title: The development and validation of the HIV/AIDS Stigma Instrument - Nurse (HASI-N).
abstract: Illness-related stigma remains a serious problem in the management of HIV disease in Africa. This article describes a series of study phases conducted to develop and validate an instrument to measure HIV/AIDS-related stigma as perpetrated and experienced by nurses. Data were collected in Lesotho, Malawi, South Africa, Swaziland and Tanzania, from 2004-2006. The first phase was a qualitative study with focus group participants (n=251) to gather emic and etic descriptions of HIV/AIDS-related stigma in the five countries. Based on the qualitative data, a 46-item instrument was developed and tested during a second phase in the same five countries (n=244). The result of this phase was a 33-item, three-factor instrument with an average Cronbach alpha of 0.85. A third phase tested the instrument in 1474 nurses. The result was a final 19-item instrument, the HIV/AIDS Stigma Instrument - Nurse (HASI-N), comprised of two factors (Nurses Stigmatizing Patients and Nurses Being Stigmatized) with a Cronbach alpha of 0.90. Concurrent validity was tested by comparing the level of stigma with job satisfaction and quality of life. A significant negative correlation was found between stigma and job satisfaction. The HASI-N is the first inductively derived instrument measuring stigma experienced and enacted by nurses. It has the potential to be used not only to measure stigma, but also to develop stigma-reduction interventions.
authors.affiliation: University of KwaZulu-Natal, Durban, South Africa.
authors.forename: Leana R
authors.initials: LR
authors.lastname: Uys
authors.forename: William L
authors.initials: WL
authors.lastname: Holzemer
authors.forename: Maureen L
authors.initials: ML
authors.lastname: Chirwa
authors.forename: Priscilla S
authors.initials: PS
authors.lastname: Dlamini
authors.forename: Minrie
authors.initials: M
authors.lastname: Greeff
authors.forename: Thecla W
authors.initials: TW
authors.lastname: Kohi
authors.forename: Lucia N
authors.initials: LN
authors.lastname: Makoae
authors.forename: Anita L
authors.initials: AL
authors.lastname: Stewart
authors.forename: Joseph
authors.initials: J
authors.lastname: Mullan
authors.forename: René D
authors.initials: RD
authors.lastname: Phetlhu
authors.forename: Dean J
authors.initials: DJ
authors.lastname: Wantland
authors.forename: Kevin L
authors.initials: KL
authors.lastname: Durrheim
authors.forename: Yvette P
authors.initials: YP
authors.lastname: Cuca
authors.forename: Joanne R
authors.initials: JR
authors.lastname: Naidoo
mesh_terms: D000163:Acquired Immunodeficiency Syndrome / Q000523:psychology; D000328:Adult; D000353:Africa, Southern / Q000453:epidemiology; D000368:Aged; D005260:Female; D015658:HIV Infections / Q000453:epidemiology / Q000523:psychology*; D006801:Humans; D007588:Job Satisfaction; D008297:Male; D008875:Middle Aged; D015404:Nursing Methodology Research; D036301:Qualitative Research; D011788:Quality of Life; D013240:Stereotyping; D013636:Tanzania / Q000453:epidemiology; D054928:Validation Studies as Topic; D055815:Young Adult