Skip to main content
Top
Published in: Health and Quality of Life Outcomes 1/2018

Open Access 01-12-2018 | Research

Validation of two scales for measuring participation and perceived stigma in Chinese community-based rehabilitation programs

Authors: Eva Yin-han Chung, Gigi Lam

Published in: Health and Quality of Life Outcomes | Issue 1/2018

Login to get access

Abstract

Background

The World Health Organization has asserted the importance of enhancing participation of people with disabilities within the International Classification of Functioning, Disability and Health framework. Participation is regarded as a vital outcome in community-based rehabilitation. The actualization of the right to participate is limited by social stigma and discrimination. To date, there is no validated instrument for use in Chinese communities to measure participation restriction or self-perceived stigma. This study aimed to translate and validate the Participation Scale and the Explanatory Model Interview Catalogue (EMIC) Stigma Scale for use in Chinese communities with people with physical disabilities.

Methods

The Chinese versions of the Participation Scale and the EMIC stigma scale were administered to 264 adults with physical disabilities. The two scales were examined separately. The reliability analysis was studied in conjunction with the construct validity. Reliability analysis was conducted to assess the internal consistency and item-total correlation. Exploratory factor analysis was conducted to investigate the latent patterns of relationships among variables. A Rasch model analysis was conducted to test the dimensionality, internal validity, item hierarchy, and scoring category structure of the two scales.

Results

Both the Participation Scale and the EMIC stigma scale were confirmed to have good internal consistency and high item-total correlation. Exploratory factor analysis revealed the factor structure of the two scales, which demonstrated the fitting of a pattern of variables within the studied construct. The Participation Scale was found to be multidimensional, whereas the EMIC stigma scale was confirmed to be unidimensional. The item hierarchies of the Participation Scale and the EMIC stigma scale were discussed and were regarded as compatible with the cultural characteristics of Chinese communities.

