Citation

Pathak EB, Wieten SE, Wheldon CW. BMJ Open 2017; 7(11): e015137.

Copyright

(Copyright © 2017, BMJ Publishing Group)

DOI

10.1136/bmjopen-2016-015137

PMID

29138193

PMCID

PMC5695468

Abstract

INTRODUCTION: We developed and validated a new parsimonious scale to measure stoic beliefs. Key domains of stoicism are imperviousness to strong emotions, indifference to death, taciturnity and self-sufficiency. In the context of illness and disease, a personal ideology of stoicism may create an internal resistance to objective needs, which can lead to negative consequences. Stoicism has been linked to help-seeking delays, inadequate pain treatment, caregiver strain and suicide after economic stress.
METHODS: During 2013-2014, 390 adults aged 18+ years completed a brief anonymous paper questionnaire containing the preliminary 24-item Pathak-Wieten Stoicism Ideology Scale (PW-SIS). Confirmatory factor analysis (CFA) was used to test an a priori multidomain theoretical model. Content validity and response distributions were examined. Sociodemographic predictors of strong endorsement of stoicism were explored with logistic regression.
RESULTS: The final PW-SIS contains four conceptual domains and 12 items. CFA showed very good model fit: root mean square error of approximation (RMSEA)=0.05 (95% CI 0.04 to 0.07), goodness-of-fit index=0.96 and Tucker-Lewis Index=0.93. Cronbach's alpha was 0.78 and ranged from 0.64 to 0.71 for the subscales. Content validity analysis showed a statistically significant trend, with respondents who reported trying to be a stoic 'all of the time' having the highest PW-SIS scores. Men were over two times as likely as women to fall into the top quartile of responses (OR=2.30, 95% CI 1.44 to 3.68, P<0.001). ORs showing stronger endorsement of stoicism by Hispanics, Blacks and biracial persons were not statistically significant.
DISCUSSION: The PW-SIS is a valid and theoretically coherent scale which is brief and practical for integration into a wide range of health behaviour and outcomes research studies.

Language: en

Keywords

Humans; Adult; Female; Male; masculinity; gender; Young Adult; Sex Factors; Surveys and Questionnaires; Health; Patient Acceptance of Health Care; help-seeking; Asian; Philosophy; stoicism; Black or African American; Hispanic or Latino; White People; patient perspectives; health behaviour theories