Measuring stigma after spinal cord injury: Development and psychometric characteristics of the SCI-QOL Stigma item bank and short form

Kisala, Pamela A.; Tulsky, David S.; Pace, Natalie; Victorson, David; Choi, Seung W.; Heinemann, Allen W.

doi:10.1179/1079026815z.000000000410

Cited by 24 publications

(17 citation statements)

References 48 publications

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“…Indeed, individuals with SCI have been shown to internalise stigma, reporting feelings of shame and embarrassment about their physical disability and subsequent coping. 13 In comparison, the level of anonymity offered by a selfadministered measure may help reduce any discomfort experienced when revealing sensitive information regarding psychological symptoms. 12 However, there is also evidence that self-report surveys can lead to an underestimation of the true rates of mental illness among the general community, due to socially desirable responding.…”

Section: Introductionmentioning

confidence: 99%

Anxiety prevalence following spinal cord injury: a meta-analysis

Dorstyn

2016

Spinal Cord

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Study design: Meta-analysis. Objectives: Prevalence estimates indicate that anxiety following spinal cord injury (SCI) is a common problem. However, methodological differences between studies may impact the clinical interpretation of these data. Methods: Data from 18 independent studies (N participants = 3158), which reported the prevalence of an anxiety disorder or associated symptoms, were identified from the Embase, PubMed and PsycInfo databases. Proportions were the primary effect size estimate. Confidence intervals, fail-safe Ns and the I 2 statistic were additionally calculated to identify the extent to which findings were robust and consistent across studies. Results: Five per cent of participants met the criteria for either GAD or panic disorder, with Agoraphobia identified in 2.5%. These diagnostic data were, however, limited to two studies. Higher rates were noted for self-reported 'caseness' of anxiety, with 27% reporting clinically significant symptoms. Anxiety prevalence estimates varied across the individual self-report measures (range: 15-32%). Method of administration (range: 26-32%) did not impact significantly on these estimates nor did recruitment source, with similarly high anxiety levels reported by hospital (27%) and community (29%) samples. Conclusions: Early identification and treatment of anxiety are important in SCI rehabilitation, with a subgroup of individuals experiencing chronic symptoms. Further research is needed to establish guidelines for the interpretation of self-report data, including the use of clinical cutoffs.

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Section: Introductionmentioning

confidence: 99%

Anxiety prevalence following spinal cord injury: a meta-analysis

Dorstyn

2016

Spinal Cord

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“…Participants responded to items such as “I felt embarrassed about my injury” and “Because of my injury, people avoided looking at me.” Scores range from 0 to 50, where higher scores represent a greater degree of perceived stigma. The SCI QOL Stigma-SF is psychometrically reliable for the SCI population (Kisala et al, 2015).…”

Section: Methodsmentioning

confidence: 99%

“…For individuals living with spinal cord injury (SCI), perceptions of stigma are often rooted in how visually apparent the injury is (e.g., the use of wheelchair) and the degree to which a person requires assistance from others (Kisala et al, 2015). In a recent qualitative study, participants with SCI described feeling looked down upon, invisible, and uncomfortable in the presence of others (Monden et al, 2020).…”

Section: Introductionmentioning

confidence: 99%

The impact of stigma on psychosocial outcomes following spinal cord injury: A cross-sectional analysis of stigma-mediated relationships.

Monden¹,

Philippus²,

MacIntyre³

et al. 2021

Rehabilitation Psychology

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Purpose/Objective: The purpose of this study was to (a) assess the relationship between stigma and psychosocial outcomes and (b) examine the potential mediating influence of stigma on the relationship between sociodemographic and injury-related characteristics and psychosocial outcomes after spinal cord injury (SCI). Research Method/Design: This cross-sectional, observational study included participants enrolled in the Rocky Mountain Regional Spinal Cord Injury Model System. Questionnaires were administered via telephone. Stigma was assessed using the Spinal Cord Injury Quality of Life Stigma Short Form. Results: Questionnaires were completed by 225 participants (78% male; 22% female). Stigma was significantly, positively associated with depression symptoms, perceived disability, injustice appraisals, and participation (physical independence and mobility). Stigma was significantly, negatively associated with quality of life and self-efficacy. Stigma partially mediated several relationships between sociodemographic or injury-related characteristics and psychosocial outcomes. Stigma fully mediated the relationships between each time since injury and self-efficacy, length of rehabilitation stay and injustice appraisals, wheelchair use and self-efficacy, and wheelchair type and quality of life. Conclusions/Implication: Stigma is an important psychological factor associated with several person- and injury-related characteristics and psychosocial outcomes. Furthermore, stigma mediates particular relationships between sociodemographic or injury-related characteristics and outcomes. These findings will inform the development of interventions designed to mitigate stigma’s negative impact on outcomes such as mood, quality of life, and participation after SCI.

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“…Increasingly, PROMs are being administered using a tailored approach, known as computer adaptive testing (CAT). 5 , 6 CAT has been developed for use in health outcomes, 7 , 8 rehabilitation, 9 , 10 and clinical applications. 11 , 12 Adaptive item administration is attractive because it reduces respondent burden with little erosion of measurement precision.…”

Section: Introductionmentioning

confidence: 99%

Calibration and validation of an item bank for measuring general physical function of patients in medical rehabilitation settings

Cook¹,

Kallen²,

Hayes³

et al. 2017

PROM

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ObjectiveThe objective of this study was to report the item response theory (IRT) calibration of an 18-item bank to measure general physical function (GPF) in a wide range of conditions and evaluate the validity of the derived scores.MethodsAll 18 items were administered to a large sample of patients (n=2337) who responded to the items in the context of their outpatient rehabilitation care. The responses, collected 1997– 2000, were modeled using the graded response model, an IRT model appropriate for items with two or more response options. Inter-item consistency was evaluated based on Cronbach’s alpha and item to total correlations. Validity of scores was evaluated based on known-groups comparisons (age, number of health problems, symptom severity). The strength of a single, general factor was evaluated using a bi-factor model. Results were used to evaluate IRT assumption and as an indicator of construct validity. Local independence of item responses was also evaluated.ResultsResponse data met the assumptions of unidimensionality and local independence. Explained common variance of a single general factor was 0.88 (omega hierarchical =0.86). Only two of the 153 pairs of item residuals were flagged for local dependence. Inter-item consistency was high (0.93) as were item to total correlations (mean =0.61). Substantial variation was found in both IRT location (difficulty) and discrimination parameters. All omnibus known-groups comparisons were statistically significant (p<0.001).ConclusionItem responses fit the IRT unidimensionality assumptions and were internally consistent. The usefulness of GPF scores in discriminating among patients with different levels of physical function was confirmed. Future studies should evaluate the validity of GPF scores based on an adaptive administration of items.

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Measuring stigma after spinal cord injury: Development and psychometric characteristics of the SCI-QOL Stigma item bank and short form

Cited by 24 publications

References 48 publications

Anxiety prevalence following spinal cord injury: a meta-analysis

Anxiety prevalence following spinal cord injury: a meta-analysis

The impact of stigma on psychosocial outcomes following spinal cord injury: A cross-sectional analysis of stigma-mediated relationships.

Calibration and validation of an item bank for measuring general physical function of patients in medical rehabilitation settings

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