Conclusion

The Chinese versions of the Participation Scale and the EMIC stigma scale were thoroughly tested in this study to demonstrate their robustness and feasibility in measuring the participation restriction and perceived stigma of people with physical disabilities in Chinese communities. This is crucial as it provides valid measurements to enable comprehensive understanding and assessment of the participation and stigma among people with physical disabilities in Chinese communities.
Literature
1.
go back to reference Aziz AA. Rasch model fundamentals: scale construct and measurement structure. Kuala Lumpur: Perpustakaan Negara Malaysia; 2010. Aziz AA. Rasch model fundamentals: scale construct and measurement structure. Kuala Lumpur: Perpustakaan Negara Malaysia; 2010.
2.
go back to reference Bedford O, Hwang K. Guilt and shame in chinese culture: a cross-cultural framework from the perspective of morality and identity. J Theory Soc Behav. 2003;33(2):127–44.CrossRef Bedford O, Hwang K. Guilt and shame in chinese culture: a cross-cultural framework from the perspective of morality and identity. J Theory Soc Behav. 2003;33(2):127–44.CrossRef
3.
go back to reference Bond, T., & Fox, C. M. (2015). Applying the rasch model: Fundamental measurement in the human sciences Routledge. Bond, T., & Fox, C. M. (2015). Applying the rasch model: Fundamental measurement in the human sciences Routledge.
4.
go back to reference Chan HH, Wong ET, Yeung CK. Psychosocial perception of adults with onychomycosis: a blinded, controlled comparison of 1,017 adult Hong Kong residents with or without onychomycosis. BioPsychoSocial Med. 2014;8(1):15.CrossRef Chan HH, Wong ET, Yeung CK. Psychosocial perception of adults with onychomycosis: a blinded, controlled comparison of 1,017 adult Hong Kong residents with or without onychomycosis. BioPsychoSocial Med. 2014;8(1):15.CrossRef
6.
go back to reference Cohen, J. (1988). Lawrence Earlbaum Associates. Hillsdale, 20–26. Cohen, J. (1988). Lawrence Earlbaum Associates. Hillsdale, 20–26.
7.
go back to reference Costello AB, Osborne JW. Best practices in exploratory factor analysis: four recommendations for getting the most from your analysis. Pract Assess Res Eval. 2005;10(7):1–9. Costello AB, Osborne JW. Best practices in exploratory factor analysis: four recommendations for getting the most from your analysis. Pract Assess Res Eval. 2005;10(7):1–9.
8.
go back to reference Daniels MJ, Rodgers EBD, Wiggins BP. “Travel tales”: an interpretive analysis of constraints and negotiations to pleasure travel as experienced by persons with physical disabilities. Tour Manag. 2005;26(6):919–30.CrossRef Daniels MJ, Rodgers EBD, Wiggins BP. “Travel tales”: an interpretive analysis of constraints and negotiations to pleasure travel as experienced by persons with physical disabilities. Tour Manag. 2005;26(6):919–30.CrossRef
9.
go back to reference Deepak S, Sharma M. A participatory evaluation of community-based rehabilitation programme in north Central Vietnam. Disabil Rehabil. 2001;23(8):352–8.CrossRefPubMed Deepak S, Sharma M. A participatory evaluation of community-based rehabilitation programme in north Central Vietnam. Disabil Rehabil. 2001;23(8):352–8.CrossRefPubMed
10.
go back to reference Fabrigar LR, Wegener DT, MacCallum RC, Strahan EJ. Evaluating the use of exploratory factor analysis in psychological research. Psychol Methods. 1999;4(3):272.CrossRef Fabrigar LR, Wegener DT, MacCallum RC, Strahan EJ. Evaluating the use of exploratory factor analysis in psychological research. Psychol Methods. 1999;4(3):272.CrossRef
11.
go back to reference Field A. Discovering statistics using IBM SPSS statistics: London: Sage; 2013. Field A. Discovering statistics using IBM SPSS statistics: London: Sage; 2013.
12.
go back to reference Franchignoni F, Giordano A, Sartorio F, Vercelli S, Pascariello B, Ferriero G. Suggestions for refinement of the disabilities of the arm, shoulder and hand outcome measure (DASH): a factor analysis and rasch validation study. Arch Phys Med Rehabil. 2010;91(9):1370–7.CrossRefPubMed Franchignoni F, Giordano A, Sartorio F, Vercelli S, Pascariello B, Ferriero G. Suggestions for refinement of the disabilities of the arm, shoulder and hand outcome measure (DASH): a factor analysis and rasch validation study. Arch Phys Med Rehabil. 2010;91(9):1370–7.CrossRefPubMed
13.
go back to reference Furr M. Scale construction and psychometrics for social and personality psychology. London: SAGE Publications Ltd; 2011. Furr M. Scale construction and psychometrics for social and personality psychology. London: SAGE Publications Ltd; 2011.
14.
go back to reference Glass TA, De L, Mendes CF, Bassuk SS, Berkman LF. Social engagement and depressive symptoms in late life: longitudinal findings. J Aging Health. 2006;18(4):604–28.CrossRefPubMed Glass TA, De L, Mendes CF, Bassuk SS, Berkman LF. Social engagement and depressive symptoms in late life: longitudinal findings. J Aging Health. 2006;18(4):604–28.CrossRefPubMed
