Propiedades psicométricas de la versión en español del Type 2 Diabetes Stigma Assessment Scale (DSAS 2) en población colombiana

Victor Pedrero, Luz Marina Alonso , Jorge Manzi , .

Palabras clave: diabetes mellitus, estigma social, reproducibilidad de los resultados

Resumen

Introducción. El estigma se ha asociado negativamente al control metabólico y la calidad de vida de pacientes con diabetes de tipo 2. El cuestionario Diabetes Stigma Assesment Scale 2 (DSAS 2) fue diseñado para medir específicamente el estigma asociado en personas con este tipo de diabetes. Sin embargo, las propiedades psicométricas de su versión en español aún no han sido analizadas.
Objetivo. Analizar la validez y confiabilidad de la versión en español del DSAS 2 en población colombiana.
Materiales y métodos. Se solicitó a 501 pacientes con diabetes de tipo 2 en Barranquilla contestar la versión en español del DSAS 2, un cuestionario con indicadores sociodemográficos y clínicos, así como instrumentos de medición de la depresión, la autoeficacia y el estrés. Se hizo un análisis factorial (exploratorio y confirmatorio) para determinar la estructura interna del DSAS 2 en español y se usó el coeficiente alfa (α) para evaluar su confiabilidad. Además, se analizó la relación entre los puntajes del DSAS 2 y las otras variables estudiadas.
Resultados. La estructura de tres factores (trato diferente-juicio, culpa y vergüenza) se ajustó adecuadamente a los datos (raíz del error cuadrático medio (RMSEA)=0,081, índice de ajuste comparativo (CIF)=0,959, índice de Tucker-Lewis (TLI)=0,95) y su confiabilidad fue buena (α=0,76). Se observaron correlaciones significativas del puntaje del DSAS 2 en español con la autoeficacia (rs=-0,37; p<0,001), el estrés (rs=0,24; p<0,001) y la presencia de síntomas depresivos (rs=0,1; p=0,021). Además, los puntajes de la escala mostraron variaciones asociadas a variables sociodemográficas y clínicas.
Conclusiones. La versión en español presenta ciertas diferencias con la versión original del DSAS2, sin embargo, su validez y confiabilidad son suficientes y adecuadas para su uso en Colombia.

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  • Victor Pedrero Facultad de Enfermería, Universidad Andrés Bello, Santiago, Chile; Escuela de Psicología, Pontificia Universidad Católica de Chile, Santiago, Chile
  • Luz Marina Alonso Departamento de Salud Pública, Universidad del Norte, Barranquilla, Colombia
  • Jorge Manzi Escuela de Psicología, Pontificia Universidad Católica de Chile, Santiago, Chile

Referencias bibliográficas

International Diabetes Federation. IDF Diabetes Atlas. Brussels, Belgium: International Diabetes Federation; 2019.

Vargas-Uricoechea H, Casas-Figueroa LA. An epidemiologic analysis of diabetes in Colombia. Ann Glob Health. 2015;81:742-53. https://doi.org/10.1016/j.aogh.2015.11.001

Gallardo-Rincón H, Cantoral A, Arrieta A, Espinal C, Magnus MH, Palacios C, et al. Review: Type 2 diabetes in Latin America and the Caribbean: Regional and country comparison on prevalence, trends, costs and expanded prevention. Prim Care Diabetes. 2020;15:352-9. https://doi.org/10.1016/j.pcd.2020.10.001

Avilés-Santa ML, Monroig-Rivera A, Soto-Soto A, Lindberg NM. Current state of diabetes mellitus prevalence, awareness, treatment, and control in Latin America: Challenges and innovative solutions to improve health outcomes across the continent. Curr Diab Rep. 2020;20:62. https://doi.org/10.1007/s11892-020-01341-9

Speight J, Hendrieckx C, Pouwer F, Skinner TC, Snoek FJ. Back to the future: 25 years of ‘Guidelines for encouraging psychological well-being’ among people affected by diabetes’. Diabet Med. 2020;37:1225-9. https://doi.org/10.1111/dme.14165

Goffman E. Stigma: Notes on the management of spoiled identity. New York: J. Aronson; 1974. p.147

Gollust SE, Lantz PM. Communicating population health: Print news media coverage of type 2 diabetes. Soc Sci Med. 2009;69:1091-8. https://doi.org/10.1016/j.socscimed.2009.07.009

Abdoli S, Doosti Irani M, Hardy LR, Funnell M. A discussion paper on stigmatizing features of diabetes. Nurs Open. 2018;5:113-9. https://doi.org/10.1002/nop2.112

