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

Adult 03 medical and health sciences Cross-Sectional Studies 0302 clinical medicine Diabetes Mellitus, Type 2 Psychometrics Surveys and Questionnaires Humans Reproducibility of Results Linguistics 10. No inequality
DOI: 10.1016/j.pcd.2022.08.004 Publication Date: 2022-08-11T12:12:56Z
ABSTRACT
To culturally and linguistically adapt the Type 2 Diabetes Stigma Assessment Scale (DSAS-2) into Arabic and assess its psychometric properties.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.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.The Arabic DSAS-2 has excellent reliability and acceptable validity, supporting a three-factor structure as well as the use of a total score.
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