ArticleBMJ open2026
Validation of the Workplace COVID-19 Knowledge and Stigma Scale (WoCKSS) in Malaysia: a cross-sectional study using item response theory and factor analyses.
Article in BMJ open, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
objectiveTo validate the Workplace COVID-19 Knowledge and Stigma Scale (WoCKSS) using item response theory (IRT), exploratory factor analysis (EFA) and confirmatory factor analysis (CFA).
designCross-sectional psychometric validation.
settingManufacturing companies registered in Malaysia.
participantsA total of 137 factory workers participated in the exploratory phase and 300 in the confirmatory phase. Inclusion criteria were Malaysian nationality and ability to read Malay.
methodsThe knowledge domain was examined using the two-parameter logistic IRT model in two stages: an exploratory IRT analysis in phase 1 to screen items and a confirmatory IRT analysis in phase 2 to evaluate the final item set. The stigma domain was analysed using EFA followed by CFA. Reliability was assessed using Cronbach's alpha and McDonald's omega (ω). The development process and content and face validity results were previously published.
results14 knowledge items were retained after exploratory IRT and formed the final knowledge scale evaluated in confirmatory IRT. For these final items, discrimination parameters ranged from 0.77 to 3.17 and difficulty values from -4.47 to 0.23, with unidimensionality supported (p=0.644). EFA supported a three-factor stigma structure (stereotype, fear, prejudice), and CFA confirmed excellent model fit (χ
conclusionWoCKSS is a reliable and valid instrument for assessing workplace COVID-19 knowledge and stigma in industrial sectors in Malaysia.
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