The science of diabetes self-management and care · 2026
Psychometric Evaluation of the Indonesian Version of the Type 2 Diabetes Stigma Assessment Scale and Its Clinical Correlates With Glycated Hemoglobin, Fatigue, and Depression.
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Romadlon Debby Syahru, Alharrasi Samia Salim, Joseph Mickael Antoine, Kurniawan Rudy, Al Baqi Safiruddin, Pratama Mario
Аннотация
PURPOSE: The purpose of the study was to adapt and psychometrically evaluate an Indonesian version of the Type 2 Diabetes Stigma Assessment Scale (I-DSAS-2) for Indonesians with type 2 diabetes.
METHODS: A cross-sectional psychometric and correlational study was conducted among 190 participants recruited from outpatient clinics. The Type 2 Diabetes Stigma Assessment Scale was translated and culturally adapted following established guidelines. Psychometric evaluation included exploratory factor analysis, internal consistency testing (Cronbach's alpha), and test-retest reliability (intraclass correlation coefficient). Clinical outcomes were assessed using A1C, the Indonesian Multidimensional Fatigue Inventory, and the Beck Depression Inventory-2nd Edition. Associations between stigma and clinical outcomes were analyzed using Pearson correlations and multiple linear regression, adjusting for age, gender, diabetes duration, and comorbidities.
RESULTS: The I-DSAS-2 demonstrated excellent psychometric properties, revealing a 3-factor structure (treated differently, blame and judgement, and self-stigma), strong internal consistency, and high test-retest reliability. Higher stigma scores were significantly associated with elevated A1C, greater fatigue, and more severe depressive symptoms. In multivariate models, stigma independently predicted all 3 outcomes, with the strongest association observed for depression.
CONCLUSION: The I-DSAS-2 is a valid, reliable, and culturally relevant instrument for assessing diabetes-related stigma in Indonesian populations. It captures the multifaceted nature of stigma and its significant links to critical clinical outcomes.
METHODS: A cross-sectional psychometric and correlational study was conducted among 190 participants recruited from outpatient clinics. The Type 2 Diabetes Stigma Assessment Scale was translated and culturally adapted following established guidelines. Psychometric evaluation included exploratory factor analysis, internal consistency testing (Cronbach's alpha), and test-retest reliability (intraclass correlation coefficient). Clinical outcomes were assessed using A1C, the Indonesian Multidimensional Fatigue Inventory, and the Beck Depression Inventory-2nd Edition. Associations between stigma and clinical outcomes were analyzed using Pearson correlations and multiple linear regression, adjusting for age, gender, diabetes duration, and comorbidities.
RESULTS: The I-DSAS-2 demonstrated excellent psychometric properties, revealing a 3-factor structure (treated differently, blame and judgement, and self-stigma), strong internal consistency, and high test-retest reliability. Higher stigma scores were significantly associated with elevated A1C, greater fatigue, and more severe depressive symptoms. In multivariate models, stigma independently predicted all 3 outcomes, with the strongest association observed for depression.
CONCLUSION: The I-DSAS-2 is a valid, reliable, and culturally relevant instrument for assessing diabetes-related stigma in Indonesian populations. It captures the multifaceted nature of stigma and its significant links to critical clinical outcomes.