Cross-cultural validation of a measure of felt stigma in people with intellectual disabilities

Abstract

Background One trade-off for increased independence of adults with intellectual disabilities in developing countries is that they may find themselves more exposed to the negative perceptions held by the general population regarding the mentally ill and disabled. The aim of this study was to adapt and translate a tool to measure felt stigma in people with intellectual disabilities designed in the United Kingdom (UK) to make it culturally viable, and to determine its reliability and validity in the multi-ethnic and multilingual context of South Africa (SA) and to compare the item responses and factor structures of the tool between the UK and SA. Methods We translated the tool into local languages and refined it by conducting focus groups and pilot studies with professionals and adults with intellectual disabilities, after which test-retest reliability, factor analysis and internal consistency were calculated. Results Participants were from three different population groups: Afrikaans (n=71; 37%), English (n=67; 35%) and Xhosa (n=53; 28%), who had mild (n=106; 56%) or moderate intellectual disabilities (n=85; 44%). 98 (51%) were re-interviewed. The resulting international version of the perceived stigma measure consisted of 10 questions with good test-retest reliability (κ ranging from 0.41 to 0.59) and a similar factor structure to the UK version, despite including a different set of questions. Conclusions There is evidence for the validity of felt stigma ratings reported by adults with intellectual disabilities, despite different cultural and health service contexts. © 2011 Blackwell Publishing Ltd.