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Family Stigma Stress Scale in Family Caregivers of People with Mental Illness: Reproducibility and Minimal Detectable Change

Chung-Ying Lin, Ph.D., O.T./L., Chih-Cheng Chang, Ph.D., M.S., M.D.,Jian-An Su, M.S., M.D., Mirja Koschorke, Ph.D., M.D.,Graham Thornicroft, Ph.D., M.D.

Objective: Stigma-related stress (or stigma stress) is a critical issue that should be considered by mental health professionals. In addition, stigma stress can occur in the family caregivers of people with mental illness (PWMI), and the Fam- ily Stigma Stress Scale (FSSS) can be used to detect the stigma stress for family caregivers. The application of the FSSS, its reproducibility, especially the minimal detectable change (MDC), should be maximized and studied. In this study, we in- tended to study the reproducibility of the FSSS in family caregivers of PWMI in different durations of test-retest reliability assessments. Methods: We asked fam- ily caregivers of PWMI to fill the FSSS in various time from 2 weeks to 3 months. We computed the intra-class correlation coefficient (ICC), and calculated the MDC with the ICC results, to generate MDC%, and finally to determine acceptable re- producibility (< 30% indicates acceptable). Results: Family caregivers of PWMI (n = 197) completed the FSSS twice within an interval of 2 weeks to 3 months, 112 completed between 2 weeks and 1 month, 48 between 1 and 2 months, and 37 between 2 and 3 months. The reproducibility of the FSSS was acceptable regard- less the lengths of the test-retest intervals (ICC = 0.67 to 0.86). The MDC for the FSSS total score was between 3.67 and 4.56. MDC% revealed that the reproduc- ibility for the FSSS total score was nearly acceptable or acceptable in all different lengths of intervals (MDC% = 22.09% to 35.36%). Conclusion: The FSSS total score is reliable in monitoring the stigma stress in family caregivers of PWMI within an interval of three months.
Key Word reliability, mental illness, minimal detectable change, stigma stress
Editorial Committe, Taiwanese Journal of Psychiatry
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