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Title: Psychometric properties of the Opening Minds Stigma Scale for Health Care Providers in 32 European countries - A bifactor ESEM representation
Authors: Őri, Dorottya
Szocsics, Péter
Molnár, Tamás
Bankovska Motlova, Lucie
Kazakova, Olga
Mörkl, Sabrina
Wallies, Michael
Abdulhakim, Mohamed
Boivin, Sylvie
Bruna, Krista
Cabaços, Carolina 
Carbone, Elvira Anna
Dashi, Elona
Grech, Giovanni
Greguras, Stjepan
Ivanovic, Iva
Guevara, Kaloyan
Kakar, Selay
Kotsis, Konstantinos
Klinkby, Ida Maria Ingeholm
Maslak, Jovana
Matheiken, Shevonne
Mirkovic, Ana
Nechepurenko, Nikita
Panayi, Angelis
Pereira, Ana Telma 
Pomarol-Clotet, Edith
Raaj, Shaeraine
Rus Prelog, Polona
Soler-Vidal, Joan
Strumila, Robertas
Schuster, Florian
Kisand, Helena
Hargi, Ann
Ahmadova, Gumru
Vircik, Matus
Yilmaz Kafali, Helin
Grinko, Natalia
Győrffy, Zsuzsa
Rózsa, Sandor
Keywords: OMS-HC; stigma; mental health-related stigma; psychometrics; bifactor; bifactor ESEM; opening minds; psychiatrist
Issue Date: 2023
Publisher: Frontiers Media S.A.
Project: DŐ was awarded the National Youth Talent Award in 2020 and 2021 (Ministry of Human Resources, Hungary, (NTP-NFTÖ-20-B-0134 and NTP-NFTÖ-21-B-0280) and the Prominence Award of the Kerpel-Fronius Talent Support Program of Semmelweis University in 2021 (EFOP-3.6.3-VEKOP-16-2017-00009), which covered the expenses of the 1-year account of the online survey platform and the dissemination of the study results at international congresses. SRó was supported by the Károli Gáspár University of the Reformed Church (Grant No. 20754B800). 
Serial title, monograph or event: Frontiers in Public Health
Volume: 11
Abstract: Aims: To measure the stigma of healthcare providers toward people suffering from mental illness, the Opening Minds Stigma Scale for Health Care Providers (OMS-HC) is a commonly applied instrument. However, this scale has not been thoroughly validated in many European countries, its psychometric properties are still unknown and data on practicing psychiatrists is lacking. Therefore, this multicenter study aimed to assess the psychometric characteristics of the 15-item OMS-HC in trainees and specialists in adult and child psychiatry in 32 countries across Europe. Materials and methods: The OMS-HC was conducted as an anonymous online survey and sent via Email to European adult and child psychiatrists. Parallel analysis was used to estimate the number of OMS-HC dimensions. Separate for each country, the bifactor ESEM, a bifactor exploratory structural equation modeling approach, was applied to investigate the factor structure of the scale. Cross-cultural validation was done based on multigroup confirmatory factor analyses and reliability measures. Results: A total of 4,245 practitioners were included, 2,826 (67%) female, 1,389 (33%) male. The majority (66%) of participants were specialists, with 78% working in adult psychiatry. When country data were analyzed separately, the bifactor model (higher-order factor solution with a general factor and three specific factors) showed the best model fit (for the total sample χ2/df = 9.760, RMSEA = 0.045 (0.042–0.049), CFI = 0.981; TLI = 0.960, WRMR = 1.200). The average proportion of variance explained by the general factor was high (ECV = 0.682). This suggests that the aspects of ‘attitude,’ ‘disclosure and help-seeking,’ and ‘social distance’ could be treated as a single dimension of stigma. Among the specific factors, the ‘disclosure and help-seeking’ factor explained a considerable unique proportion of variance in the observed scores. Conclusion: This international study has led to cross-cultural analysis of the OMS-HC on a large sample of practicing psychiatrists. The bifactor structure displayed the best overall model fit in each country. Rather than using the subscales, we recommend the total score to quantify the overall stigmatizing attitudes. Further studies are required to strengthen our findings in countries where the proposed model was found to be weak.
ISSN: 2296-2565
DOI: 10.3389/fpubh.2023.1168929
Rights: openAccess
Appears in Collections:I&D CIBIT - Artigos em Revistas Internacionais
FMUC Medicina - Artigos em Revistas Internacionais

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