Measuring public attitudes towards people living with chronic diseases in Arabic-speaking populations: adaptation and development of the Social Stigma Scale of Chronic Diseases (SSS-CD)

BMC Public Health

Research

Georgio Chidiac¹  Rabih Hallit²  Souheil Hallit³  Mariam Dabbous⁴  Diana Malaeb⁵  Sahar Obeid⁶  Feten Fekih-Romdhane⁷ 

[1] School of Medicine and Medical Sciences, Holy Spirit University of Kaslik, P.O. Box 446, Jounieh, Lebanon;Department of Dermatology, University Claude Bernard Lyon 1, Lyon, France;School of Medicine and Medical Sciences, Holy Spirit University of Kaslik, P.O. Box 446, Jounieh, Lebanon;Department of Infectious Disease, Bellevue Medical Center, Mansourieh, Lebanon;Department of Infectious Disease, Notre Dame des Secours University Hospital Center, Street 93, Byblos, Postal Code 3, Lebanon;School of Medicine and Medical Sciences, Holy Spirit University of Kaslik, P.O. Box 446, Jounieh, Lebanon;Research Department, Psychiatric Hospital of the Cross, Jal Eddib, Lebanon;Applied Science Research Center, Applied Science Private University, Amman, Jordan;School of Pharmacy, Lebanese International University, Beirut, Lebanon;School of Pharmacy, Lebanese International University, Beirut, Lebanon;College of Pharmacy, Gulf Medical University, Ajman, United Arab Emirates;Social and Education Sciences Department, School of Arts and Sciences, Lebanese American University, Jbeil, Lebanon;The Tunisian Center of Early Intervention in Psychosis, Department of Psychiatry “Ibn Omrane”, Razi hospital, 2010, Manouba, Tunisia;Faculty of Medicine of Tunis, Tunis El Manar University, Tunis, Tunisia;

关键词: Chronic diseases;    Social stigma;    Attitudes;    Psychometric properties;    Arabic;   

DOI  :  10.1186/s12889-023-16315-1

 received in 2023-01-09, accepted in 2023-07-14,  发布年份 2023

来源: Springer

【 摘 要 】

BackgroundA large proportion of the population in Arab countries suffer from chronic diseases. According to the statistics by the Global Health Estimates, chronic illnesses contribute by 71% to total deaths in the Arab region. While chronic illnesses have been demonstrated to carry high levels of social stigma, it is only recently that little research attention has been given to this topic in the Arab world. It is well-established that the social stigma construct is culturally-dependent. Therefore, the lack of an Arabic measure highlighted the urgent need for developing a culturally adapted and valid instrument to assess social stigma toward people living with chronic diseases. In this study, we aimed to examine the psychometric properties of the Arabic translation, adaptation and development of “the Social Stigma Scale of Chronic Diseases” (SSS-CD).MethodFifteen items derived from the literature and assessing social stigma towards chronic diseases have been administered to 570 Arabic-speaking adults from the Lebanese general population (aged 24.59 ± 6.75years; 68.6% women). Items were translated into Arabic using a forward-backward translation method. Exploratory factor analysis (EFA) using a principal-axis EFA on the first split-half subsample, followed by a confirmatory factor analysis (CFA) tested on the model extracted from the EFA on the second split-half subsample, were conducted to examine the construct validity of the SSS-CD. Fit indices were deemed adequate if the normed model chi-square (χ²/df) ≤ 3, the Steiger-Lind root mean square error of approximation (RMSEA) ≤ 0.08, the Tucker-Lewis Index (TLI) and the comparative fit index (CFI) ≥ 0.90.ResultsFindings revealed that the 10-item SSS-CD has a unidimensional factor structure, with the following fit indices: χ2/df = 92.95/34 = 2.73, RMSEA = 0.077 (90% CI 0.059, 0.096), SRMR = 0.062, CFI = 0.939, TLI = 0.919. A good internal consistency was demonstrated by a McDonald’s omega value of 0.73 for the total score. Findings also supported invariance across gender, with men exhibiting higher levels of social stigma attached to chronic diseases than women. All three dimensions of stigmatization (social, psychological and evolutionary stigmatization) were positively correlated with SSS-CD scores (Social self-interest [r = .40; p < .001], Evolutionary self-interest [r = .37; p < .001], Psychological self-interest [r = .42; p < .001]), demonstrating relatively strong convergent validity.ConclusionOur findings suggest that the SSS-CD has robust psychometric qualities. We thus preliminarily suggest that the scale is valid, reliable and suitable for use among Arabic-speaking people from the general population to measure public attitudes towards people living with chronic diseases. Providing this psychometrically sound measure will hopefully enable to foster research in this area in order to draw a clear overview of the prevalence and characteristics of social stigma attached to chronic diseases in Arabic-speaking communities. However, given that this was the first study to examine the psychometric properties of the SSS-CD, the present findings and conclusions should be considered tentative pending future cross-national validation studies.

【 授权许可】

CC BY   
© The Author(s) 2023