two distinct forms of stigma (felt stigma and enacted stigma) for those with podoconiosis and those without the disease. The scales were formatted as two questionnaires, one for podoconiosis patients and one for unaffected community members. 150 podoconiosis patients and 500 unaffected community members from Wolaita zone, Southern Ethiopia were selected through multistage random sampling to complete the questionnaires which were interview-administered. The scales were evaluated through reliability assessment, content and construct validity analysis of the items, factor analysis and internal consistency analysis.

Results

All scales had Cronbach’s alpha over 0.7, indicating good consistency. The content and construct validity of the scales were satisfactory with modest correlation between items. There was significant correlation between the felt and enacted stigma scales among patients (Spearman’s r = 0.892; p < 0.001) and within the community (Spearman’s r = 0.794; p < 0.001).

Conclusion

We report the development and testing of the first standardised measures of podoconiosis stigma. Although further research is needed to validate the scales in other contexts, we anticipate they will be useful in situational analysis and in designing, monitoring and evaluating interventions. The scales will enable an evidence-based approach to mitigating stigma which will enable implementation of more effective disease control and help break the cycle of poverty and NTDs.

【 授权许可】

   
2013 Franklin et al.; licensee BioMed Central Ltd.

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