Type 2 Diabetes Stigma Assessment Scale (DSAS-2): Cultural and linguistic adaptation and psychometric assessment of the Arabic version. Issue 5 (October 2022)

• Record Type: Journal Article
• Authors: Alzubaidi, Hamzah; Namara, Kevin Mc; Samorinha, Catarina; Saidawi, Ward; Versace, Vincent L.; Speight, Jane
• Is Part Of: Primary care diabetes. Volume 16:Issue 5(2022)
• Page Start: 703
• Page End: 708
• Publication Date: 2022-10
• Subjects: Diabetes Mellitus -- Type 2 -- Social stigma -- Validation study -- Psychometrics -- Surveys and questionnaires; Diabetes -- Periodicals; 616.462
• DOI: 10.1016/j.pcd.2022.08.004
• Languages: English
• ISSNs: 1751-9918

Abstract

Abstract: Aims: To culturally and linguistically adapt the Type 2 Diabetes Stigma Assessment Scale (DSAS-2) into Arabic and assess its psychometric properties. Methods: Following forward-backward translation of the DSAS-2, the Content Validity Index (CVI) was assessed. Cognitive debriefing and pilot testing were conducted with adults with T2DM. The Arabic DSAS-2 was included in a multi-center, cross-sectional study (N = 327) Arabic-speaking adults with type 2 diabetes. Psychometric analyses included exploratory and confirmatory factor analysis (EFA/CFA), internal consistency reliability, and convergent validity. Results: The Arabic DSAS-2 was considered appropriate, with an excellent CVI (0.98). Unforced EFA revealed a satisfactory three-factor structure, indicating the same subscales as the original instrument ('Treated differently', 'Blame and judgment', 'Self-stigma'). EFA for three factors showed good indicators (KMO=0.924; Bartlett's test of sphericity χ2 = 4063.709, df=171, p < 0.001). Internal consistency was satisfactory for both the three-factor structure (α = 0.91, α = 0.88, and α = 0.88, respectively) and the single factor (α = 0.94). CFA results were inconclusive. Although fit indices improved for the single-factor model, compared to the three-factor, they remained inadequate. The total scale demonstrated satisfactory convergent validity with self-esteem. Conclusions: The Arabic DSAS-2 has excellent reliability and acceptable validity, supporting a three-factor structure as well as the use of a total score. Highlights: Arabic version of the Type 2 Diabetes Stigma Assessment Scale (DSAS-2) was developed A rigorous cultural adaptation and validation process was followed The Arabic DSAS-2 has excellent reliability and acceptable validity Internal consistency was satisfactory for three factors and a single factor (α ≥ 0.88) The Arabic DSAS-2 can be used in the 25 Arabic-speaking countries