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Protocol - Sickle Cell Disease Health-Related External Stigma - Adolescent and Adult

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Description

The Sickle Cell Disease Health-Related Stigma Scale (SCD-HRSS) is a 30-item self-administered questionnaire that measures the amount of external stigma experienced by SCD patients (specifically, related to pain).

Specific Instructions

The Psychosocial and SDoH Working Group recognizes that these instruments were not developed using inclusive language. The WG recognizes that investigators may want to implement the protocols with appropriate language, but caution that changes should not otherwise alter the items.

This scale is designed to be completed with sickle cell disease (SCD) patients who experience pain as a complication of their disease. It was designed in the United States and may require adaptations for use with SCD populations outside of the United States.

Availability

Available

Protocol

SCD Health-Related Stigma Scale

Please select the number that best reflects your agreement with each statement below.

5 = Strongly Agree
4 = Somewhat Agree
3 = Neutral
2 = Somewhat Disagree
1 = Strongly Disagree

In the following 10 statements, the word "people" refers to people in general, not members of your family.

1.*

People believe that someone with sickle cell pain is as mentally and emotionally healthy as the average person.

5

4

3

2

1

2.

People believe that it is mostly the patients fault when his/her pain does not get better.

5

4

3

2

1

3.*

People are sympathetic when they hear about my pain condition.

5

4

3

2

1

4.

People believe that sickle cell is used as an excuse to get pain medication.

5

4

3

2

1

5.*

People understand the suffering experienced by someone with chronic pain.

5

4

3

2

1

6.

I feel embarrassed to tell people that I cannot do something because of my pain.

5

4

3

2

1

7.

People think less of someone who is unable to work because of sickle cell.

5

4

3

2

1

8.

People believe that having sickle cell pain is a sign of weakness.

5

4

3

2

1

9.

People think that someone taking prescription pain medication on a regular basis is a "drug addict".

5

4

3

2

1

10.

When people hear that someone has sickle cell pain, they think that person is also likely to have mental or emotional problems.

5

4

3

2

1


In the following 10 statements, the word "doctor" refers to all of the doctors you have seen for sickle cell pain.

5 = Strongly Agree
4 = Somewhat Agree
3 = Neutral
2 = Somewhat Disagree
1 = Strongly Disagree

1.*

Most doctors believe that there is a real physical cause for sickle cell pain.

5

4

3

2

1

2.

Doctors think that people with sickle cell exaggerate their pain.

5

4

3

2

1

3.

Many doctors think that people with sickle cell pain want more pain medication than is necessary for their physical pain.

5

4

3

2

1

4.

Doctors think that sickle cell pain is mostly a mental or emotional problem.

5

4

3

2

1

5.*

Most doctors think that people with sickle cell use pain medication appropriately.

5

4

3

2

1

6.*

Most doctors think that people with sickle cell complain about their illness about as much as people with other medical conditions.

5

4

3

2

1

7.

Many doctors believe that people with sickle cell could be more physically active if they wanted.

5

4

3

2

1

8.

Many doctors think that people with sickle cell are less emotionally stable than people with other medical problems.

5

4

3

2

1

9.

Many doctors think that people with sickle cell pain are "drug addicts".

5

4

3

2

1

10.

Most doctors would prefer not to treat people with sickle cell disease.

5

4

3

2

1


In the following 10 statements, the word "family" refers to the people who are most important and significant to you.

5 = Strongly Agree
4 = Somewhat Agree
3 = Neutral
2 = Somewhat Disagree
1 = Strongly Disagree

1.*

My family understands that I have physical pain.

5

4

3

2

1

2.

My family thinks I need less pain medication than I take.

5

4

3

2

1

3.

My family feels that I exaggerate how much I hurt in order to get out of doing things that I dont want to do.

5

4

3

2

1

4.*

My family understands that I can use only as much pain medication as is medically necessary.

5

4

3

2

1

5.

My family thinks that I could be more physically active if I wanted.

5

4

3

2

1

6.

My family thinks that by taking pain medication on a regular basis, I have become a "drug addict".

5

4

3

2

1

7.*

My family understands that sickle cell is a real medical condition.

5

4

3

2

1

8.

I feel that my family has less respect for me since I have sickle cell.

5

4

3

2

1

9.

My family thinks that sickle cell pain is more of a mental or emotional problem than a physical problem.

5

4

3

2

1

10.

My family feels embarrassed to tell people that I have sickle cell.

5

4

3

2

1


Scoring: Each subscale score is the sum of the 10 items in the subscale scale. Be sure to use recoded items in scoring (Range: 10-50). Items to be reverse coded are marked with an asterisk (*).