Pedrero V, Alonso L, Manzi J. El estigma asociado a la diabetes: elementos conceptuales, mecanismos involucrados y desafíos. Salud Uninorte. 2021;37:205-19. https://doi.org/10.14482/sun.37.1.610.7

Liu NF, Brown AS, Folias AE, Younge MF, Guzmán SJ, Close KL, et al. Stigma in people with type 1 or type 2 diabetes. Clin Diabetes. 2017;35:27-34. https://doi.org/10.2337/cd16-0020

Browne JL, Ventura AD, Mosely K, Speight J. Measuring the stigma surrounding type 2 diabetes: Development and validation of the type 2 Diabetes Stigma Assessment Scale (DSAS-2). Diabetes Care. 2016;39:2141-8. https://doi.org/10.2337/dc16-0117

Kato A, Yamauchi T, Kadowaki T. A closer inspection of diabetes-related stigma: Why more research is needed. Diabetol Int. 2020;11:73-5. https://doi.org/10.1007/s13340-019-00421-w

Gredig D, Bartelsen-Raemy A. Diabetes-related stigma affects the quality of life of people living with diabetes mellitus in Switzerland: Implications for healthcare providers. Health and Social Care in the Community. 2016;25:1620-33. https://doi.org/10.1111/hsc.12376

Holmes-Truscott E, Ventura AD, Thuraisingam S, Pouwer F, Speight J. Psychosocial moderators of the impact of diabetes stigma: Results from the second diabetes MILES -Australia (MILES-2) Study. Diabetes Care. 2020;43:2651-9. https://doi.org/10.2337/dc19-2447

Kato A, Fujimaki Y, Fujimori S, Isogawa A, Onishi Y, Suzuki R, et al. How self-stigma affects patient activation in persons with type 2 diabetes: A cross-sectional study. BMJ Open. 2020;10:e034757. https://doi.org/10.1136/bmjopen-2019-034757

Puhl RM, Himmelstein MS, Hateley-Browne JL, Speight J. Weight stigma and diabetes stigma in US adults with type 2 diabetes: Associations with diabetes self-care behaviors and perceptions of health care. Diabetes Res Clin Pract. 2020;168:108387. https://doi.org/10.1016/j.diabres.2020.108387

Brown SA, García AA, Brown A, Becker BJ, Conn VS, Ramírez G, et al. Biobehavioral determinants of glycemic control in type 2 diabetes: A systematic review and meta-analysis. Patient Educ Couns. 2016;99:1558-67. https://doi.org/10.1016/j.pec.2016.03.020

Nyblade L, Stockton MA, Giger K, Bond V, Ekstrand ML, Lean RM, et al. Stigma in health facilities: Why it matters and how we can change it. BMC Medicine. 2019;17:25. https://doi.org/10.1186/s12916-019-1256-2

Lorig KR, Ritter PL, González VM. Hispanic chronic disease self-management: A randomized community-based outcome trial. Nurs Res. 2003;52:361-9. https://doi.org/10.1097/00006199-200311000-00003

Young-Hyman D, Groot Md, Hill-Briggs F, González JS, Hood K, Peyrot M. Psychosocial care for people with diabetes: A position statement of the American Diabetes Association. Diabetes Care. 2016;39:2126-40. https://doi.org/10.2337/dc16-2053

Martínez P, Soto-Brandt G, Brandt S, Guajardo V, Rojas G. Validación inicial de Patient Health Questionnaire 2-Item para detectar síntomas depresivos en diabéticos y / o hipertensos en l atención primaria de salud. Rev Med Chil. 2020;148:1614-8. https://doi.org/10.4067/S0034-98872020001101614

McGuire BE, Morrison TG, Hermanns N, Skovlund S, Eldrup E, Gagliardino J, et al. Shortform measures of diabetes-related emotional distress: The Problem Areas in Diabetes Scale (PAID)-5 and PAID-1. Diabetologia. 2010;53:66-9. https://doi.org/10.1007/s00125-009-1559-5

Beléndez-Vázquez M, Lorente-Armendariz I, Maderuelo-Labrador M. Emotional distress and quality of life in people with diabetes and their families. Gac Sanit. 2015;29:300-3. https://doi.org/10.1016/j.gaceta.2015.02.005

Beléndez M, Hernández-Mijares A, Marco J, Domínguez JR, Pomares FJ. Validation of the Spanish version of the Problem Areas in Diabetes (PAID-SP) Scale. Diabetes Res Clin Pract. 2014;106:e93-e5. https://doi.org/10.1016/j.diabres.2014.09.012

