Journal of Korean Academy of Nursing

Research Paper

The Reliability and Validity of Korean Version of the Infertility Stigma Scale (K-ISS): Kim, Miok , Ban, Minkyung; J Korean Acad Nurs 2022;52(6):582-597. Published online December 31, 2022; DOI: https://doi.org/10.4040/jkan.22068

Abstract PDF: Purpose
This study aimed to translate the Infertility Stigma Scale (ISS) into Korean and to evaluate its reliability and validity in the Korean context.
Methods
Data were collected from 350 women who underwent in vitro fertilization (IVF). Data were analyzed using SPSS WIN 25.0 and AMOS 22.0. Content validity was analyzed using the item-level content validity index (I-CVI) and scale-level content validity index/averaging (S-CVI/Ave). The preliminary survey was conducted on 20 women who had experienced IVF at least once to check the level of understanding of the tool and the time required to fill out the questionnaire. Exploratory and confirmatory factor analyses were used to test construct validity. Additionally, hypothesis-testing construct validity were tested. Cronbach’s α was used to assess the reliability.
Results
The Korean-ISS (K-ISS) consists of 25 items, excluding two items from the original ISS questionnaire. Exploratory factor analysis identified four factors, which explained 75.6% of the total variance. The four distinct factors were infertility stigma with self-devaluation (56.8%), public stigma (8.1%), social withdrawal (6.5%), and family stigma (4.2%). In the confirmatory factor analysis, the 25 items in the four-factor structure were validated (χ² /df ≤ 3, RMSEA ≤ 10). The hypothesis-testing construct validity of K-ISS against FPI (r = .58∼.71, p < .001) and FQI (r = - .49∼- .65, p < .001) was tested and found to be significant. The internal consistency reliability of the K-ISS, assessed using Cronbach’s α, was .97.
Conclusion
The K-ISS has satisfactory construct validity and reliability; therefore, it can help minimize the negative impact of stigma by measuring the stigma associated with women experiencing infertility.

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Original Articles

The Effect of Human Potential Seminars on the Perceived Stigma of Adults with Epilepsy: Eun Ja Kim; Journal of Korean Academy of Nursing 1998;28(4):1003-1012. Published online March 29, 2017; DOI: https://doi.org/10.4040/jkan.1998.28.4.1003

The purpose of this research was to identify the effect of human potential seminars on the perceived stigma of adults with epilepsy. the research employed a quasi experimental design and unequivalent control group pre-post design. The test was conducted on 15 adults with epilepsy attending one psychiatric out-patient clinic in Masan City, Korea. The stigma questionnaire was used as a pre-test to these patients. HPS was done ten times for five weeks from May 6, to July 26, 1996. The stigma questionnaire was again given, but this time as a post test. The control group of 14 adults with epilepsy were receiving medication at the same clinic. The human potential seminars were structured by Mcholland(1972) and translated by Lee, Hae Seung(1990). The stigma research tool was modified and revised to be appropriate to Korean culture. It consisted of 15 sentences. The internal consistency was 0.92 with Crombach's alpha. Research results are as follows. 1) To determine the homogeneity of the experimental and control groups. the pre-stigma results were used and democratic-sociologic characteristics, job characteristics and disease related variables were compare. There was no significant difference between the two groups. 2) To identify the relationship between stigma and patient characteristics a pre-test was done. The study used both Mann-whitney U-test and ANOVA test for statistical analysis. The variables related to stigma were the reason of unemployment and age at onset of epilepsy. 3) The test results of the effect of the human potential seminars on stigma in the patients with epilepsy, showed that stigma in the experimental group was lower than in the control group. the statistical method used to determine the difference between pre and post stigma results was the Wilcoxon signed rank test. The test results were statistically significant at the one percent level. 4) As a follow-up evaluation, ten more patients(66.7% of the total) were additionally tested. In order to investigate f the stigmas were different between the pre, post and follow-up, Repeated measure ANOVA was used. The test results showed that the stigma scores were statistically different between the three groups at the one percent level(F=10.076, d.f.=2, p=0.00).

Citations

Citations to this article as recorded by

Structural Equation Modeling on Health-Related Quality of Life in Adults with Epilepsy
Jeong Ok Ko, Myung Ha Lee
Journal of Korean Academy of Nursing.2017; 47(5): 624. CrossRef

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Prediction Model for Health-Related Quality of Life in Hospitalized Patients with Pulmonary Tuberculosis: Kwang-Sim Jang, Gyeong-Suk Jeon; J Korean Acad Nurs 2017;47(1):60-70. Published online February 28, 2017; DOI: https://doi.org/10.4040/jkan.2017.47.1.60

Abstract PDF

Purpose

This study was conducted to construct and test a structural equation model of health-related quality of life (HRQoL) among hospitalized patients with pulmonary tuberculosis (PTB).

Methods

Participants were 256 patients with PTB who were 20 years or older and admitted in two national tuberculosis hospitals. The patients participated in pulmonary function testing and responded to structured questionaries.

Results

The goodness-of-fit statistics of the final hypothetical model were as follows: χ²/df=2.19, RMSEA=.07, SRMR=.05, GFI=.95, NFI=.95, CFI=.96, TLI=.92, and PCFI=.52. Symptoms and general health perception had significant direct effects, and subjective economic status, social support and stigma had significant indirect effect on HRQoL of hospitalized patients with PTB. These variables explained 64% of variance in the prediction model.

Conclusion

Findings suggest that strategies and intervention for physical symptoms and depressive symptoms are crucial to improve the quality of life in hospitalized patients with PTB. The development of various social support programs is also recommended.

