Factor structure, internal reliability and construct validity of the Methadone Maintenance Treatment Stigma Mechanisms Scale (MMT-SMS).
Factor structure, internal reliability and construct validity of the Methadone Maintenance Treatment Stigma Mechanisms Scale (MMT-SMS).
复制标题
美沙酮维持治疗耻辱机制量表 (MMT-SMS) 的因素结构、内部信度和结构效度。
DOI：
10.1111/add.14799
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发表时间：
2020
期刊：
影响因子：
--
通讯作者：
Earnshaw,ValerieA
中科院分区：
文献类型：
--
作者：
Smith,LaramieR;Mittal,MariaLuisa;Wagner,Karla;Copenhaver,MichaelM;Cunningham,ChinazoO;Earnshaw,ValerieA
美沙酮维持治疗（MMT）的耻辱感可能是阿片类药物使用障碍患者使用这种治疗的障碍。我们评估了基于理论的污名测量的因素结构、内部信度、结构和效标效度，美沙酮维持治疗污名机制量表（MMT‐SMS），并与物质使用污名机制量表（SU‐SMS）进行比较设计在前瞻性研究开始和结束时进行调查，并记录研究期间的药物使用和治疗出勤情况。93名接受MMT的参与者;平均每日美沙酮剂量为84.8 mg/天（标准差= 28.39 mg/天）。测量MMT-SMS使用自我报告问卷评估三个维度，反映与接受MMT特别相关的预期（9项），实施（9项）和内化耻辱（7项）的经验。预期和制定的规模包括三个耻辱源分量表（家庭，雇主，卫生保健工作者;三个项目）。在5分制李克特量表上记录反应，然后取平均值以产生MMT-SMS量表/子量表评分。SU-SMS是一种自我报告问卷，用于评估有关物质使用史的预期，制定和内化耻辱的经验。两个量表均在最终母研究访视时进行。在母研究中评估了纳入的其他指标，并用于评估终生和近期MMT（例如当前MMT剂量）和药物使用经验（例如过去30天的海洛因注射）。验证性因素分析支持七因素量表结构，区分预期、实施和内化污名的经历，以及预期和实施污名源分量表（家庭、雇主、医护人员）[近似均方根误差（RMSEA）= 0.076，90%可信区间（CI）= 0.061- 0.090，P-close = 0.003;验证性拟合指数（CFI）= 0.974; Tucker-Lewis指数（TLI）= 0.971]。结构效度有助于区分MMT-SMS与已建立的物质使用污名结构。标准效度观察协会与物质使用的经验，而MMT，可能预测未来MMT的成功。内在的MMT耻辱感与每日MMT剂量唯一相关。关于标准有效性：预期的MMT和制定的物质使用耻辱与过去30天的海洛因注射相关，MMT耻辱与接受MMT时的阿片类药物使用行为唯一相关，结论美沙酮维持治疗污名机制量表似乎是一个可靠的措施美沙酮维持治疗污名与强大的效度在一个样本的人与阿片类药物使用障碍接受美沙酮维持治疗
Background and aimExperience of stigma towards methadone maintenance treatment (MMT) may be a barrier to the use of this treatment by people with opioid use disorder. We evaluated the factor structure, internal reliability, construct and criterion validity of a theory‐based stigma measure, the Methadone Maintenance Treatment Stigma Mechanisms Scale (MMT‐SMS) and compared this with the Substance Use Stigma Mechanism Scale (SU‐SMS).DesignSurveys at the beginning and end of a prospective study together with records of drug use and treatment attendance during that study.SettingCommunity methadone clinic in the Northeastern USA.ParticipantsNinety‐three participants who were receiving MMT; the average daily methadone dose was 84.8 mg/day (standard deviation = 28.39 mg/day).MeasurementsThe MMT‐SMS uses a self‐report questionnaire to assess three dimensions reflecting experiences of anticipated (nine items), enacted (nine items) and internalized stigma (seven items) specifically related to receiving MMT. Anticipated and enacted scales include three stigma source subscales (family, employers, health care workers; three items each). Responses are recorded on a five‐point Likert‐type scale, then averaged to produce the MMT‐SMS scale/subscale scores. The SU‐SMS is a self‐report questionnaire to assess experiences of anticipated, enacted and internalized stigma regarding substance use history. Both scales were administered at the final parent study visit. Other measures included were assessed in the parent study and used to assess life‐time and recent MMT (e.g. current MMT dose) and drug use experiences (e.g. past 30‐day heroin injection).FindingsThe MMT‐SMS demonstrated good internal reliability (α = 0.806–0.952 for components). Confirmatory factor analysis supported the seven‐factor scale structure, distinguishing between experiences of anticipated, enacted and internalized stigma, and anticipated and enacted stigma source subscales (family, employers, health care workers) [root mean square error of approximation (RMSEA) = 0.076, 90% confidence interval (CI) = 0.061–0.090,P‐close = 0.003; confirmatory fit index (CFI) = 0.974; Tucker–Lewis index (TLI) = 0.971]. Construct validity helped to distinguish the MMT‐SMS from established substance use stigma constructs. Criterion validity observed associations with substance use experiences while on MMT, likely to predict future MMT success. Internalized MMT stigma was uniquely associated with daily MMT dose. Regarding criterion validity: anticipated MMT and enacted substance use stigma were associated with past 30‐day heroin injection, MMT stigma uniquely associated with opioid use behaviors while receiving MMT, and substance use stigma broadly associated with injection‐related behaviors.ConclusionsThe Methadone Maintenance Treatment Stigma Mechanisms Scale appears to be a reliable measure of methadone maintenance treatment stigma with robust validity in a sample of people with opioid use disorders receiving methadone maintenance treatment.
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