The total score is the sum of all four subscale scores (Range: 40-200). Higher total Sickle Cell Disease Health-Related Stigma Scale (SCD-HRSS) total scores or subscale scores indicate higher levels of perceived stigma.

Personnel and Training Required

None

Equipment Needs

None

Requirements
Requirement CategoryRequired
Major equipment No
Specialized training No
Specialized requirements for biospecimen collection No
Average time of greater than 15 minutes in an unaffected individual No
Mode of Administration

Self-administered questionnaire

Lifestage

Adolescent, Adult

Participants

Adult, adolescent with sickle cell disease

Selection Rationale

The Sickle Cell Disease Health-Related Stigma Scale (SCD-HRSS) is a standardized, reliable, and valid instrument used to collect information about external sources of stigma experienced by patient populations with sickle cell disease due to their health-related condition.

Language

English

Standards
StandardNameIDSource
Derived Variables

None

Process and Review

Not applicable

Protocol Name from Source

Sickle Cell Disease Health-Related Stigma Scale (SCD-HRSS)

Source

Jenerette, C., O'Brien, J., Jaja, C., Carvalho, E. S. S., Brewer, C., & Hickman, R. L., Jr (2022). Psychometrics of the Sickle Cell Disease Health-Related Stigma Scale-Short Form. Western journal of nursing research, 1939459221142164. Advance online publication. doi:10.1177/01939459221142164

General References

Bediako, S. M., Lanzkron, S., Diener-West, M., Onojobi, G., Beach, M. C., & Haywood, C. (2014). The measure of sickle cell stigma: Initial findings from the Improving Patient Outcomes through Respect and Trust study. Journal of Health Psychology, 21(2), 808-820. doi:10.1177/1359105314539530

Bulgin, D., Tanabe, P., & Jenerette, C. (2018). Stigma of sickle cell disease: A systematic review, Issues in Mental Health Nursing, 39(8), 675-686. doi:10.1080/01612840.2018.1443530

Jenerette, C., Brewer, C.A., Crandell, J., & Ataga, I. (2012). Preliminary validity and reliability of the Sickle Cell Disease Health-Related Stigma Scale. Issues in Mental Health Nursing, 33(6), 363-369. doi:10.3109/01612840.2012.656823

