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March 21, 2026BMJ Open0 citationsOpen Access

Validation of the Workplace COVID-19 Knowledge and Stigma Scale (WoCKSS) in Malaysia: a cross-sectional study using item response theory and factor analyses

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IBIzyan Hazwani BaharuddinHospital Sungai BulohNNN N NaingSultan Zainal Abidin UniversityMPMeg PattersonTexas A&M University System

Key Points

  • The study aims to validate the Workplace COVID-19 Knowledge and Stigma Scale using various statistical methods.
  • Conducted a cross-sectional psychometric validation in Malaysian manufacturing companies.
  • Used item response theory (IRT) for the knowledge domain analysis in two phases: exploratory and confirmatory.
  • Applied exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) for the stigma domain evaluation.
  • Assessed reliability using Cronbach’s alpha and McDonald’s omega.
  • 14 knowledge items were retained after exploratory IRT, demonstrating effective discrimination and difficulty levels.
  • EFA revealed a three-factor structure for stigma: stereotype, fear, and prejudice, confirmed by CFA.
  • CFA showed an excellent model fit with various fit indices supporting the stigma scale's validity.

Abstract

Objective To validate the Workplace COVID-19 Knowledge and Stigma Scale (WoCKSS) using item response theory (IRT), exploratory factor analysis (EFA) and confirmatory factor analysis (CFA). Design Cross-sectional psychometric validation. Setting Manufacturing companies registered in Malaysia. Participants A 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. Methods The 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. Results 14 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 2 =8.91, df=11, p=0.630; root mean square error of approximation=0.00; Comparative Fit Index=1.00; Tucker-Lewis Index=1.00; standardised root mean square residual=0.021). Composite reliability by McDonald’s omega ranged from 0.691 to 0.893. Conclusion WoCKSS is a reliable and valid instrument for assessing workplace COVID-19 knowledge and stigma in industrial sectors in Malaysia.

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Cite This Study

Baharuddin et al. (2026) studied this question.

synapsesocial.com/papers/69be38ca6e48c4981c6797a2https://doi.org/10.1136/bmjopen-2025-115233
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