The purpose of this study was to develop and evaluate the self stigma scale for diabetes patients. In this study, a scale was development two steps; the development of the items and a test of the scale.


The First step which is the development of the items consist of three sub steps; concept analysis, developing preliminary items, and content validity. Concept analysis used hybrid method. As a result of concept analysis, three dimensions, nine attributes and 23 indicators were derived. The development preliminary items were developed based on concept analysis, literature review, existing tools and interview data of ten patients. The content validity of the developed preliminary items was performed by ten experts. The second step was a test of the scale that performs pilot test, construct validity (item analysis, exploratory factor analysis, and confirmatory factor analysis), and reliability. A total of 399 diabetes patients were recruited in this step.

A total 40 preliminary items were developed. After revising and deleting a part of the items through content validity, a total 33 items remained. After the pilot study 6 items were deleted. At item analysis for construct validity testing 2 items below score 0.2 for total correlation of correlated items were deleted. And In initial exploratory factor analysis, 4 items below 0.4 for communality were deleted. After the exploratory factor analysis for 21 items, 4 factors (incompetence, social withdrawal, self devaluation, and negative feeling) accounted for 51.17% of the variance. The confirmatory factor analysis was performed with four factors. In this process, 5 items below 0.4 for standard regression weight were deleted. The final confirmatory factor analysis for the 16 items 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.

The findings revealed that the self-stigma scale for diabetes patients was a valid and reliable instrument. Consequently, the scale developed through this study can measure a self-stigma for diabetes patients. And it will be able to be used as a fundament for intervention to reduce self-stigma of patients with diabetes.