Despite the widespread international use of the Affiliate Stigma Scale in the context of disability, much research on its psychometric properties has taken dubious statistical approaches.
OBJECTIVE:
The aim of this study was to examine the psychometric properties of the Affiliate Stigma Scale in a sample of Turkish spinal cord injury/disorder (SCI/D) caregivers.
METHODS:
Participants completed the Affiliate Stigma Scale, Zarit Burden Interview, and Generalized Anxiety Disorder-7. This study conducted a series of confirmatory factor analyses (CFAs) of the Turkish Affiliate Stigma Scale using its originally theorized 3-factor structure and a 1-factor structure, as well as an exploratory factor analysis (EFA) to refine the scale items to create a short form, with a final CFA of the items in the short form.
RESULTS:
The 3-factor and 1-factor CFAs of the 22 items from the Affiliate Stigma Scale suggested poor fit to the data across every fit index. An EFA yielded four factors, although the patterns of item loading onto the factors did not map in any discernible way to the original subscales theorized by the scale creators. A 1-factor CFA with the six items loading onto factor 1 of the EFA showed much better fit indices, with most achieving good or adequate fit.
CONCLUSION:
The current study supports a 1-factor solution with a short form comprised of six items, at least in Turkish and with SCI/D caregivers.
Akan,N. (2002) Nöral tüp defektli bebek doğurma riski azaltılabilir. C Ü Hemşirelik Yüksekokulu Dergisi, 6(1), 42–48.
2.
Chang,C.-C., Su,J.-A., & Lin,C.-Y. (2016) Using the Affiliate Stigma Scale with caregivers of people with dementia: psychometric evaluation. Alzheimer’s Research & Therapy, 8(1), 1–8.
3.
Chang,C. C., Su,J. A., Tsai,C. S., Yen,C. F., Liu,J. H., & Lin,C. Y. (2015) Rasch analysis suggested three unidimensional domains for Affiliate Stigma Scale: additional psychometric evaluation. J Clin Epidemiol, 68(6), 674–683. doi: 10.1016/j.jclinepi.2015.01.018.
4.
Chapman,D. W., & Carter,J. F. (1979) Translation procedures for the cross cultural use of measurement instruments. Educational Evaluation and Policy Analysis, 1(3), 71–76.
5.
Coleman,J. A., Harper,L. A., Perrin,P. B., Olivera,S. L., Perdomo,J. L., Arango,J. A., & Arango-Lasprilla,J. C. (2013) Examining the relationship between health-related quality of life in individuals with spinal cord injury and the mental health of their caregivers in Colombia, South America. Int J Rehabil Res, 36(4), 308–31410.1097/MRR.0b013e3283634e7f.
6.
Dijkers,M. P., Yavuzer,G., Ergin,S., Weitzenkamp,D., & Whiteneck,G. G. (2002) A tale of two countries: environmental impacts on social participation after spinal cord injury. Spinal Cord, 40(7), 351–36210.1038/sj.sc.3101310.
7.
DIN,P. C. B. (2001) International classification of functioning, disability and health.
8.
Elliott,T. R., & Frank,R. G. (1996) Depression following spinal cord injury. Arch Phys Med Rehabil, 77(8), 816–82310.1016/s0003-9993(96)90263-4.
9.
Fuhrer,M. J., Rintala,D. H., Hart,K. A., Clearman,R., & Young,M. E. (1992) Relationship of life satisfaction to impairment, disability, and handicap among persons with spinal cord injury living in the community. Retrieved from, Arch Phys Med Rehabil. 73(6), 552–557https://www.ncbi.nlm.nih.gov/pubmed/1622304.
10.
Hansen,B., Szaflarski,M., Bebin,E. M., & Szaflarski,J. P. (2018) Affiliate stigma and caregiver burden in intrble epilepsy. Epilepsy Behav, 85, 1–610.1016/j.yebeh.2018.05.028acta.
11.
