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

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

Background

Stigma toward mental illness significantly contributes to a lower quality of healthcare that can be provided. There are few studies on this topic in Portugal, so validating a scale that can evaluate and study the stigma is paramount. The aim of this study was to validate the Opening Minds Stigma Scale for Portuguese healthcare professionals.

Methods

A total of 503 participants were included in this study, and the majority was female (81.1%). The sample consisted mainly of psychologists (39.4%) and physicians (30.8%). Reliability and validity analyses were conducted and included exploratory factor analysis (EFA) and confirmatory factor analysis (CFA).

Results

Our results suggest that a 12-item model was the most appropriate (RMSEA = 0.026, SRMR = 0.057, CFI = 0.979, TLI = 0.973, GFI = 0.955) compared to our 15-item model and the original model. Items 8, 9 and 10 were removed. The 12-item scale's internal consistency was adequate (α = 0.71; ω = 0.72).

Conclusion

The 12-item model of the scale showed good reliability and validity and is appropriate for use with Portuguese healthcare professionals.

Psychometric assessment of the Persian adaptation of the attitudes toward seeking professional psychological help scale-short form

BACKGROUND AND PURPOSE

Mental health disorders are a growing concern worldwide, with a significant impact on public health. Understanding attitudes toward seeking professional psychological help is essential in addressing these issues. In the Iranian context, there is a need for a reliable tool to measure these attitudes. This study aims to assess the validity and reliability of the Persian Adaptation of the Attitudes Toward Seeking Professional Psychological Help Scale-Short Form (ATSPPH-SF).

MATERIALS AND METHODS

A cross-sectional study was conducted in May 2023, utilizing a convenience sampling method with 1050 participants aged 10 to 65 years in Iran.The ATSPPH-SF questionnaire, consisting of 10 items and 2 subscales, was employed. The questionnaire underwent translation and cultural adaptation, and its validity was assessed through qualitative face and content validities. Confirmatory factor analysis (CFA) was used to evaluate construct validity. Reliability was assessed using McDonald's omega coefficient and Cronbach's alpha coefficient. Data collection was conducted through an online survey.

RESULTS

The CFA results indicated a two-factor structure for the ATSPPH-SF, with one factor representing openness to seeking treatment for emotional problems and the other factor reflecting the value and need for seeking treatment. The model demonstrated acceptable fit indices. Both McDonald's omega coefficient and Cronbach's alpha coefficient suggested good internal consistency for the scale. The mean total score for the ATSPPH-SF was 21.37 (SD = 5.52), indicating the reliability and validity of the scale for the Iranian population.

CONCLUSION

This study confirms the suitability of the short-form ATSPPH-SF with 10 items and 2 subscales as a valid and reliable tool for assessing attitudes toward seeking professional psychological help in the Iranian population. With no prior appropriate instrument available, this scale fills a crucial gap. It can be employed to measure attitudes among various demographic groups, aiding in the design of targeted interventions to enhance mental health literacy and reduce the stigma associated with seeking professional psychological help in Iran.

Psychometric properties of the Mexican version of the opening minds stigma scale for health care providers (OMS-HC)

Background

Healthcare providers are one of the main groups that contribute to the stigmatization of people with mental disorders. Apathy, accusation, fatalism, and morbid curiosity are the most common forms of stigmatization encountered, and these are associated with inadequate treatment, reduced treatment adherence, decreased help-seeking behavior, an increased risk of relapse, and complications with other medical conditions. The aim of this study was to examine the psychometric properties of an adapted Spanish version of the Opening Minds Stigma Scale (OMS-HC) for healthcare providers in Mexico and identify certain stigmatizing attitudes within this group.

Methods

An ex-post facto cross-sectional observational study was conducted with 556 healthcare providers in Mexico, with an average age of 29.7 years, who were mostly women (80.4%). Validity was examined through confirmatory factor analysis. Differences according to gender, discipline, occupation, and educational level were analyzed using multivariate methods.

Results

The factor structure of the OMS-HC, consisting of three subscales identified by the original authors of the instrument (attitudes of healthcare providers towards people with mental illness, secrecy/help-seeking, and social distance), was confirmed. The model demonstrated good fit (x2/df = 2.36, RMSEA = 0.050, CFI = 0.970, TLI = 0.962, SRMR = 0.054, NFI = 0.950, PNFI = 0.742). Internal consistency was found to be adequate (α = 0.73, ω = 0.76) for the scale itself and slightly lower than acceptable for the subscales. Significant differences were found by discipline, educational level, and, for student providers, by academic semester. Higher scores were observed on the OMS-HC scale among nursing and medical professionals, undergraduate students, and those in early semesters.

Conclusions

The Spanish version of the OMS-HC has demonstrated adequate psychometric properties and could be a useful tool to facilitate research on this topic in Mexico, and to carry out comparative studies with healthcare personnel in other Spanish-speaking countries.

Psychometric validation of the Reported and Intended Behaviour Scale (RIBS) in Hungary with a particular focus on 'Don't know' responses and further scoring recommendations

AIMS

Reported and Intended Behaviour Scale (RIBS) was designed to measure mental health stigma-related behaviors in the general public. We aimed to examine its psychometric properties and validate the scale in a Hungarian non-clinical community sample. The secondary aim of this study was to assess the appropriateness of the current scoring recommendations of 'Don't know' responses being coded as neutral, which had never been investigated before. In addition, we provide an overview of the results of already existing studies on the scale.