15.
go back to reference Goffman E. Stigma: notes on the management of spoiled identity. New York: Simon and Schuster; 2009. Goffman E. Stigma: notes on the management of spoiled identity. New York: Simon and Schuster; 2009.
16.
go back to reference Imms C, Adair B, Keen D, Ullenhag A, Rosenbaum P, Granlund M. ‘Participation’: a systematic review of language, definitions, and constructs used in intervention research with children with disabilities. Dev Med Child Neurol. 2016;58(1):29–38.CrossRefPubMed Imms C, Adair B, Keen D, Ullenhag A, Rosenbaum P, Granlund M. ‘Participation’: a systematic review of language, definitions, and constructs used in intervention research with children with disabilities. Dev Med Child Neurol. 2016;58(1):29–38.CrossRefPubMed
17.
go back to reference International Federation of Anti-Leprosy Association. (2011). Guidelines to reduce stigma. Retrieved from file:///C:/users/chunge/downloads/ilep-stigma-guidelines-2-how-to-assess-health-related-stigma.Pdf. International Federation of Anti-Leprosy Association. (2011). Guidelines to reduce stigma. Retrieved from file:///C:/users/chunge/downloads/ilep-stigma-guidelines-2-how-to-assess-health-related-stigma.Pdf.
18.
go back to reference Ismail R, Noh M. A tale of two construct validation analysis: Rasch model and exploratory factor analysis approach for three-factor eating questionnaire (TFEQ-R21) among malaysian male workers. Med J Malaysia. 2015;70(3):169–76. Ismail R, Noh M. A tale of two construct validation analysis: Rasch model and exploratory factor analysis approach for three-factor eating questionnaire (TFEQ-R21) among malaysian male workers. Med J Malaysia. 2015;70(3):169–76.
19.
go back to reference Kleinman A. Patients and healers in the context of culture: An exploration of the borderland between anthropology, medicine, and psychiatry. Berkeley: Univ of California Press; 1980. Kleinman A. Patients and healers in the context of culture: An exploration of the borderland between anthropology, medicine, and psychiatry. Berkeley: Univ of California Press; 1980.
20.
go back to reference Koo L. A journey into the cultural aspects of health and ill-health in chinese society in Hong Kong: the importance of health and preventive medicine in chinese society. J Comm Dent Health. 1989;11:51–8. Koo L. A journey into the cultural aspects of health and ill-health in chinese society in Hong Kong: the importance of health and preventive medicine in chinese society. J Comm Dent Health. 1989;11:51–8.
21.
go back to reference Lebel S, Castonguay M, Mackness G, Irish J, Bezjak A, Devins GM. The psychosocial impact of stigma in people with head and neck or lung cancer. Psycho-Oncology. 2013;22(1):140–52.CrossRefPubMed Lebel S, Castonguay M, Mackness G, Irish J, Bezjak A, Devins GM. The psychosocial impact of stigma in people with head and neck or lung cancer. Psycho-Oncology. 2013;22(1):140–52.CrossRefPubMed
22.
go back to reference Lim K, Tan C. Epilepsy stigma in asia: the meaning and impact of stigma. Neurol Asia. 2014;19(1):1–10. Lim K, Tan C. Epilepsy stigma in asia: the meaning and impact of stigma. Neurol Asia. 2014;19(1):1–10.
24.
go back to reference Mauro V, Biggeri M, Grilli L. Does community-based rehabilitation enhance the multidimensional well-being of deprived persons with disabilities? A multilevel impact evaluation. World Dev. 2015;76:190–202.CrossRef Mauro V, Biggeri M, Grilli L. Does community-based rehabilitation enhance the multidimensional well-being of deprived persons with disabilities? A multilevel impact evaluation. World Dev. 2015;76:190–202.CrossRef
25.
go back to reference Montesinos AH, Rapp M, Temur-Erman S, Heinz A, Hegerl U, Schouler-Ocak M. The influence of stigma on depression, overall psychological distress, and somatization among female turkish migrants. Eur Psychiatry. 2012;27:S22–6.CrossRef Montesinos AH, Rapp M, Temur-Erman S, Heinz A, Hegerl U, Schouler-Ocak M. The influence of stigma on depression, overall psychological distress, and somatization among female turkish migrants. Eur Psychiatry. 2012;27:S22–6.CrossRef
26.
go back to reference Peters RM, Van Brakel WH, Zweekhorst MB, Damayanti R, Bunders JF. The cultural validation of two scales to assess social stigma in leprosy. PLoS Negl Trop Dis. 2014;8(11):e3274.CrossRefPubMedPubMedCentral Peters RM, Van Brakel WH, Zweekhorst MB, Damayanti R, Bunders JF. The cultural validation of two scales to assess social stigma in leprosy. PLoS Negl Trop Dis. 2014;8(11):e3274.CrossRefPubMedPubMedCentral
27.
go back to reference Pike KL. Language in relation to a unified theory of the structure of human behavior. Walter de Gruyter GmbH & co KG; 1967. Pike KL. Language in relation to a unified theory of the structure of human behavior. Walter de Gruyter GmbH & co KG; 1967.
28.
go back to reference Portney LG, Watkins MP. Foundations of clinical research: Applications to practice. NJ: Prentice Hall Upper Saddle River; 2000. Portney LG, Watkins MP. Foundations of clinical research: Applications to practice. NJ: Prentice Hall Upper Saddle River; 2000.
