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
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.
Keywords
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Article info
Publication history
Published online: August 11, 2022
Accepted:
August 5,
2022
Received in revised form:
June 21,
2022
Received:
October 17,
2021
Identification
Copyright
© 2022 Primary Care Diabetes Europe. Published by Elsevier Ltd. All rights reserved.
