Abstract
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.
Get full access to this article
View all access options for this article.
References
Supplementary Material
Please find the following supplemental material available below.
For Open Access articles published under a Creative Commons License, all supplemental material carries the same license as the article it is associated with.
For non-Open Access articles published, all supplemental material carries a non-exclusive license, and permission requests for re-use of supplemental material or any part of supplemental material shall be sent directly to the copyright owner as specified in the copyright notice associated with the article.
