Adaptation and validation of the Van Rie tuberculosis stigma scale in Vietnam

Lisa Redwood, Ellen M. H. Mitchell, Thu Anh Nguyen, Kerri Viney, Linh Duong, Huu Thuong Pham, Binh Hoa Nguyen, Viet Nhung Nguyen, Greg J. Fox

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Objectives: Tuberculosis (TB) stigma contributes to diagnostic delay, disease concealment, and reduced wellbeing for affected individuals. Despite the availability of several TB stigma scales, most high-TB burden countries do not have a culturally validated version available. This study evaluated the Van Rie TB stigma scale (VTSS) among people with TB in Vietnam.

Methods: This study consisted of two phases. In phase 1, the VTSS was culturally and linguistically adapted to the Vietnamese context. In phase 2, people with TB were invited to complete a survey containing the VTSS, a depression scale, and a quality of life scale. The data analysis included confirmatory factor analysis (CFA), exploratory factor analysis (EFA), construct validity, and floor or ceiling effects.

Results: In phase 1, items were reworded from the third person to the first person. The TB/HIV co-infection items (items 7 and 11) were the least relevant for people with TB (62% and 73% relevance, respectively). In phase 2, the CFA demonstrated adequate goodness-of-fit indices (GFI = 0.88, CFI = 0.96, RMSEA = 0.058); however several of the item factor loadings were low. The EFA demonstrated good internal consistency (alpha = 0.85) and revealed one dominant factor. Construct validity was low.

Conclusions: The VTSS demonstrated good psychometric properties in Vietnam. Depending on the purpose of the scale, the HIV co-infection items and item 10 could be considered for removal. (C) 2021 The Authors. Published by Elsevier Ltd on behalf of International Society for Infectious Diseases.

Original languageEnglish
JournalInternational Journal of Infectious Diseases
Pages (from-to)97-104
Number of pages8
Publication statusPublished - 2022


  • Psychometrics
  • TB
  • Measurement
  • Confirmatory factor analysis
  • Vietnam
  • Stigma


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