Debby Syahru Romadlon, Samia Salim Alharrasi, Mickael Antoine Joseph, Rudy Kurniawan, Safiruddin Al Baqi, Mario Pratama
Purpose: The purpose of the study was to adapt and psychometrically evaluate an Indonesian version of the Type 2 Diabetes Stigma Assessment Scale (I-DSAS-2) for Indonesians with type 2 diabetes. Methods: A cross-sectional psychometric and correlational study was conducted among 190 participants recruited from outpatient clinics. The Type 2 Diabetes Stigma Assessment Scale was translated and culturally adapted following established guidelines. Psychometric evaluation included exploratory factor analysis, internal consistency testing (Cronbach’s alpha), and test-retest reliability (intraclass correlation coefficient). Clinical outcomes were assessed using A1C, the Indonesian Multidimensional Fatigue Inventory, and the Beck Depression Inventory–2nd Edition. Associations between stigma and clinical outcomes were analyzed using Pearson correlations and multiple linear regression, adjusting for age, gender, diabetes duration, and comorbidities. Results: The I-DSAS-2 demonstrated excellent psychometric properties, revealing a 3-factor structure (treated differently, blame and judgement, and self-stigma), strong internal consistency, and high test-retest reliability. Higher stigma scores were significantly associated with elevated A1C, greater fatigue, and more severe depressive symptoms. In multivariate models, stigma independently predicted all 3 outcomes, with the strongest association observed for depression. Conclusion: The I-DSAS-2 is a valid, reliable, and culturally relevant instrument for assessing diabetes-related stigma in Indonesian populations. It captures the multifaceted nature of stigma and its significant links to critical clinical outcomes. © The Author(s) 2026
Faculty of Nursing, Chulalongkorn University, Bangkok, Thailand; College of Nursing, Sultan Qaboos University, Muscat, Oman; Fundamentals and Administration Department, College of Nursing, Sultan Qaboos University, Muscat, Oman; Diabetes Connection Care, Eka Hospital Bumi Serpong Damai, Tangerang, Indonesia; Faculty of Education and Teaching Sciences, State Islamic University of Kiai Ageng Muhammad Besari Ponorogo, Ponorogo, Indonesia; Faculty of Psychology and Health, Universitas Negeri Padang, Sumatera Barat, Indonesia
