The stigma scale : adapta??o transcultural para o portugu?s brasileiro e primeiras evid?ncias de validade

Estudos apontam que o estigma da doen?a mental (EDM) ? um agravante dos transtornos mentais. O estigma social inibe a busca e reduz a taxa de ades?o aos tratamentos psicoter?picos e farmacol?gicos. No entanto, mensurar o EDM ? uma tarefa complexa, visto que existem m?ltiplas formas de estigma e opini?es divergentes sobre qual tipo de estigma um instrumento pode mensurar em determinada popula??o. Essa tarefa ? ainda mais desafiadora no Brasil, pois at? onde se tem conhecimento, ainda n?o existe um instrumento capaz de avaliar as percep??es e as experi?ncias de EDM vivenciadas por pessoas com transtorno mental. Sendo assim, um instrumento capaz de mensurar o EDM pode contribuir para o planejamento de interven??es capazes de reduzir o EDM e aumentar a busca e a ades?o aos tratamentos, favorecendo a sa?de mental da popula??o brasileira. Desta forma, a presente disserta??o teve como objetivo realizar a adapta??o transcultural da Escala de Estigma da Doen?a Mental (EEDM) para o portugu?s do Brasil e obter suas primeiras evid?ncias de validade. No primeiro estudo, foi realizada uma revis?o sistem?tica da literatura, a qual seguiu as etapas sugeridas pelo PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses), objetivando identificar quais os instrumentos mais utilizados para a mensura??o do estigma percebido e experienciado e verificar quais as principais vari?veis intervenientes nos estudos do EDM. No segundo estudo, foi realizada a adapta??o transcultural da EEDM e obtidas suas primeiras evid?ncias de validade psicom?trica. As etapas metodol?gicas seguidas foram: 1) obten??o da permiss?o para adapta??o; 2) tradu??o do instrumento; 3) s?ntese e avalia??o por especialistas; 4) retrotradu??o e avalia??o por especialistas; 5) estudo piloto. O ?ndice de confiabilidade entre os avaliadores (n = 3) foi mensurado atrav?s do ?ndice Light?s Kappa. A amostra do estudo piloto foi composta por 23 adultos (18-61 anos). A consist?ncia interna da EEDM foi estimada por meio de matrizes de correla??es polic?ricas dos itens e do coeficiente Alpha de Cronbach ordinal. Os resultados apontam que a EEDM apresenta boas evid?ncias de validade de conte?do (k = 0,81) e consist?ncia interna (? = 0,87). Contudo, destaca-se que estes dados psicom?tricos, embora promissores, ainda s?o preliminares. Sendo assim, novas pesquisas devem ser realizadas com a EEDM, levando em considera??o outros contextos culturais a n?vel nacional, visando confirmar e expandir as conclus?es desta disserta??o. Studies suggest that the mental illness stigma (MIS) is an aggravating factor for mental disorders. Social stigma inhibits the search and reduces the rate of adherence to psychotherapeutic and pharmacological treatments. However, measuring MIS is a complex task, since there are multiple forms of stigma and divergent opinions about what type of stigma an instrument can measure in a particular population. This task is even more challenging in Brazil, because as far as we know, there is no instrument capable of evaluating the perceptions and experiences of MIS lived by people with mental disorders. Thus, an instrument capable of measuring MIS can contribute to the planning of interventions capable of reducing MIS and increasing the search and adherence to treatments, supporting the mental health of the Brazilian population. Thus, the present dissertation had as objective the transcultural adaptation of the Stigma Scale of Mental Illness (SSMI) to Brazilian Portuguese and to obtain its first evidences of validity. In the first study, a systematic review was conducted following the steps suggested by PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses), aiming to investigate which psychometric instruments are most utilized in the measurement of perceived and experienced stigma and to verify the main intervenient variables involved in the MIS studies. In the second study, the transcultural adaptation of SSMI was performed and its first psychometric validity evidences were obtained. The methodological steps followed were: 1) obtaining permission to adapt; 2) translation of the instrument; 3) synthesis and evaluation by specialists; 4) back-translation and specialists? evaluation; 5) pilot study. The reliability index among the specialists (n = 3) was measured using the Light's Kappa index. The pilot study sample consisted in 23 adults (18-61 years). The internal consistency of the SSMI was estimated by means of polycory correlation matrices of the items and the ordinal Cronbach Alpha coefficient. The findings suggest that the SSMI show good evidence of content validity (k = 0.81) and internal consistency (? = 0.87). However, it is noteworthy that, although promising, these psychometric data are still preliminary. Therefore, new surveys with the SSMI that take into account other cultural contexts at national level are needed in order to confirm and expand the conclusions of this dissertation. Conselho Nacional de Pesquisa e Desenvolvimento Cient?fico e Tecnol?gico - CNPq