Adaptation and Validation of the COVID-19 Stigma Instrument in Nurses:A Cross-sectional Survey

Background: Stigma is a prominent issue among nurses working with patients with infectious diseases, but the unavailability of validated measures of such stigma. The aim of our study was to adapt, modify, and validate the COVID-19 Stigma Instrument-Nurse -Version 3 (CSI-N-3) with both classical test theory and item response theory (IRT) analysis. Methods: We administered the scale to 249 eligible nurses who worked in a COVID-19 designed hospital in Shanghai, China. Results: The two-factor structure was confirmed by confirmatory factor analysis. The 15-item CSI-N-3 achieved Cronbach's α of 0.64 to 0.84. Convergent validity was also demonstrated. In IRT analysis, the CSI-N-3 has ordered response thresholds, with the appropriate item difficulty and infit and outfit mean squares. Self-reported social support was the only factor influencing nurses' COVID-19 stigma (standardized coefficients β =-0.21). Conclusions: The CSI-N-3 is an instrument with sound psychometric properties that can be used to measure COVID-19 stigma during the COVID-19 outbreak or afterward among nurses.