Subramaniam Mythily, Abdin Edimansyah, Bhuvaneswari S, AshaRani P V, Devi Fiona, Roystonn Kumarasan, Wang Peizhi, Samari Ellaisha, Shafie Saleha, Vaingankar Janhavi Ajit, van Dam Rob M, Lee Eng Sing, Sum Chee Fang, Chong Siow Ann
Research Division, Institute of Mental Health, Singapore, Singapore.
Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore.
Front Psychol. 2021 Jul 9;12:692573. doi: 10.3389/fpsyg.2021.692573. eCollection 2021.
To examine the extent of social stigma toward diabetes among Singapore's multi-ethnic general population and determine whether this differs across socio-demographic sub-groups. Data for this study came from a nationwide cross-sectional study. A diabetes stigma questionnaire comprising Social Distance Scale and Negative Attitudes and Stereotyping Scale was administered to those respondents who had not been diagnosed with diabetes. Exploratory factor analysis was conducted to determine the dimensionality of the instruments and validated using confirmatory factor analysis. Multiple linear regression analysis was conducted to examine associations between socio-demographic factors and measures of diabetes stigma. In all, 2,895 participants were recruited from the general population giving a response rate of 66.2%. Factor analyses found that a one-factor model resulted in an acceptable fit for both stigma scales, which measured social distance and negative attitudes and stereotyping, respectively. Multiple linear regression analyses identified Indian ethnicity (vs. Chinese), higher personal income (≥SGD2000 vs. < SGD 2000) and having close friends or family members who had been diagnosed with diabetes to be significantly associated with lower social distance scores while those aged 50-64 years and those with secondary and vocational education (vs. degree and above) were significantly associated with higher social distance scores. Those with a personal income of SG$2,000-3,999 and SGD $6,000 and above, and those with close friends or family members diagnosed with diabetes were significantly associated with lower negative attitudes and stereotyping scores. In contrast those aged 35 years and above, those with primary education and below, and those of Malay ethnicity were significantly associated with higher negative attitudes and stereotyping scores. The study found a relatively low level of stigma toward diabetes in the general population of Singapore, although some stigmatizing beliefs emerged. While greater knowledge of diabetes could reduce stigma, anti-stigma messaging should be incorporated into the "War on Diabetes" programme in Singapore.
为了调查新加坡多民族普通人群中对糖尿病的社会污名化程度，并确定不同社会人口亚组之间是否存在差异。本研究的数据来自一项全国性横断面研究。对未被诊断出患有糖尿病的受访者进行了一份包含社会距离量表以及负面态度和刻板印象量表的糖尿病污名调查问卷。进行探索性因素分析以确定这些量表的维度，并使用验证性因素分析进行验证。进行多元线性回归分析以研究社会人口因素与糖尿病污名化测量指标之间的关联。总共从普通人群中招募了2895名参与者，回复率为66.2%。因素分析发现单因素模型对两个污名量表都有可接受的拟合度，这两个量表分别测量社会距离以及负面态度和刻板印象。多元线性回归分析确定印度族裔（与华裔相比）、较高的个人收入（≥2000新元与<2000新元相比）以及有亲密朋友或家庭成员被诊断患有糖尿病与较低的社会距离得分显著相关，而年龄在50 - 64岁之间以及接受中等和职业教育的人（与本科及以上学历相比）与较高的社会距离得分显著相关。个人收入在2000 - 3999新元以及6000新元及以上的人，以及有亲密朋友或家庭成员被诊断患有糖尿病的人与较低的负面态度和刻板印象得分显著相关。相比之下，35岁及以上的人、接受小学及以下教育的人以及马来族裔的人与较高的负面态度和刻板印象得分显著相关。该研究发现新加坡普通人群中对糖尿病的污名化程度相对较低，尽管出现了一些污名化观念。虽然对糖尿病有更多了解可以减少污名，但反污名信息应纳入新加坡的“糖尿病防治战”计划中。
