Assessing Stigma in Multiple Sclerosis

Abstract

Background: The stigma associated with neurologic disorders plays a part in poor health-related quality of life. The eight-item Stigma Scale for Chronic Illness (SSCI-8) is a brief self-assessment tool for measuring perceived level of stigma. The psychometric performance of the SSCI-8 in people with multiple sclerosis (MS) was assessed. Methods: A multicenter, cross-sectional study in adults with relapsing-remitting or primary progressive MS was performed. A nonparametric item response theory procedure, Mokken analysis, was done to preliminarily study the dimensional structure of the SSCI-8. A confirmatory factor analysis (CFA) model was then fit, and the behavior and information covered by the eight items were assessed by parametric item response theory analysis. Results: A total of 201 patients (mean ± SD age, 43.9 ± 10.5 years; 60.2% female; 86.1% with relapsing-remitting MS) were studied. The Mokken analysis found that the SSCI-8 is a unidimensional strong scale (scalability index H = 0.56) with high reliability (Cronbach α = 0.88). The CFA model confirmed the unidimensionality (comparative fit index = 0.975, root mean square error of approximation = 0.077). The information covered by the SSCI-8 items ranges from 3.79 to 13.52, for a total of 66.56. More than half (66%) of the SSCI-8 overall information is conveyed by four items: 1 (“Some people avoided me”), 2 (“I felt left out of things”), 3 (“People avoided looking at me”), and 7 (“People were unkind to me”). Conclusions: The SSCI-8 shows appropriate psychometric characteristics and is, therefore, a useful instrument for assessing stigma in people with MS.

Psychological distress and associated factors among asthmatic patients in Southern, Ethiopia, 2021

“…The total score ranges from 8 to 40, a higher score indicates higher levels of perceived stigma. Those who scored above the mean value [ 12 ] were considered to have a stigma [ 31 ].…”

“…Stigma was also assessed using SSCI- 8 items which assess enacted and internalized stigma and have adequate internal reliability and validity in relation to PD [ 31 ].…”

Perception of Stigma in Patients with Neuromyelitis Optica Spectrum Disorder

“…The 8-item Stigma Scale for Chronic Illness (SSCI-8), the Expanded Disability Status Scale (EDSS), the 29-item Multiple Sclerosis Impact Scale (MSIS-29), the Beck Depression Inventory-Fast Screen (BDI-FS), the MOS Pain Effects Scale (MOS-PES) and the Fatigue Impact Scale for Daily Use (D-FIS) were used to assess the perception of stigma, disability, quality of life, mood, pain and fatigue, respectively. 24–30 …”

“…The 8-item Stigma Scale for Chronic Illness (SSCI-8), the Expanded Disability Status Scale (EDSS), the 29-item Multiple Sclerosis Impact Scale (MSIS-29), the Beck Depression Inventory-Fast Screen (BDI-FS), the MOS Pain Effects Scale (MOS-PES) and the Fatigue Impact Scale for Daily Use (D-FIS) were used to assess the perception of stigma, disability, quality of life, mood, pain and fatigue, respectively. [24][25][26][27][28][29][30] The SSCI-8 was developed to assess perceptions of stigma across different neurological conditions. 24,25 It comprises eight items rated on a 5-point Likert scale from 1 (never) to 5 (always).…”

“…[24][25][26][27][28][29][30] The SSCI-8 was developed to assess perceptions of stigma across different neurological conditions. 24,25 It comprises eight items rated on a 5-point Likert scale from 1 (never) to 5 (always). Total scores range from 8 to 40, with a cut-off score >8 indicating the presence of stigmatization.…”