Adaptation and Validation of an Instrument for Measuring Stigma towards Mental Health Problems in Children among Health Professionals
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Abstract
Introduction. One of the main barriers to receiving care faced by children and adolescents is stigma.
Objective. Evaluate the reliability and construct validity of the Health Personnel Questionnaire and determine the efficiency indicators of the clinical vignettes comprising it. Method. The Health Personnel Questionnaire (HPQ), a self-administered instrument with 20 clinical vignettes and 37 items, was administered to a sample of 2,477 health professionals, evaluating knowledge, prejudice and discriminatory intent as components of stigma. Efficiency values were calculated for the clinical vignettes provided, using assessments by child psychiatrists as the gold standard. An internal consistency analysis was conducted for construct validity. The sample was randomly divided into two groups, with exploratory factor analysis (EFA) being conducted with the first group (n=1250), and confirmatory factor analysis (CFA) with the second (n=1227).
Results. The efficiency of the clinical vignettes obtained an overall agreement rate among child psychiatrists of 97%. Exploratory factor analysis identified six dimensions related to prejudice and one related to discriminatory intent. In the confirmatory factor analysis, factors behaved in the same way with factor loadings for the items and similar alphas.
Discussion and conclusion. Research on stigma towards children’s mental health by health personnel is scant, partly due to the lack of valid, reliable instruments. The Health Personnel Questionnaire effectively explored attitude problems (prejudice) and discriminatory intent as aspects of stigma towards mental illness in children and adolescents. The analysis of these components among health professionals has significant implications for the mental health care of children and adolescents.
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