Factor structure of The Opening Minds Stigma Scale for Health Care Providers and psychometric properties of its Hungarian version

Abstract

Background The Opening Minds Stigma Scale for Health Care Providers (OMS-HC) is a widely used questionnaire to measure the stigmatising attitudes of healthcare providers towards patients with mental health problems. The psychometric properties of the scale; however, have never been investigated in Hungary. We aimed to thoroughly explore the factor structure of the OMS-HC and examine the key psychometric properties of the Hungarian version. Methods The OMS-HC is a self-report questionnaire that measures the overall stigmatising attitude by a total score, and three subscales can be calculated: Attitude, Disclosure and Help-seeking, and Social Distance. Our study population included specialists and trainees in adult and child psychiatry (n = 211). Exploratory and confirmatory factor analyses were performed, and higher-order factors were tested. We calculated the test-retest reliability on a subgroup of our sample (n = 31) with a follow-up period of 1 month. The concurrent validity of the scale was measured with the Mental Illness: Clinician’s Attitudes-4 scale (MICA-4). Results Three factors were extracted based on a parallel-analysis. A bifactor solution (a general factor and three specific factors) showed an excellent model-fit (root mean square error of approximation = 0.025, comparative fit index = 0.961, and Tucker-Lewis index = 0.944). The model-based reliability was low; however, the general factor showed acceptable reliability (coefficient omega hierarchical = 0.56). The scale demonstrated a good concurrent validity with the MICA-4 [intraclass correlation coefficient (ICC) = 0.77]. The test-retest reliability was excellent for the general factor (ICC = 0.95) and good for the specific factors (ICC = 0.90, 0.88, and 0.84, respectively). Conclusions The three dimensions of the OMS-HC was confirmed, and the scale was found to be an adequate measure of the stigmatising attitude in Hungary. The bifactor model is more favourable as compared to the three correlated factor model; however, despite the excellent internal structure, its model-based reliability was low.

Validation of the Opening Minds Scale for Health Care Providers (OMS-HC): Factor Structure and Psychometric Properties of the Brazilian Version

“…Other criteria, such as eigenvalue larger than 1 or significance of the Chi-square difference test, suggested more than four factors, but such a large number of factors was inconsistent with the conception of the scale and the existing literature. A study in Hungary [ 43 ] found three factors, which is not entirely inconsistent with our findings ( Table 2 ), but four factors is meaningfully more than was reported in the original OMS-HC development paper, where two factors were found using 12 items. Our three-factor solution showed several cross-loadings, and the factors did not yield a clear interpretation.…”

Psychometric Evaluation of the German Version of the Opening Minds Stigma Scale for Health Care Providers (OMS-HC)

“…The con rmatory factor analysis showed good model t with respect of the original version. This is in line with a recent OMS-HC validation study in Chile and partly consistent with a Hungarian study that ran a series of factor analyses, resulting in a nal two-factor solution [32,33].…”

The stigma towards mental illness: Portuguese validation of the Opening Minds Stigma Scale for Healthcare Providers (OMS-HC)

“…The German study showed good internal consistency for the total scale (α = 0.74) and lower for the three factors (α < 0.70), and the authors maintained the original factor structure ( Zuaboni et al, 2021 ). The Hungarian study ( Őri et al, 2020 ) also had good internal consistency (α = 0.73) and lower internal consistency for the three factors of the factor structure (α < 0.70). However, its results showed that one of its items should be removed ( Őri et al, 2020 ).…”

“…The Hungarian study ( Őri et al, 2020 ) also had good internal consistency (α = 0.73) and lower internal consistency for the three factors of the factor structure (α < 0.70). However, its results showed that one of its items should be removed ( Őri et al, 2020 ). In addition, although they obtained good results for a three-factor structure, their results indicated good results for a bifactor structure with one global factor and three specific factors ( Őri et al, 2020 ).…”

“…So, considering this need the Opening Minds Stigma Scale for Healthcare Providers (OMS-HC) was the first scale developed to assess stigma toward mental illness specifically among healthcare professionals ( Kassam et al, 2012 ). A team of researchers from the University of Calgary in Canada developed this scale, and, since then it has been validated in several countries, including Malaysia ( Fernandez et al, 2016 ), Singapore ( Chang et al, 2017 ), Italy ( Destrebecq et al, 2018 ), Pakistan ( Laraib et al, 2018 ), Bahrain ( Al Saif et al, 2019 ), Chile ( Sapag et al, 2019 ), Hungary ( Őri et al, 2020 ), Germany ( Zuaboni et al, 2021 ), Iran ( Movahedi et al, 2022 ) and Brazil ( Carrara et al, 2022 , 2023 ).…”