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Validation of the Perceived Stigmatization Questionnaire for Brazilian adult burn patients

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  • Noélle de Oliveira Freitas
  • Carlos García Forero
  • Marina Paes Caltran
  • Jordi Alonso
  • Rosana A Spadoti Dantas
  • Monica Sarto Piccolo
  • Jayme Adriano Farina Jr
  • John W Lawrence
  • Lidia A Rossi

Abstract

Currently, there is no questionnaire to assess perceived stigmatization among people with visible differences in Brazil. The Perceived Stigmatization Questionnaire (PSQ), developed in the United States, is a valid instrument to assess the perception of stigmatizing behaviours among burn survivors. The objective of this cross-sectional and multicentre study was to assess the factor structure, reliability and validity of the Brazilian Portuguese version of the PSQ in burn patients. A Brazilian version of the 21-item PSQ was answered by 240 adult burn patients, undergoing rehabilitation in two burns units in Brazil. We tested its construct validity by correlating PSQ scores with depression (Beck Depression Index-BDI) and self-esteem (Rosenberg Self-Esteem Scale-RSE), as well as with two domains of the Revised Burn Specific Health Scale—BSHS-R: affect and body image, and interpersonal relationships. We used Confirmatory Item Factor Analysis (CIFA) to test whether the data fit a measurement model involving a three-factor structure (absence of friendly behaviour; confusing/staring behaviour; and hostile behaviour). We conducted Exploratory Factor Analyses (EFA) of the subscale in a 50% random sample of individuals (training split), treating items as ordinal categorical using unweighted least squares estimation. To assess discriminant validity of the Brazilian version of the PSQ we correlated PSQ scores with known groups (sex, total body surface area burned, and visibility of the scars) and assessed its reliability by means of Cronbach's alpha and using test-retest. Goodness-of-fit indices for confirmatory factor analysis were satisfactory for the PSQ, but not for the hostile behaviour subscale, which was modified to improve fit by eliminating 3 items. Cronbach’s alphas for the PSQ refined version (PSQ-R) ranged from 0.65 to 0.88, with test-retest reliability 0.87 for the total score. The PSQ-R scores correlated strongly with depression (0.63; p

Suggested Citation

  • Noélle de Oliveira Freitas & Carlos García Forero & Marina Paes Caltran & Jordi Alonso & Rosana A Spadoti Dantas & Monica Sarto Piccolo & Jayme Adriano Farina Jr & John W Lawrence & Lidia A Rossi, 2018. "Validation of the Perceived Stigmatization Questionnaire for Brazilian adult burn patients," PLOS ONE, Public Library of Science, vol. 13(1), pages 1-15, January.
    • Handle: RePEc:plo:pone00:0190747
    DOI: 10.1371/journal.pone.0190747
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    References listed on IDEAS

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    1. Moustaki, Irini & Victoria-Feser, Maria-Pia, 2006. "Bounded-Influence Robust Estimation in Generalized Linear Latent Variable Models," Journal of the American Statistical Association, American Statistical Association, vol. 101, pages 644-653, June.
    2. Klaas Sijtsma, 2009. "On the Use, the Misuse, and the Very Limited Usefulness of Cronbach’s Alpha," Psychometrika, Springer;The Psychometric Society, vol. 74(1), pages 107-120, March.
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    1. Antonio Baldassarre & Gabriele Giorgi & Federico Alessio & Lucrezia Ginevra Lulli & Giulio Arcangeli & Nicola Mucci, 2020. "Stigma and Discrimination (SAD) at the Time of the SARS-CoV-2 Pandemic," IJERPH, MDPI, vol. 17(17), pages 1-29, August.

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