Life sciences · Journal article

Content Validation and Reliability Test for Depression, Stigma, Social Support and Patient’s Satisfaction Scale among Tuberculosis Patients in Serian Division, Sarawak

Medicine & Health · July 31, 2026

Preliminary Why this matters to you Expert discussion

Early or partial results. Treat as a signal, not a conclusion.

AI Summary

This is an instrument validation and pilot reliability study that adapted four psychometric scales (PHQ-9, TB Stigma Scale, Multidimensional Scale of Perceived Social Support, PSQ-18) for use among TB patients in a single Malaysian region. Expert content validation and pilot internal consistency testing (n=56) support the reliability of these instruments within this population, but the work is exploratory and localized; it does not assess clinical utility, predictive validity, or generalizability beyond the study site.

What was studied

Two-stage instrument validation study: expert content validation panel followed by pilot reliability study. TB patients in the Serian Division of Sarawak; detailed eligibility criteria and demographic characteristics not reported.. Intervention: PHQ-9 (depression screening), Tuberculosis Stigma Scale, Multidimensional Scale of Perceived Social Support, and Patient Satisfaction Questionnaire Short Form (PSQ-18); all adapted from original versions. n = 56. Serian Division, Sarawak, Malaysia.

Key findings

Eight experts in public health and psychiatry confirmed content validity with all items showing strong agreement in relevance, clarity, simplicity and lack of ambiguity Pilot study (n=56) yielded Cronbach's alpha values between 0.73 and 0.95, with overall reliability score of 0.86, indicating good to excellent reliability All four instruments (PHQ-9, TB Stigma Scale, MSPSS, PSQ-18) demonstrated psychometric robustness and cultural appropriateness for TB patients in Serian Division

Safety

Safety was not reported in the material analysed. Check the source before drawing any conclusion about harm.

Who this may help

These validated instruments may support future TB research and psychosocial interventions in this region, but clinical utility and predictive validity for patient outcomes remain unproven. Clinicians and researchers should treat these as culturally adapted tools ready for larger confirmatory studies, not yet as established clinical assessment instruments.

Plain-language summary

A single-centre validation and pilot study with modest sample size (n=56) demonstrating internal consistency of adapted psychometric instruments; establishes feasibility and reliability but requires larger confirmatory studies before clinical application.

Study design

As stated by the source record.

MethodsEight experts in public health and psychiatry assessed content validity of four adapted psychometric instruments using item-level and scale-level content validity indices; all items required no modifications based on expert review. A pilot study (n=56) then assessed internal consistency by calculating Cronbach's alpha for each instrument and an overall composite score.

DesignTwo-stage instrument validation study: expert content validation panel followed by pilot reliability study

PopulationTB patients in the Serian Division of Sarawak; detailed eligibility criteria and demographic characteristics not reported.

Sample size56

InterventionPHQ-9 (depression screening), Tuberculosis Stigma Scale, Multidimensional Scale of Perceived Social Support, and Patient Satisfaction Questionnaire Short Form (PSQ-18); all adapted from original versions

SettingSerian Division, Sarawak, Malaysia

Reported figures

Quoted from the source exactly as published.

Expert panel size8

Pilot sample size56

Cronbach's alpha range (PHQ-9, TB Stigma Scale, MSPSS, PSQ-18)0.73 to 0.95

Overall reliability score0.86

Clinical bottom line

Caveats

Single-centre study in one Malaysian division; generalizability to other TB populations and settings unknown
No report of test–retest reliability, construct validity, or criterion validity
Pilot sample size (n=56) limits precision of internal consistency estimates and prevents factor structure confirmation
No clinical outcomes, patient benefit, or impact on TB management reported

Evidence assessment

Graded across the dimensions that decide whether you should act, each from what the source actually supports. There is no single score, and where a dimension was not assessed it says so.

Study design

moderate

Two-stage design: expert content validation followed by pilot study; no control group or external comparison.

Directness

moderate

Measures psychometric properties of instruments; does not assess clinical outcomes or patient-level impact of using them.

Consistency

limited

Single site in one region; no external validation or cross-site replication reported.

Risk of bias

insufficient

No mention of blinding, conflict of interest, or systematic bias assessment in validation process.

Sample adequacy

limited

Pilot sample n=56; adequate for internal consistency estimation but underpowered for factor structure confirmation.

Source abstract

This study evaluated the content validity and internal consistency reliability of four psychosocial measurement instruments-the PHQ-9 (depression), Tuberculosis Stigma Scale, Multidimensional Scale of Perceived Social Support and Patient Satisfaction Questionnaire Short Form (PSQ-18) among tuberculosis (TB) patients in the Serian Division of Sarawak.The instruments were adopted from their original versions and subsequently validated among TB patients in the Serian Division of Sarawak.Content validation, conducted by eight experts in public health and psychiatry, utilised item-level and scale-level content validity indices, with all items demonstrating strong agreement in relevance, clarity, simplicity and lack of ambiguity requiring no modifications.A pilot study (n = 56) was then carried out to assess internal consistency, yielding Cronbach's alpha values between 0.73 and 0.95, with an overall reliability score of 0.86, indicating good to excellent reliability.The findings confirmed the psychometric robustness and cultural appropriateness of these instruments for evaluating psychosocial determinants in TB care.These validated tools provide a reliable framework for future research and interventions aiming at enhancing patient-centred care and addressing psychosocial challenges in TB populations.