Stigma is known as social isolation of an individual because of his/her situation such as chronic disease conditions. Stigma in chronic disease have been associated with patients’ psychosocial behaviors. Stigma is classified as social stigma and self-stigma, but studies of self-stigma in diabetes was insufficient due to lack of measuring tools. The aim of this study was to develop and evaluate the self-stigma scale in patients with diabetes. The preliminary items of self-stigma scale developed through hybrid concept analysis. To confirm the psychometric properties, contents validity by experts, construct validity such as item analysis, exploratory and confirmatory factor analysis, and reliability were performed. Total 399 patients with diabetes (type 1 and type 2) were recruited from two University hospital in Korea. Initial 40 items were extracted through literature review and in-depth interview during hybrid concept analysis. In content validity, 27 items remained. At item analysis for construct validity, two items below score 0.2 for total correlation of correlated items were deleted. In exploratory factor analysis, 21 items with 4 factors (incompetence, social withdrawal, self-devaluation, and negative feeling) were extracted and it accounted for 51.17% of the variance. In confirmatory factor analysis, 5 items below 0.4 for standard regression weight were dropped. Final 16 items with four factors was acceptable level of goodness-of-fit parameters (CMIN/DF=2.742, SRMR=0.149, RMSEA=0.090, GFI=0.867, AGFI=0.816, CFI=0.910). The reliability of the scale was Cronbach’s alpha=.89.
In conclusion, the self-stigma scale in diabetes have shown good validity and reliability. This scale can be used as an effective tool to measure diabetes related self-stigma, and be investigated what factors can be associated with self-stigma in diabetes in future study.
K. Seo: None. J. Cho: None. B. Ku: Research Support; Self; AstraZeneca. Speaker's Bureau; Self; AstraZeneca, Lilly Diabetes, Sanofi-Aventis. A. Lim: None. G. Ko: None. Y. Song: None.