Validation and Cultural Adaptation of Explanatory Model Interview Catalogue (EMIC) in Assessing Stigma among Recovered Patients with COVID-19 in Saudi Arabia.

Amer S. Alali,Shatha F. Al-Thunayan,Adel S. Bashatah,Faleh Alqahtani,Faisal Alamri,Omar A. Almohammed,Munirah A. Alkathiri,Lamia A. Al-Zamel,Yazed AlRuthia,Yousif A. Asiri,Afnan A. Al-Rasheed

doi:10.3390/ijerph18168261

Abstract

Stigma is a negative feeling affecting many patients with various health conditions, especially the contagious ones such as COVID-19. The Explanatory Model Interview Catalogue (EMIC) is one of the valid and reliable stigma-measuring tools; however, it has not been translated and validated in Arabic. Therefore, the aim of this study was to translate and validate the EMIC in Arabic among a sample of Arabic-speaking adults who recently recovered from COVID-19 in Saudi Arabia. The 12 items of the EMIC scale were forward- and backward-translated and reviewed by all authors to check the face and content validity prior to approving the final version of the Arabic 12-item EMIC. A total of 174 participants aged ≥18 years who contracted COVID-19 and recovered as of 29 July 2020 were interviewed. The Cronbach’s alpha of the Arabic version of the 12-item EMIC was 0.79, indicating an acceptable level of internal consistency. Using principal component analysis with varimax rotation, two factors explained more than 60% of the variance of the translated EMIC scale. The mean EMIC score was 5.91, implying a low level of stigma among participants. Married participants (β = 2.93; 95%CI 0.88 to 4.98, p = 0.005) and those with a family history of mental illness (β = 2.38; 95%CI 0.29 to 4.46, p = 0.025) were more likely to have higher EMIC scores in comparison to their counterparts who were unmarried and had no family history of mental illness. On the contrary, older adults were less likely to have high EMIC scores (β = −0.11; 95%CI −0.21 to −0.01, p = 0.03). Future studies with larger samples of patients with COVID-19 and various health conditions should be conducted to examine the validity and reliability of the Arabic version of the EMIC among different patient populations and to unveil the factors that may play a role in patients’ feelings of stigmatization in this part of the world.

Highlights

The coronavirus disease (COVID-19) is caused by a novel coronavirus known as severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), where the first cases were identified in Wuhan, China in 2019, and, since it has spread rapidly throughout the world, causing universal panic [1]
The fear of this new virus has brought a whole range of negative perceptions and behaviors, such as stigma, as people who have been infected, or were in close contact with patients infected with SARS-CoV-2, were stigmatized by people around them [5]
Adult patients aged 18 years and above who understand Arabic and had recently recovered from COVID-19 that was confirmed by a polymerase chain reaction (PCR) test for SARS-CoV-2 during their infection were identified using the HESN database, which is the national database for documenting all COVID-19 infections in Saudi Arabia

Summary

Introduction

The coronavirus disease (COVID-19) is caused by a novel coronavirus known as severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), where the first cases were identified in Wuhan, China in 2019, and, since it has spread rapidly throughout the world, causing universal panic [1]. In order to contain this pandemic and the transmission of the infection, physical distancing and quarantine were necessary to break the chain of infection, learning from the examples of other previous infections, such as plague, yellow fever, tuberculosis (TB), and Ebola virus. These precautionary measures may have resulted in stigma and discrimination toward individuals infected with SARS-CoV-2 [3,4].

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