Psychometric properties of the participation scale among former buruli ulcer patients in Ghana and Benin.
BACKGROUND
Buruli ulcer is a stigmatising disease treated with antibiotics and wound care, and sometimes surgical intervention is necessary. Permanent limitations in daily activities are a common long term consequence. It is unknown to what extent patients perceive problems in participation in social activities. The psychometric properties of the Participation Scale used in other disabling diseases, such as leprosy, was assessed for use in former Buruli ulcer patients.


METHODS
Former Buruli ulcer patients in Ghana and Benin, their relatives, and healthy community controls were interviewed using the Participation Scale, Buruli Ulcer Functional Limitation Score, and the Explanatory Model Interview Catalogue to measure stigma. The Participation Scale was tested for the following psychometric properties: discrimination, floor and ceiling effects, internal consistency, inter-item correlation, item-total correlation and construct validity.


RESULTS
In total 386 participants (143 former Buruli ulcer patients with their relatives (137) and 106 community controls) were included in the study. The Participation Scale displayed good discrimination between former Buruli ulcer patients and healthy community controls. No floor and ceiling effects were found. Internal consistency (Cronbach's alpha) was 0.88. In Ghana, mean inter-item correlation of 0.29 and item-total correlations ranging from 0.10 to 0.69 were found while in Benin, a mean inter-item correlation of 0.28 was reported with item-total correlations ranging from -0.08 to 0.79. With respect to construct validity, 4 out of 6 hypotheses were not rejected, though correlations between various constructs differed between countries.


CONCLUSIONS
The results indicate the Participation Scale has acceptable psychometric properties and can be used for Buruli ulcer patients in Ghana and Benin. Future studies can use this Participation Scale to evaluate the long term restrictions in participation in daily social activities of former BU patients.
University of Groningen, University Medical Center Groningen, Department of Internal Medicine/Infectious Diseases, Groningen, The Netherlands.
Janine
J
de Zeeuw
University of Groningen, University Medical Center Groningen, Department of Internal Medicine/Infectious Diseases, Groningen, The Netherlands.
Marlies
M
Douwstra
University of Groningen, University Medical Center Groningen, Department of Internal Medicine/Infectious Diseases, Groningen, The Netherlands.
Till F
TF
Omansen
Programme National de Lutte contre la Lèpre et L'Ulcère de Buruli, Ministère de la Santé, Cotonou, République du Bénin.
Ghislain E
GE
Sopoh
Fondation Raoul Follereau, Cotonou, République du Bénin.
Christian
C
Johnson
Kwame Nkrumah University of Science and Technology, School of Medical Sciences, Department of Medicine, Kumasi, Ghana.
Richard O
RO
Phillips
University of Groningen, University Medical Center Groningen, Department of Health Sciences, Groningen, The Netherlands.
Marike
M
Alferink
American Leprosy Missions, Greenville, South Carolina, United States of America.
Paul
P
Saunderson
University of Groningen, University Medical Center Groningen, Department of Internal Medicine/Infectious Diseases, Groningen, The Netherlands.
Tjip S
TS
Van der Werf
University of Groningen, University Medical Center Groningen, Department of Rehabilitation and Department of Oral and Maxillofacial Surgery, Groningen, The Netherlands.
Pieter U
PU
Dijkstra
University of Groningen, University Medical Center Groningen, Department of Internal Medicine/Infectious Diseases, Groningen, The Netherlands.
Ymkje
Y
Stienstra
D000328:Adult; D001541:Benin / Q000453:epidemiology; D054312:Buruli Ulcer / Q000453:epidemiology*; D005260:Female; D005869:Ghana / Q000453:epidemiology; D006801:Humans; D008297:Male; D011594:Psychometrics; D058992:Social Participation / Q000523:psychology*; D057545:Social Stigma