Yang LH, Chen FP, Sia KJ, Lam J, Lam K, Ngo H, et al. “What matters most:” a cultural mechanism moderating structural vulnerability and moral experience of mental illness stigma. Soc Sci Med. 2014;103:84-93. https://doi.org/10.1016/j.socscimed.2013.09.009

Geifman N, Cohen R, Rubin E. Redefining meaningful age groups in the context of disease. Age (Dordr). 2013;35:2357-66. https://doi.org/10.1007/s11357-013-9510-6

Morales L. El financiamiento del sistema de seguridad social en salud en Colombia. Santiago, Chile: Comisión Económica para America Latina y El Caribe (CEPAL); 1997.

Hair JF. Multivariate data analysis. Eighth edition. Andover, Hampshire: Cengage; 2019. 813 p.

Inkaya B, Karadag E. Turkish validity and reliability study of type 2 diabetes stigma assessment scale. Turk J Med Sci. 2021;51:1302-6. https://doi.org/10.3906/sag-2006-255

Phelan J, Link BG, Dovidio JF. “Stigma and prejudice: One animal or two?”. Soc Sci Med. 2008;67:358-67. https://doi.org/10.1016/j.socscimed.2008.03.022

Corrigan PW, Rao D. On the self-stigma of mental illness: Stages, disclosure, and strategies for change. Can J Psychiatry. 2012;57:464-9. https://doi.org/10.1177/070674371205700804

Gausel N, Leach CW. Concern for self-image and social image in the management of moral failure: Rethinking shame. Eur J Soc Psychol. 2011;41:468-78. https://doi.org/10.1002/ejsp.803

Tracy JL, Robins RW. Appraisal antecedents of shame and guilt: Support for a theoretical model. Pers Soc Psychol Bull. 2006;32:1339-51. https://doi.org/10.1177/0146167206290212

Dawson AZ, Walker RJ, Campbell JA, Egede LE. Effect of perceived racial discrimination on self-care behaviors, glycemic control, and quality of life in adults with type 2 diabetes. Endocrine. 2015;49:422-8. https://doi.org/10.1007/s12020-014-0482-9

Werner P, Aviv A, Barak Y. Self-stigma, self-esteem and age in persons with schizophrenia. Int Psychogeriatr. 2008;20:174-87. https://doi.org/10.1017/S1041610207005340

Brown RL. Perceived stigma among people with chronic health conditions: The influence of age, stressor exposure, and psychosocial resources. Res Aging. 2015;37:335-60. https://doi.org/10.1177/0164027514533133

Clement S, Schauman O, Graham T, Maggioni F, Evans-Lacko S, Bezborodovs N, et al. What is the impact of mental health-related stigma on help-seeking? A systematic review of quantitative and qualitative studies. Psychol Med. 2015;45:11-27. https://doi.org/10.1017/S0033291714000129

Smith PB, Vignoles VL, Becker M, Owe E, Easterbrook MJ, Brown R, et al. Individual and culture-level components of survey response styles: A multi-level analysis using cultural models of selfhood. Int J Psychol. 2016;51:453-63. https://doi.org/10.1002/ijop.12293

Johnson T, Kulesa P, Cho YI, Shavitt S. The relation between culture and response styles: Evidence from 19 countries. Journal of Cross-Cultural Psychology. 2005;36:264-77. https://doi.org/10.1177/0022022104272905

Pedrero V, Manzi J. Self-beliefs, engagement and motivation in science and mathematics: Are they universal? Int J Educ Res. 2020;101:101562. https://doi.org/10.1016/j.ijer.2020.101562

Cameron J, Voth J, Jaglal SB, Guilcher SJT, Hawker G, Salbach NM. “In this together”: Social identification predicts health outcomes (via self-efficacy) in a chronic disease selfmanagement program. Soc Sci Med. 2018;208:172-9. https://doi.org/10.1016/j.socscimed.2018.03.007

American Educational Research A, American Psychological A, National Council on Measurement in E. Standards for educational and psychological testing 2014 edition. Washington, D.C: AERA; 2014. p. 230

Cómo citar
1.
Pedrero V, Alonso LM, Manzi J. Propiedades psicométricas de la versión en español del Type 2 Diabetes Stigma Assessment Scale (DSAS 2) en población colombiana. biomedica [Internet]. 1 de mayo de 2022 [citado 26 de noviembre de 2022];42(Sp. 1):41-54. Disponible en: https://revistabiomedica.org/index.php/biomedica/article/view/6128
Publicado
2022-05-01

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