Substance use stigma: Reliability and validity of a theory-based scale for substance-using populations.
Substance use stigma: Reliability and validity of a theory-based scale for substance-using populations.
复制标题
DOI：
10.1016/j.drugalcdep.2016.02.019
复制
发表时间：
2016-05-01
影响因子：
4.2
通讯作者：
Cunningham CO
中科院分区：
文献类型：
--
作者：
Smith LR;Earnshaw VA;Copenhaver MM;Cunningham CO
药物使用障碍一直是全世界最受耻辱的疾病之一。因此，物质使用耻辱加剧了物质使用障碍患者之间的健康不平等，并且仍然是成功筛查和治疗工作的主要障碍。目前衡量药物使用耻辱的努力是有限的。本研究旨在通过利用污名理论开发和评估物质使用污名机制量表（SU-SMS）来推进测量工作。 SU-SMS 旨在捕获当前和过去患有药物使用障碍的人中已制定的、预期的和内化的药物使用耻辱机制，并区分最有可能影响该目标人群的关键耻辱源。这项研究是对 SU-SMS 的有效性、可靠性和普遍性的横断面评估，涉及两个具有不同物质使用和治疗史的独立样本。研究结果支持 SU-SMS 的结构和构建有效性，表明该量表能够将已制定的、预期的和内化的耻辱作为独特的耻辱体验来捕获。它还进一步区分了两种不同的耻辱来源（家庭和医疗保健提供者）。对这些机制和心理社会指标的分析表明，该量表还与其他健康相关的结果相关。此外，SU-SMS 在具有不同物质使用障碍和治疗史的两个独立样本中表现出高水平的内部可靠性和普遍性。 SU-SMS 可以作为一个有价值的工具，用于更好地了解物质使用耻辱破坏物质使用障碍患者的关键健康行为和结果的过程。
Substance use disorders consistently rank among the most stigmatized conditions worldwide. Thus, substance use stigma fosters health inequities among persons with substance use disorders and remains a key barrier to successful screening and treatment efforts. Current efforts to measure substance use stigma are limited. This study aims to advance measurement efforts by drawing on stigma theory to develop and evaluate the Substance Use Stigma Mechanisms Scale (SU-SMS). The SU-SMS was designed to capture enacted, anticipated, and internalized substance use stigma mechanisms among persons with current and past substance use disorders, and distinguish between key stigma sources most likely to impact this target population. This study was a cross-sectional evaluation of the validity, reliability, and generalizability of the SU-SMS across two independent samples with diverse substance use and treatment histories. Findings support the structural and construct validity of the SU-SMS, suggesting the scale was able to capture enacted, anticipated, and internalized stigma as distinct stigma experiences. It also further differentiated between two distinct stigma sources (family and healthcare providers). Analysis of these mechanisms and psychosocial metrics suggests that the scale is also associated with other health-related outcomes. Furthermore, the SU-SMS demonstrated high levels of internal reliability and generalizability across two independent samples of persons with diverse substance use disorders and treatment histories. The SU-SMS may serve as a valuable tool for better understanding the processes through which substance use stigma serves to undermine key health behaviors and outcomes among persons with substance use disorders.