29.
go back to reference Radomski MV, Latham CAT. Occupational therapy for physical dysfunction. Philadelphia: Lippincott Williams & Wilkins; 2008. Radomski MV, Latham CAT. Occupational therapy for physical dysfunction. Philadelphia: Lippincott Williams & Wilkins; 2008.
30.
go back to reference Rensen C, Bandyopadhyay S, Gopal PK, Van Brakel WH. Measuring leprosy-related stigma–a pilot study to validate a toolkit of instruments. Disabil Rehabil. 2011;33(9):711–9.CrossRefPubMed Rensen C, Bandyopadhyay S, Gopal PK, Van Brakel WH. Measuring leprosy-related stigma–a pilot study to validate a toolkit of instruments. Disabil Rehabil. 2011;33(9):711–9.CrossRefPubMed
31.
go back to reference Schumacker R, Linacre J. Factor analysis and rasch analysis. Rasch Meas Trans. 1996;9(4):470. Schumacker R, Linacre J. Factor analysis and rasch analysis. Rasch Meas Trans. 1996;9(4):470.
32.
go back to reference Stevelink S, Hoekstra T, Nardi S, van der Zee C, Banstola N, Premkumar R, van Brakel W. Development and structural validation of a shortened version of the participation scale. Disabil Rehabil. 2012;34(19):1596–607.CrossRefPubMed Stevelink S, Hoekstra T, Nardi S, van der Zee C, Banstola N, Premkumar R, van Brakel W. Development and structural validation of a shortened version of the participation scale. Disabil Rehabil. 2012;34(19):1596–607.CrossRefPubMed
33.
go back to reference Tam S, Chan MH, Lam HW, Lam LH. Comparing the self-concepts of Hong Kong chinese adults with visible and not visible physical disability. J Psychol. 2003;137(4):363–72.CrossRefPubMed Tam S, Chan MH, Lam HW, Lam LH. Comparing the self-concepts of Hong Kong chinese adults with visible and not visible physical disability. J Psychol. 2003;137(4):363–72.CrossRefPubMed
34.
go back to reference Tsang HW, Tam PK, Chan F, Cheung W. Stigmatizing attitudes towards individuals with mental illness in Hong Kong: implications for their recovery. J Commun Psychol. 2003;31(4):383–96.CrossRef Tsang HW, Tam PK, Chan F, Cheung W. Stigmatizing attitudes towards individuals with mental illness in Hong Kong: implications for their recovery. J Commun Psychol. 2003;31(4):383–96.CrossRef
35.
go back to reference Rockville MD. Mental health: A report of the Surgeon General. US Department of Health and Human Services; 1999. Rockville MD. Mental health: A report of the Surgeon General. US Department of Health and Human Services; 1999.
36.
go back to reference Van Brakel WH, Anderson AM, Mutatkar R, Bakirtzief Z, Nicholls PG, Raju M, Das-Pattanayak RK. The participation scale: measuring a key concept in public health. Disabil Rehabil. 2006;28(4):193–203.CrossRefPubMed Van Brakel WH, Anderson AM, Mutatkar R, Bakirtzief Z, Nicholls PG, Raju M, Das-Pattanayak RK. The participation scale: measuring a key concept in public health. Disabil Rehabil. 2006;28(4):193–203.CrossRefPubMed
37.
go back to reference Van Brakel, W. H., Sihombing, B., Djarir, H., Beise, K., Kusumawardhani, L., Yulihane, R.,. .. Wilder-Smith, A. (2012). Disability in people affected by leprosy: the role of impairment, activity, social participation, stigma and discrimination. Glob Health Action, 5(1), 18394.CrossRef Van Brakel, W. H., Sihombing, B., Djarir, H., Beise, K., Kusumawardhani, L., Yulihane, R.,. .. Wilder-Smith, A. (2012). Disability in people affected by leprosy: the role of impairment, activity, social participation, stigma and discrimination. Glob Health Action, 5(1), 18394.CrossRef
38.
go back to reference Van de Velde D, Bracke P, Van Hove G, Josephsson S, Vanderstraeten G. Perceived participation, experiences from persons with spinal cord injury in their transition period from hospital to home. Int J Rehabil Res. 2010;33(4):346–55.CrossRef Van de Velde D, Bracke P, Van Hove G, Josephsson S, Vanderstraeten G. Perceived participation, experiences from persons with spinal cord injury in their transition period from hospital to home. Int J Rehabil Res. 2010;33(4):346–55.CrossRef
39.
go back to reference WHO, I., & UNESCO, I. (2010). Community-based rehabilitation: CBR guidelines. WHO, I., & UNESCO, I. (2010). Community-based rehabilitation: CBR guidelines.
40.
go back to reference World Health Organization. International classification of functioning, disability and health: ICF. Geneva: World Health Organization; 2001. World Health Organization. International classification of functioning, disability and health: ICF. Geneva: World Health Organization; 2001.
Metadata
Title
Validation of two scales for measuring participation and perceived stigma in Chinese community-based rehabilitation programs
Authors
Eva Yin-han Chung
Gigi Lam
Publication date
01-12-2018
Publisher
BioMed Central
Published in
Health and Quality of Life Outcomes / Issue 1/2018
Electronic ISSN: 1477-7525
DOI
https://doi.org/10.1186/s12955-018-0938-3

Other articles of this Issue 1/2018

Health and Quality of Life Outcomes 1/2018 Go to the issue