Zhongguo quanke yixue (Jun 2024)
Reliability and Validity of the Chinese Version of Type 1 Diabetes Stigma Assessment Scale for Adolescents
Abstract
Background Stigma in adolescents with type 1 diabetes mellitus (T1DM) is closely associated with their health outcomes. Currently, there is a lack of stigma assessment tools for this population. Objective To translate the Type 1 Diabetes Stigma Assessment Scale (DSAS-1) and test its reliability and validity in Chinese adolescents with T1DM. Methods A total of 194 patients with T1DM admitted to the First Affiliated Hospital with Nanjing Medical University and Children's Hospital of Nanjing Medical University were selected as the study subjects by using the convenient sampling method from March 2022 to March 2023. The English version of DSAS-1 was directly translated, back-translated and culturally adapted by using Brislin's classical back translation model to form a Chinese version. The Self-designed General Information Questionnaire, the Chinese version of the DSAS-1, the Diabetes Strengths and Resilience Measure for Adolescents, the Parent-child Relationship Scale, and the Quality of Life Scale was used to conduct investigation. Exploratory factor analysis and confirmatory factor analysis were used to test the structural validity of the scale, and the internal consistency of the version was evaluated by calculating the Cronbach's α coefficients. Correlation analyses with the Diabetes Strengths and Resilience Measure for Adolescents, the Parent-child Relationship Scale, and the Quality of Life Scale were conducted to confirm the effect of the Chinese version of DSAS-1 in detecting stigma among adolescents. Results A total of 194 valid questionnaires were recovered. The exploratory factor analysis and confirmatory factor analysis results showed that the Chinese version of DSAS-1 for adolescents was categorized into three dimensions of differential treatment, complaints and comments and identity concerns, with good structural validity (all factor load>0.55, cumulative variance=67.98%), convergent validity (AVE>0.5), and discriminant validity (correlation coefficients of each dimension less than the square root of AVE). The reliability test results showed good internal consistency of the scale (Cronbach's α coefficient of 0.930). The total score of the Chinese version of DSAS-1 for adolescents was negatively correlated with the total scores of the Diabetes Strengths and Resilience Measure for Adolescents (r=-0.425, P<0.001), the Parent-child Relationship Scale (r=-0.302, P<0.001), and the Quality of Life Scale (r=-0.408, P<0.001) . Conclusion The Chinese version of DSAS-1 for adolescents has good reliability and validity and is simple and easy to conduct, which can provide a reliable quantitative assessment tool for the stigma of adolescents with T1DM in China.
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