Karacan,I., Koyuncu,H., Pekel,O., Sumbuloglu,G., Kirnap,M., Dursun,H..,...Tekeoglu, I. (2000) Traumatic spinal cord injuries in Turkey: a nation-wide epidemiological study. Spinal Cord, 38(11), 697–70110.1038/sj.sc.3101064.
Kisala,P. A., Tulsky,D. S., Pace,N., Victorson,D., Choi,S. W., & Heinemann,A. W. (2015) Measuring stigma after spinal cord injury: Development and psychometric characteristics of the SCI-QOL Stigma item bank and short form. J Spinal Cord Med, 38(3), 386–39610.1179/1079026815Z.000000000410.
14.
Ma,G. Y., & Mak,W. W. (2016) Caregiving-specific worry, affiliate stigma, and perceived social support on psychological distress of caregivers of children with physical disability in Hong Kong. Am J Orthopsychiatry, 86(4), 436–44610.1037/ort0000171.
15.
Mak, W., Cheung, R. (2008) Affiliate stigma among caregivers of people with mental illness or intellectual disability. Journal of Applied Research in Intellectual Disabilities, 21, 532–545.
16.
Manns, P. J., Chad, K. E. (2001) Components of quality of life for persons with a quadriplegic and paraplegic spinal cord injury. Qual Health Res, 11(6), 795–81110.1177/104973201129119541.
17.
Meyers, L. S., Gamst, G., Guarino, A. J. (2016) Sage publications, Applied multivariate research: Design and interpretation.
18.
MiddletonJ., TranY., & CraigA. (2007) Relationship between quality of life and self-efficacy in persons with spinal cord injuries. Arch Phys Med Rehabil, 88(12), 1643–164810.1016/j.apmr.2007.09.001.
19.
ÖZLÜA., YILDIZM., & AKERT. (2009) Zarit BakıcıYük Ölçeğinin Şizofreni Hasta YakınlarındaGeçerlilik ve Güvenilirlik Çalışması. Archives of Neuropsychiatry/Noropsikiatri Arsivi, 46.
20.
PostM. W., BloemenJ., & De Witte L. P. (2005) Burden of support for partners of persons with spinal cord injuries. Spinal Cord, 43(5), 311–31910.1038/sj.sc.3101704.
21.
Robinson-WhelenS., & RintalaD. H. (2003) Informal care providers for veterans with SCI: who are they and how are they and how are they doing?J Rehabil Res Dev,
40(6), 511–51610.1682/jrrd.2003.11.0511.
22.
Se∖cinti E., YavuzH. M., & Sel∖cuk B. (2017) Feelings of burden among family caregivers of people with spinal cord injury in Turkey. Spinal Cord, 55(8), 782–787.
23.
SinghA., TetreaultL., Kalsi-RyanS., NouriA., & FehlingsM. G. (2014) Global prevalence and incidence of traumatic spinal cord injury. Clin Epidemiol, 6, 309–33110.2147/CLEP.S68889.
24.
SpitzerR. L., KroenkeK., WilliamsJ. B., & LoweB. (2006) A brief measure for assessing generalized anxiety disorder: the GAD-7. Arch Intern Med, 166(10), 1092–109710.1001/archinte.166.10.1092.
25.
Werner,S., & Shulman,C. (2013) Subjective well-being among family caregivers of individuals with developmental disabilities: the role of affiliate stigma and psychosocial moderating variables. Research in developmental disabilities, 34(11), 4103–4114.
26.
ZaritS. H., ReeverK. E., & Bach-PetersonJ. (1980) Relatives of the Impaired Elderly: Correlates of Feelings of Burden1. The Gerontologist, 20(6), 649–65510.1093/geront/20.6.649.
27.
ZhangY., SubramaniamM., LeeS. P., AbdinE., SagayadevanV., JeyagurunathanA., & Vaingankar J. A. (2018) Affiliate stigma and its association with quality of life among caregivers of relatives with mental illness in Singapore. Psychiatry research, 265, 55–61.
