Development and validation of the Perceived Care Stigma Scale (PerCSS): measuring cognitive, emotional and behavioral reactions to (unpaid) caregivers of older family members and friends.

Objectives: This study reports the development and validation of the first scale to measure perceived care stigma among unpaid (family and friends) caregivers of older adults based on a social stigma framework.

Methods: Based on data from the Attitudes Towards Informal Caregiving (ATTIC) project collected in Germany in December 2023, a sample of 433 unpaid caregivers of older relatives or friends (65+ years) was questioned with an online survey. Supported by a group of informal caregivers, the Perceived Care Stigma Scale (PerCSS) was developed. The PerCSS was tested for content and concurrent validity, factor structure and reliability by using two subsamples and conducting exploratory and confirmatory factor analyses.

Results: The PerCSS's two subscales (Perceived Prejudice and Rejection and Perceived Support and Admiration) showed good to excellent internal consistency based on McDonald's omega. They showed high concurrent and discriminant validity when compared to the Warmth-Competence Scale and the Social Impact Scale.

Discussion: This study developed and tested the first instrument to measure stigmatization of informal care for older adults as perceived by caregivers in their close social network (family and friends). This provides the basis for further research on the impact perceived care stigma has on caregivers' well-being, decision-making and care performance.