The Stroke Stigma Scale: a reliable and valid stigma measure in patients with stroke.

Objective: The objective of the study is to analyse the psychometric properties of the Stroke Stigma Scale, a novel scale to assess perceived stigma of patients with stroke. Design: This is a psychometric study. Setting: Neurology or rehabilitation units in three hospitals in China. Subjects: A total of 288 patients with stroke. Interventions: None. Measures: The content validity of the Stroke Stigma Scale was assessed through expert consultation. Criterion validity was evaluated based on the scale's relationships with the Stigma Scale for Chronic Illness and the Self-rating Depression Scale. Construct validity was assessed using exploratory factor analysis, and internal consistency was tested with Cronbach's alpha. Results: The final version Stroke Stigma Scale consists of 16 items. It showed strong positive correlations with both the Stigma Scale for Chronic Illness (rho = 0.89, P < 0.001) and the Self-rating Depression Scale (rho = 0.82, P < 0.001). The exploratory factor analysis revealed four components of the Stroke Stigma Scale: internalized stigma, physical impairment, discrimination experience, and social isolation, which were strongly associated with our perceived stroke stigma model. Cronbach's alpha for the total scale was 0.92, and that of each subscale was 0.77-0.86. The test-retest reliability with intra-class correlation coefficients of the total scale was 0.92 (P < 0.001), and intra-class correlation coefficients of each subscale were 0.74-0.89 (P < 0.001). Conclusions: The Stroke Stigma Scale is a reliable and valid measure of perceived stigma in patients with stroke, which may be useful in stigma prevention and stroke rehabilitation.