Factors associated with perceived stigma of epilepsy in Croatia: a study using the revised Epilepsy Stigma Scale.
OBJECTIVE
It is believed that a large number of factors influence feelings of stigma, but their relative contribution is not yet entirely clear. Most studies to date were conducted using the Epilepsy Stigma Scale (ESS); only one used a revised version of the ESS (rESS). The following study aims to determine factors contributing to epilepsy stigma in outpatients with chronic epilepsy in Croatia, and to analyze some psychometric properties of the Croatian translation of the rESS.


METHODS
Alongside standard testing for validity of the scale, a simulation model of the original ESS (smESS) was created. This model, which does not include a grading Likert 0-3 scale, was compared with the rESS.


RESULTS
In total, 159 out of 298 subjects (53%) reported feeling stigmatised, with 136 (45%) mild to moderately and 23 (8%) highly. Internal consistency of the Croatian translation of the rESS was 0.887. Feelings of stigma were significantly associated with age ≤ 50 years, younger age of epilepsy onset, more than 50 seizures to date, generalized tonic-clonic seizures, and a shorter seizure-free period. Multiple stepwise regression showed number of seizures to date as a significant variable (Beta=0.246). By adapting data into the smESS significant associations with younger age and age of epilepsy onset were lost. Internal consistency of the smESS was 0.849.


CONCLUSIONS
The Croatian translation of the rESS has been proved to be a suitable instrument for diagnosing epilepsy stigma. The results of our model point to the possibility that the rESS might be more sensitive than the original ESS.
Department of Neurology, Sveti Duh University Hospital, Zagreb, Croatia. Electronic address: ibielen@kbsd.hr.
Ivan
I
Bielen
Department of Neurology, Sveti Duh University Hospital, Zagreb, Croatia.
Latica
L
Friedrich
Department of Neurology, Sveti Duh University Hospital, Zagreb, Croatia.
Ana
A
Sruk
Department of Neurology, Sveti Duh University Hospital, Zagreb, Croatia.
Miljenka Planjar
MP
Prvan
Department of Neurology, University Hospital Centre Zagreb, Zagreb, Croatia.
Sanja
S
Hajnšek
Department of Neurology, University Hospital Centre Zagreb, Zagreb, Croatia.
Zeljka
Z
Petelin
Department of Neurology, University Hospital Centre Osijek, Osijek, Croatia.
Renata
R
Sušak
Department of Neurology, University Hospital Centre Osijek, Osijek, Croatia.
Marija
M
Candrlić
Division of Public Health, University of Liverpool, Liverpool, United Kingdom.
Ann
A
Jacoby
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D017668:Age of Onset; D000368:Aged; D000369:Aged, 80 and over; D003198:Computer Simulation; D017523:Croatia; D004827:Epilepsy / Q000523:psychology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D008960:Models, Psychological; D010045:Outpatients / Q000523:psychology; D011594:Psychometrics; D012640:Seizures / Q000523:psychology; D057545:Social Stigma; D013240:Stereotyping; D011795:Surveys and Questionnaires; D055815:Young Adult
Croatia; Epilepsy; Internal consistency; Stigma; Stigma scale