Psychometric Properties of the Persian Version of the Thai Internalized Stigma Scale among Elderly Nursing Home Residents

Introduction: The Thai version of the Internalized Stigma of Living in a Care Home Scale (TIS-LCH) was developed to assess internalized stigma among older adults. This study aimed to validate the Persian translation of the TIS-LCH for use among elderly residents in Iranian nursing homes. Methods: A forward–backward translation process was conducted to ensure the accuracy of the English-to-Persian adaptation. A total of 260 elderly individuals from nursing homes in Tabriz, Iran, were selected via convenience sampling in 2024. Internal consistency and test–retest reliability were assessed using Cronbach’s alpha and the intra-class correlation coefficient (ICC), respectively. Content validity was evaluated by a panel of ten multidisciplinary experts. Face validity was examined both qualitatively and quantitatively by ten literate elderly individuals. Construct validity was assessed using confirmatory factor analysis (CFA). Discriminant validity was evaluated through known group comparisons (men vs. women) using independent t-tests, with significance set at p < 0.05. Results: The scale demonstrated strong internal consistency (Cronbach’s alpha = 0.94), with acceptable content validity (CVI = 0.95; CVR = 0.91). Five items were revised based on qualitative face validity, and all items surpassed the impact score threshold (> 1.5) in the quantitative assessment. CFA results supported a 21-item version of the scale after removing five items with low factor loadings. Model fit indices were acceptable (CMIN/df = 2.81, GFI = 0.85, CFI = 0.82, RMSEA = 0.084). Discriminant validity indicated higher internalized stigma scores in women (mean difference = 2.60). Conclusion: The Persian version of the TIS-LCH is a reliable and valid instrument for measuring internalized stigma among elderly individuals in nursing homes. While the scale shows promising psychometric properties, further validation across different populations and settings is recommended to ensure its broader applicability and cultural relevance