Psychometric validation and reliability of the Japanese version of the type 1 diabetes stigma assessment scale (DSAS-1 JP).

Abstract

We aimed to develop and validate a Japanese version of the type 1 diabetes (T1D) stigma assessment scale (DSAS-1 JP) to measure the stigma perceived and experienced by adults with T1D. The DSAS-1 JP was created through forward and backward translations, cognitive debriefing with 10 participants, and extensive proofreading. Its reliability and validity were evaluated in 384 adults with T1D using confirmatory factor analysis, Cronbach's α for internal reliability, and Spearman's rank correlation for construct validity. The DSAS-1 JP was found to be acceptable by the experts and the target population. Confirmatory factor analysis verified the three-factor structure representing 'treated differently', 'blame and judgement', and 'identity concern', with Cronbach's α values of 0.86, 0.85, and 0.89, respectively. Overall, Cronbach's α for the DSAS-1 JP was 0.92. The model fit indices were robust (goodness-of-fit index=0.94, comparative fit index=0.94, root mean square error of approximation=0.068). Correlations of the DSAS-1 JP score with diabetes distress (r = 0.60, p < 0.001), self-esteem (r = -0.28, p < 0.001), and depressive symptoms (r = 0.34, p < 0.001) confirmed its constant validity. The test-retest reliability was strong at 0.77 (p < 0.0001). The DSAS-1 JP is a reliable and valid tool for assessing the extent of perceived and experienced stigma in Japanese adults with T1D.