Protocol ID

870201

Variables
Export Variables
Variable Name Variable IDVariable DescriptiondbGaP Mapping
PX870201_External_Stigma_Sickle_Cell_Disease_Doctor_Appropriate_Medication_Use
PX870201020500 Most doctors think that people with sickle more
cell use pain medication appropriately. show less
N/A
PX870201_External_Stigma_Sickle_Cell_Disease_Doctor_Drug_Addict_Stereotype
PX870201020900 Many doctors think that people with sickle more
cell pain are drug addicts. show less
N/A
PX870201_External_Stigma_Sickle_Cell_Disease_Doctor_Exaggerate_Pain
PX870201020200 Doctors think that people with sickle cell more
exaggerate their pain. show less
N/A
PX870201_External_Stigma_Sickle_Cell_Disease_Doctor_Illness_Complaint_Frequency
PX870201020600 Most doctors think that people with sickle more
cell complain about their illness about as much as people with other medical conditions. show less
N/A
PX870201_External_Stigma_Sickle_Cell_Disease_Doctor_Less_Emotionally_Stable
PX870201020800 Many doctors think that people with sickle more
cell are less emotionally stable than people with other medical problems. show less
N/A
PX870201_External_Stigma_Sickle_Cell_Disease_Doctor_More_Pain_Medication
PX870201020300 Many doctors think that people with sickle more
cell pain want more pain medication than is necessary for their physical pain. show less
N/A
PX870201_External_Stigma_Sickle_Cell_Disease_Doctor_Pain_Emotional_Mental_Problem
PX870201020400 Doctors think that sickle cell pain is more
mostly a mental or emotional problem. show less
N/A
PX870201_External_Stigma_Sickle_Cell_Disease_Doctor_Physically_Active
PX870201020700 Many doctors believe that people with sickle more
cell could be more physically active if they wanted. show less
N/A
PX870201_External_Stigma_Sickle_Cell_Disease_Doctor_Physical_Cause
PX870201020100 Most doctors believe that there is a real more
physical cause for sickle cell pain. show less
N/A
PX870201_External_Stigma_Sickle_Cell_Disease_Doctor_Prefer_Not_Treat_Sickle_Cell
PX870201021000 Most doctors would prefer not to treat more
people with sickle cell disease. show less
N/A
PX870201_External_Stigma_Sickle_Cell_Disease_Family_Appropriate_Pain_Medication
PX870201030400 My family understands that I can use only as more
much pain medication as is medically necessary. show less
N/A
PX870201_External_Stigma_Sickle_Cell_Disease_Family_Drug_Addict
PX870201030600 My family thinks that by taking pain more
medication on a regular basis, I have become a drug addict. show less
N/A
PX870201_External_Stigma_Sickle_Cell_Disease_Family_Embarrassment
PX870201031000 My family feels embarrassed to tell people more
that I have sickle cell. show less
N/A
PX870201_External_Stigma_Sickle_Cell_Disease_Family_Less_Pain_Medication
PX870201030200 My family thinks I need less pain medication more
than I take. show less
N/A
PX870201_External_Stigma_Sickle_Cell_Disease_Family_Less_Respect
PX870201030800 I feel that my family has less respect for more
me since I have sickle cell. show less
N/A
PX870201_External_Stigma_Sickle_Cell_Disease_Family_Mental_Emotional_Problem
PX870201030900 My family thinks that sickle cell pain is more
more of a mental or emotional problem than a physical problem. show less
N/A
PX870201_External_Stigma_Sickle_Cell_Disease_Family_More_Physically_Active
PX870201030500 My family thinks that I could be more more
physically active if I wanted. show less
N/A
PX870201_External_Stigma_Sickle_Cell_Disease_Family_Pain_Exaggeration
PX870201030300 My family feels that I exaggerate how much I more
hurt in order to get out of doing things that I don't want to do. show less
N/A
PX870201_External_Stigma_Sickle_Cell_Disease_Family_Physical_Pain
PX870201030100 My family understands that I have physical more
pain. show less
N/A
PX870201_External_Stigma_Sickle_Cell_Disease_Family_Real_Medical_Condition
PX870201030700 My family understands that sickle cell is a more
real medical condition. show less
N/A
PX870201_External_Stigma_Sickle_Cell_Disease_People_Chronic_Pain_Suffering
PX870201010500 People understand the suffering experienced more
by someone with chronic pain. show less
N/A
PX870201_External_Stigma_Sickle_Cell_Disease_People_Mental_Emotional_Problems
PX870201011000 When people hear that someone has sickle more
cell pain, they think that person is also likely to have mental or emotional problems. show less
N/A
PX870201_External_Stigma_Sickle_Cell_Disease_People_Others_Sympathetic
PX870201010300 People are sympathetic when they hear about more
my pain condition. show less
N/A
PX870201_External_Stigma_Sickle_Cell_Disease_People_Pain_Embarrassment
PX870201010600 I feel embarrassed to tell people that I more
cannot do something because of my pain. show less
N/A
PX870201_External_Stigma_Sickle_Cell_Disease_People_Pain_Medication_Excuse
PX870201010400 People believe that sickle cell is used as more
an excuse to get pain medication. show less
N/A
PX870201_External_Stigma_Sickle_Cell_Disease_People_Pain_Weakness
PX870201010800 People believe that having sickle cell pain more
is a sign of weakness. show less
N/A
PX870201_External_Stigma_Sickle_Cell_Disease_People_Patient_Fault_Pain
PX870201010200 People believe that it is mostly the more
patient's fault when his/her pain does not get better. show less
N/A
PX870201_External_Stigma_Sickle_Cell_Disease_People_Regular_Pain_Medication_Drug_Addict
PX870201010900 People think that someone taking more
prescription pain medication on a regular basis is a drug addict. show less
N/A
PX870201_External_Stigma_Sickle_Cell_Disease_People_Sickle_Cell_Mental_Emotional_Health
PX870201010100 People believe that someone with sickle cell more
pain is as mentally and emotionally healthy as the average person. show less
N/A
PX870201_External_Stigma_Sickle_Cell_Disease_People_Unable_Work
PX870201010700 People think less of someone who is unable more
to work because of sickle cell. show less
N/A
Psychosocial and Social Determinants of Health
Measure Name

Sickle Cell Disease Health-Related External Stigma

Release Date

May 26, 2023

Definition

Stigmatization due to health status or chronic disease burden is referred to as health-related stigma and involves devaluation, judgement, or social disqualification of individuals based on health condition. This protocol specifically addresses stigma associated with sickle cell disease.

Purpose

Stigma can cause detrimental effects on the health of individuals, especially those with chronic disease burden. Effects can include negative social consequences such as status loss, employment discrimination, impairment of healthcare interactions, and reduced physiological and psychological well-being.

Keywords

Stigma, external, sickle cell disease, SCD, health status, Sickle Cell Disease Health-Related Stigma Scale, SCD-HRSS, emotion, Psychosocial, chronic, chronic disease, pain

Measure Protocols
Protocol ID Protocol Name
870201 Sickle Cell Disease Health-Related External Stigma - Adolescent and Adult
Publications

There are no publications listed for this protocol.