What is the optimal tool for measuring abortion stigma? A systematic review

Abstract

Purpose

Abortion stigma is a barrier to accessing and delivering comprehensive, sustainable healthcare. This study aimed to systematically identify measures of abortion stigma, and assess their psychometric properties and uses.

Materials and methods

The systematic review was preregistered with PROSPERO (ID#127339) and adhered to Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Eight databases were screened for articles measuring abortion stigma. Data were extracted by four researchers and checked for accuracy by two reviewers. Psychometric properties were assessed with COSMIN guidelines.

Results

Of 102 articles reviewed, 21 reported original measures of abortion stigma. Instruments assessed individual and community level stigma for people who have had an abortion (n = 8), healthcare professionals (n = 4), and the public (n = 9), and predominantly originated from the United States (U.S.). Measures varied in structure, use, and comprehensiveness of psychometric properties. On psychometric properties, the Individual Level Abortion Stigma scale and Abortion Provider Stigma Scale – Revised performed best for individual-level stigma and the Stigmatising Attitudes, Beliefs and Actions Scale for community-level stigma.

Conclusion

Gaps in abortion stigma measurement include geography, conceptualisation, and structural-level stigma. Continued development and testing of tools and methods for measuring abortion stigma is needed.

SHORT CONDENSATION

A range of methods are available to measure abortion stigma, however with gaps in psychometrics, geography, and structural-level stigma. Continued development and testing of tools measuring abortion stigma is required for valid and reliable measurement, models, and intervention.

摘要

目的：堕胎污名化是获得和提供全面、可持续的医疗保健的障碍。本研究旨在系统地确定堕胎污名的测量方法, 并评估其心理计量和用途。

材料和方法：系统综述用PROSPERO（ID#127339）预先登记, 并遵守系统综述首选报告项目和荟萃分析指南。对8个数据库进行了筛选, 以寻找衡量堕胎污名的文章。数据由四名研究人员提取, 并由两名评审员检查准确性。根据COSMIN指南评估心理计量。

结果：在102篇综述文章中, 21篇报道了堕胎污名的原始测量方法。这些工具评估了堕胎者（n=8）、医疗专业人员（n=4）和公众（n=9）在个人和社区层面的耻辱感, 这些耻辱感主要来自美国（U.S.）。测量方法在结构、使用和心理计量的综合性方面各不相同。在心理计量方面, 个人水平堕胎耻辱量表和堕胎提供者耻辱量-修订版在个人水平耻辱方面表现最佳, 而社区水平耻辱的耻辱态度、信念和行动量表表现最佳。

结论：堕胎污名测量的差距包括地理、概念化和结构层面的污名。需要继续开发和测试衡量堕胎耻辱感的工具和方法。

简短总结

有一系列方法可以用来衡量堕胎污名, 但在心理计量、地理和结构层面的污名方面存在差距。需要继续开发和测试测量堕胎污名的工具, 以进行有效和可靠的测量、模型和干预。

Keywords:

• Abortion
• stigma
• psychometric properties
• systematic review

Acknowledgements

The following people made noteworthy contributions:

Valentina Sagmeister: The University of Sydney, School of Psychology, Centre for Medical Psychology & Evidence-based Decision-making, The University of Sydney, NSW 2006, Australia. University of Groningen, 712 CP Groningen, Netherlands.

Jennifer Walker: The University of Sydney, Faculty of Science, School of Psychology, Brennan MacCallum Building, A18 Manning Rd, Camperdown NSW 2050, Australia.

Linh Doh The University of Sydney, Faculty of Science, School of Psychology, Brennan MacCallum Building, A18 Manning Rd, Camperdown NSW 2050, Australia.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Additional information

Funding

Completion as part of PhD candidature. The PhD candidature was partially supported by the Lucy Firth Scholarship from the University of Sydney, School of Psychology.