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Reliability and Validity of the Korean Version of the Cancer Stigma Scale: Hyang Sook So, Myeong Jeong Chae, Hye Young Kim; J Korean Acad Nurs 2017;47(1):121-132. Published online February 28, 2017; DOI: https://doi.org/10.4040/jkan.2017.47.1.121

Abstract PDF

Purpose

In this study the reliability and validity of the Korean version of the Cancer Stigma Scale (KCSS) was evaluated.

Methods

The KCSS was formed through translation and modification of Cataldo Lung Cancer Stigma Scale. The KCSS, Psychological Symptom Inventory (PSI), and European Organization for Research and Treatment of Cancer Quality of Life Questionnaire - Core 30 (EORTC QLQ-C30) were administered to 247 men and women diagnosed with one of the five major cancers. Construct validity, item convergent and discriminant validity, concurrent validity, known-group validity, and internal consistency reliability of the KCSS were evaluated.

Results

Exploratory factor analysis supported the construct validity with a six-factor solution; that explained 65.7% of the total variance. The six-factor model was validated by confirmatory factor analysis (Q (χ²/df)= 2.28, GFI=.84, AGFI=.81, NFI=.80, TLI=.86, RMR=.03, and RMSEA=.07). Concurrent validity was demonstrated with the QLQ-C30 (global: r=-.44; functional: r=-.19; symptom: r=.42). The KCSS had known-group validity. Cronbach's alpha coefficient for the 24 items was .89.

Conclusion

The results of this study suggest that the 24-item KCSS has relatively acceptable reliability and validity and can be used in clinical research to assess cancer stigma and its impacts on health-related quality of life in Korean cancer patients.

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Development and Effects of a Cognitive-behavioral Therapy Based Program in Reducing Internalized Stigma in Patients with Schizophrenia: Mi Young Kim, Seong Sook Jun; J Korean Acad Nurs 2016;46(3):349-363. Published online June 30, 2016; DOI: https://doi.org/10.4040/jkan.2016.46.3.349

Abstract PDF

Purpose

This study was done to develop a internalized stigma reducing program based on cognitive-behavioral therapy and appropriate for patients with schizophrenia and to evaluate its effectiveness.

Methods

The study design was a mixed method research. Qualitative study, 13 patients with schizophrenia who had experience in overcoming stigma were purposively chosen for interviews and data were analyzed using Giorgi method. Quantitative study, 64 patients with schizophrenia (experimental group=32, control group=32) were recruited. The cognitive-behavioral therapy-based program for reducing internalized stigma in patients with schizophrenia was provided for 8 weeks (12 sessions). Data were collected from June. 20, 2013 to Feb. 14, 2014. Quantitative data were analyzed using χ²-test, t-test, repeated measures ANOVA with the SPSS program.

Results

Qualitative results, from the experience of coping with stigma in patients with schizophrenia seventeen themes and five themes-clusters were drawn up. Quantitative results showed that internalized stigma, self-esteem, mental health recovery and quality of life were significantly better in the experimental group compared to the control group.

Conclusion

Study findings indicate that this program for reducing internalized stigma in patients with schizophrenia is effective and can be recommended as a rehabilitation program intervention to help patients with schizophrenia to cope with internalized stigma.

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The Lived Experience of Stigma among Mentally Ill Persons: Myung Sun Hyun, Young Hee Kim, Hee Sun Kang, Kyoung A Nam; J Korean Acad Nurs 2012;42(2):226-235. Published online April 30, 2012; DOI: https://doi.org/10.4040/jkan.2012.42.2.226

Abstract PDF

Purpose

The purpose of this study was to explore the subjective experiences of stigma among mentally ill persons.

Methods

Phenomenological methodology was used for the study. Participants were twelve people with mental illness enrolled at the S community mental health center in GyeongGi-Do. Data were collected via in-depth interviews from August 30 to October 1, 2010 and analyzed using Colaizzi's framework.

Results

Four themes and sixteen formulated meanings were identified for the stigma experiences of participants with mental illness. The four themes were 'Incapable of struggling against unfair treatment', 'Living as an outsider', 'Being constrained by oneself', 'Being in suspense over disclosure of oneself'.

Conclusion

The results from this study underscore the need for an educational and awareness programs to reduce public stigma among the general population and self-stigma among people with mental illness. In addition, efforts are also needed to prioritize mental illness stigma as a major public health issue at the government and community level.

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Factors Associated with Human Papillomavirus related Stigma, Shame, and Intent of HPV Test: Hae Won Kim; J Korean Acad Nurs 2012;42(2):217-225. Published online April 30, 2012; DOI: https://doi.org/10.4040/jkan.2012.42.2.217

Abstract PDF

Purpose

This study was conducted to examine the factors associated with HPV (Human Papillomavirus) related stigma, shame and intent to have HPV test among adult women.

Methods

Data were collected from December 1, 2009 to January 31, 2010, and participants were 324 women who visited an obstetric gynecologic clinic. They anticipated testing positive for HPV. Then HPV related stigma, shame, intent to have HPV testing and HPV knowledge were measured. Descriptive statistics, Mann-Whitney U test, Kruskal Wallis test and multivariate adjusted logistic regression were used for data analysis.

Results

The levels of stigma and shame were higher than average. Intent to have HPV test was high and HPV knowledge was low. Women who answered that HPV is not sexually transmitted had lower HPV stigma than did women who answered they didn't know (OR=0.20, 95%CI 0.06-0.68). Women with lower stigma showed lower intent to have HPV test than women with higher stigma (OR=0.46, 95%CI 0.26-0.82).

Conclusion

Basic HPV information should be fully understood for women especially prior to HPV test. Normalizing HPV stigma is necessary for women who perceive HPV as sexually transmitted and women intending to have HPV test.

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