The design and psychometric evaluation of a COVID-19 social stigma questionnaire in nurses

Introduction: The patient’s fear of social reactions, the disease stigma, and being a transmission agent is a psychological and social consequence of contracting some diseases, especially infectious ones, in any society. This fear is an important issue that has not been paid attention to due to the heavy attack of the disease on different aspects of society. Therefore, the present study aimed to design and psychometrically evaluate a COVID-19 social stigma questionnaire in nurses. Methods: This mixed-method study was conducted using a sequential exploratory approach according to the Creswell method in Mazandaran Province (Iran) during 2021-22. The study was performed in three phases: 1) a qualitative phase to explain the key concept, 2) designing the scale items, and 3) an experimental phase with the scale psychometric evaluation. In the first phase, nurses’ experiences regarding the concept of COVID-19 social stigma were evaluated using a qualitative method with a phenomenological approach. In this phase, the lived experiences of 12 nurses working at hospitals of Babol University of Medical Sciences were extracted through in-depth interviews with semi-structured questions and analyzed by Van Manen’s method. In the second phase, the designed items of the scale were validated by determining face validity, content validity, and construct validity using exploratory factor analysis (EFA) and determining the scale’s reliability through internal consistency and stability. Results: After the study’s first phase, a pool of questions with 64 initial items was formed. After evaluating face and content validity, the number of items was reduced to 24 cases. An excellent total content validity (S-CVI/Ave) of 0.93 was calculated for the scale. The EFA indicated that three factors accounted for the most variance (52.82%), and four items were excluded in this phase. The KMO statistic and Bartlett’s test of sphericity were calculated at 0.776 and P < 0.001, respectively. The results of Cronbach’s alpha (0.796) and intraclass correlation (0.793) indicated the correlation and internal consistency of the scale. Conclusion: This scale can help healthcare managers and policymakers apply necessary protective measures by evaluating the social stigma of COVID-19 in nurses and emerging infectious diseases that may occur in the future.