Objective To preliminarily develop the disclosure-to-healthcare-worker status scale for people living with HIV through the Delphi method and assess the authenticity, breadth, and depth of participants′ psychological inclination when disclosing information to healthcare workers, thereby informing the prediction of HIV-related disclosure behaviors.
Methods Following a systematic literature review, an initial item pool was generated. Between June and September 2025, 32 multidisciplinary experts were invited to participate in two Delphi rounds. Experts rated their familiarity with and rationale for each domain, as well as the importance and relevance of every item on a 5-point Likert scale. The response rate was calculated to reflect expert engagement. The authority coefficient (Cr) was adopted to indicate result credibility. The coefficient of variation (CV) and Kendall′s W were used to evaluate consensus. Items with mean importance or relevance ≥ 3.5 and CV < 0.25 were retained and then finalized after team discussion and expert feedback.
Results The response rate of the experts in both rounds was 96.88% (31/32), with Cr values of 0.847 and 0.852, respectively. The Kendall′s W values of expert opinions on the importance and relevance of items were 0.152 and 0.117 in the first round and 0.090 and 0.082 in the second round, respectively. The results of the first round of expert consultation showed that the items had the importance scores of 2.68–4.81 points (CV of 0.084–0.581) and the relevance scores of 2.74–4.68 points (CV of 0.116–0.557). The results of the second round of expert consultation showed that the items had the importance scores of 4.16–4.90 points (CV of 0.061–0.264) and the relevance scores of 4.23–4.87 points (CV of 0.077–0.257). After two rounds of expert consultation and expert group meetings, a 47-item scale was finally determined, including individual psychological characteristics, situations, perceived risks, perceived benefits, and disclosure effectiveness.
Conclusions This study developed a 47-item disclosure-to-healthcare-worker status scale for people living with HIV to access their actual attitudes, concerns, and tendencies when disclosing relevant information to healthcare workers. Although the reliability and validity of this scale remains to be tested, the developed scale provides a basis for improving doctor-patient communication and enhancing the quality of HIV prevention and control services.
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