Examining psychometric properties of the Sinhala version of the 'Opening Minds Scale for Health Care Providers' to measure stigma towards mental illness using confirmatory factor analysis

Abstract

OBJECTIVES: The Opening Minds Scale for Health Care Providers (OMS-HC15) is a self-report questionnaire regarding stigmatising attitudes and behavioural intentions of healthcare providers, towards people with mental illness. In view of the scarcity of validated instruments in local languages in Sri Lanka to assess stigma towards people with mental illness among healthcare providers, this study aimed to culturally adapt OMS-HC15 to Sinhala and examine its psychometric properties among 165 Sinhala-speaking medical students. RESULTS: Confirmatory Factor Analysis for the first-order three-factor model of OMS-HC15 showed acceptable model fit indices (χ2/df = 2.11, CFI = 0.943, TLI = 0.932, RMSEA = 0.082, SRMR = 0.086), but one item demonstrated inadequate factor loading (< 0.3). Considering the poor factor loading and concerns raised on the relevance of this item by previous researchers, this item was removed. However, as removing this item resulted in a slightly worse model fit, modification indices were examined, and constraints on three error covariances were relaxed. This led to a good model fit for the 14-item scale (CFI = 0.962, TLI = 0.951, χ2/df = 1.88, RMSEA = 0.074, SRMR = 0.079). Higher-order, bifactor, and unidimensional models were not supported. The 15-item scale showed acceptable reliability (ω = 0.80; α = 0.69), which improved after removing Item 11 (ω = 0.81; α = 0.70). Subscale reliabilities were lower (Social Distance: ω = 0.70, α = 0.69; Disclosure/Help-Seeking: ω = 0.62, α = 0.61; Attitudes: ω = 0.58, α = 0.55).