METHODS

Hungarian participants completed the RIBS within this cross-sectional online survey study and were considered non-clinical individuals based on a cut-off point of the Global Severity Index T score of 63 on the Symptom Checklist-90-Revised. Confirmatory factor analysis, reliability measures, and comparative analyses were performed.

RESULTS

Of the n = 5,701, n = 5,141 participants were included in the analysis. The mean age was 27.8 ± 11.1 years, and 89.2% (n = 4,587) of the sample were female. The unidimensional structure was supported by good model fit indices (RMSEA = 0.031, CFI = 0.999, TLI = 0.996, and WRMR = 0.006). Internal consistency of the RIBS and its test-retest reliability with a 5-month follow-up period were found to be good (Cronbach's alpha = 0.88 and ICC = 0.838). We found statistically significant differences between the total scores when the 'Don't know' responders were excluded from the sample or when they were coded as neutral as recommended by the scale authors (16 (IQR:13-18) vs. 15 (IQR:13-18) p < 0.0001). There were also statistically significant differences between 'Neither agree nor disagree' and 'Don't know' participants in several aspects of lived experiences of mental health problems.

CONCLUSIONS

The RIBS demonstrated good psychometric properties and can be transferred to the Hungarian context. It will be a valuable tool in assessing stigmatizing behavior and testing the efficacy of antistigma programs. Our results suggest that 'Neither agree nor disagree' and 'Don't know' responses bear different meanings, and coding should account for this.

Psychometric properties of the Opening Minds Stigma Scale for Health Care Providers in 32 European countries - A bifactor ESEM representation

Aims

To measure the stigma of healthcare providers toward people suffering from mental illness, the Opening Minds Stigma Scale for Health Care Providers (OMS-HC) is a commonly applied instrument. However, this scale has not been thoroughly validated in many European countries, its psychometric properties are still unknown and data on practicing psychiatrists is lacking. Therefore, this multicenter study aimed to assess the psychometric characteristics of the 15-item OMS-HC in trainees and specialists in adult and child psychiatry in 32 countries across Europe.

Materials and methods

The OMS-HC was conducted as an anonymous online survey and sent via Email to European adult and child psychiatrists. Parallel analysis was used to estimate the number of OMS-HC dimensions. Separate for each country, the bifactor ESEM, a bifactor exploratory structural equation modeling approach, was applied to investigate the factor structure of the scale. Cross-cultural validation was done based on multigroup confirmatory factor analyses and reliability measures.

Results

A total of 4,245 practitioners were included, 2,826 (67%) female, 1,389 (33%) male. The majority (66%) of participants were specialists, with 78% working in adult psychiatry. When country data were analyzed separately, the bifactor model (higher-order factor solution with a general factor and three specific factors) showed the best model fit (for the total sample χ²/df = 9.760, RMSEA = 0.045 (0.042-0.049), CFI = 0.981; TLI = 0.960, WRMR = 1.200). The average proportion of variance explained by the general factor was high (ECV = 0.682). This suggests that the aspects of 'attitude,' 'disclosure and help-seeking,' and 'social distance' could be treated as a single dimension of stigma. Among the specific factors, the 'disclosure and help-seeking' factor explained a considerable unique proportion of variance in the observed scores.

Conclusion

This international study has led to cross-cultural analysis of the OMS-HC on a large sample of practicing psychiatrists. The bifactor structure displayed the best overall model fit in each country. Rather than using the subscales, we recommend the total score to quantify the overall stigmatizing attitudes. Further studies are required to strengthen our findings in countries where the proposed model was found to be weak.

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

Stigma towards people with mental illness is also present among health professionals. The study validated and estimated the reliability, dimensionality and structure of the Opening Minds Stigma Scale for Health Care Providers (OMS-HC) scale in Brazil. In this methodological study, health professionals (n = 199) from Family Health Units in Brazil were recruited by convenience sampling. The EFA conducted with 16 items resulted in four factors. The Cronbach's Alpha for the OMS scale was 0.74, which is considered to reflect reasonable reliability. The data presented contribute to the use of the scale in studies that investigate the level of stigma among health professionals towards people with mental illness, as well as in the development of anti-stigma interventions in this context.

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

Background

Healthcare professionals can be a source of stigma and discrimination for people with mental illness, and anti-stigma programs are needed for this target group. However, there is no validated German language scale to assess attitudes of healthcare professionals towards people with mental illness. This study had the aim to validate the German language version of the Opening Minds Stigma Scale for Health Care Providers (OMS-HC), a self-report measure of stigmatizing attitudes.

Methods

Staff (n=392) on general psychiatric inpatient wards (excluding child, forensic and geriatric psychiatry) at five psychiatric hospitals in Switzerland (n=3) and Germany (n=2) participated in the study. The internal consistency of the OMS-HC was examined as well as its factor structure using exploratory and confirmatory factor analyses. To assess the scales concurrent validity, we used the Social Distance Scale.

Results

Internal consistency for the OMS-HC total score was good (=0.74), acceptable for the subscales Attitudes (=0.62) and Social Distance (=0.69), and poor for the Disclosure subscale (=0.55). The original three-factor structure fit our data well. The OMS-HC total score and the Social Distance subscale score were significantly correlated with the Social Distance Scale, supporting concurrent validity.

Conclusion

The German version of the OMS-HC demonstrated satisfactory psychometric properties and can be recommended for future research and intervention evaluation.

Supplementary Information

The online version contains supplementary material available at 10.1186/s40359-021-00592-9.