Adaptation and validation of the Van Rie tuberculosis stigma scale in healthcare workers in Indonesia

Abstract

Objectives: Stigma related to tuberculosis (TB) is not limited to society and the workplace but also extends to healthcare settings. Stigma can result in delayed diagnoses, poor medication adherence, and a reduced quality of life. Currently, there is no instrument available to assess TB stigma among healthcare workers. This study aimed to adapt and validate a tuberculosis stigma scale specifically for health workers in Indonesia. Methods: This study used Exploratory Sequential Mixed Methods. Instrument development was carried out in three stages: translation, cross-cultural adaptation, and psychometric evaluation. The instrument adapted and validated in this study was the standardized Van Rie questionnaire. A total of 305 respondents from three areas such as Banyumas Regency, Yogyakarta City, and Malang City participated in this study. To assess the tool’s internal consistency and reliability, a psychometric evaluation was conducted using exploratory and confirmatory factor analyses (EFA and CFA). Results: Isolation and exclusion from medical facilities are the two categories of questions that have been identified. The results of the CFA demonstrated that the calculated chi-square value for our model was chi-square/DF = 186.713/43 = 4.3 (>3). The model was reasonably fit based on the following findings: the determining root mean square error of approximation (RMSEA) = 0.105 (>0.08), normed fit index (NFI) = 0.837 (<0.90), tucker-lewis index (TLI) = 0.832 (<0.95), and standardized root mean square residual (SRMR) = 0.080 (<0.10). The instrument was reliable with a Cronbach’s alpha of 0.829. Conclusion: This validated, consistent, and reliable adapted tool is ready to use in larger-scale evaluation of TB-related stigma among health workers in healthcare settings to develop strategies to eliminate TB-related stigma.