{
  "abstract": "Objectives To develop and validate the Internalised Stigma Scale for Gestational Diabetes Mellitus (ISS-GDM), a questionnaire measuring self-reported internalised stigma among women with prior gestational diabetes mellitus (GDM). We hypothesised that internalised GDM stigma could be reliably and validly assessed through a short psychometric instrument.Design Cross-sectional validation study.Setting Follow-up data from the Danish, multicentre Face-it trial for women with prior GDM and their families.Participants In total, 248 women completed the ISS-GDM approximately 1 year after their GDM affected pregnancy.Primary and secondary outcome measures The primary outcome was psychometric properties of the ISS-GDM, assessed using Cronbach’s alpha, confirmatory factor analysis (CFA) and Rasch analysis (RA). Secondary outcomes included identification of item anomalies (local response dependence, differential item functioning).Results A large proportion of respondents endorsed statements reflecting self-disappointment, self-blame and an altered self-perception. Less endorsed statements included feeling inferior to other mothers or guilt towards family members due to GDM. The ISS-GDM demonstrated satisfactory psychometric properties. CFA indicated that item 2 assessing self-perceived capabilities as a mother did not load onto the main factor, while CFA and RA identified local response dependence and differential item functioning by body mass index. After adjustments, a two-factor solution supported calculating a sum score of items 1 and 3–11, with item 2 retained as a stand-alone indicator of perceived parenting capabilities. The 10-item scale demonstrated acceptable reliability (Cronbach’s alpha=0.78).Conclusions The ISS-GDM is a reliable and valid tool for assessing internalised stigma among women with prior GDM. Our findings further suggest that a substantial proportion of women with prior GDM experience self-blame and an altered self-perception due to their diagnosis. The ISS-GDM scale enables research into its prevalence, severity and consequences.",
  "authors": [
    {
      "affiliations": [
        "Department of Prevention, Steno Diabetes Center Copenhagen, Herlev, Denmark",
        "Department of Public Health, Aarhus University, Aarhus, Denmark"
      ],
      "name": "Emma Davidsen"
    },
    {
      "affiliations": [
        "Department of Prevention, Steno Diabetes Center Copenhagen, Herlev, Denmark",
        "Department of Public Health, Aarhus University, Aarhus, Denmark"
      ],
      "name": "Helle Terkildsen Maindal"
    },
    {
      "affiliations": [
        "University of Copenhagen, Copenhagen, Denmark"
      ],
      "name": "Karl Bang Christensen"
    },
    {
      "affiliations": [
        "Rigshospitalet, Copenhagen, Denmark"
      ],
      "name": "Peter Damm"
    },
    {
      "affiliations": [
        "University of Galway, Galway, Ireland"
      ],
      "name": "Molly Byrne"
    },
    {
      "affiliations": [
        "Department of Prevention, Steno Diabetes Center Copenhagen, Herlev, Denmark"
      ],
      "name": "Inger K Dahl-Petersen"
    },
    {
      "affiliations": [
        "Departments of Endocrinology and Obstetrics, Rigshospitalet, Copenhagen, Denmark",
        "Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark"
      ],
      "name": "Elisabeth R Mathiesen"
    },
    {
      "affiliations": [
        "Odense University Hospital, Odense, Denmark",
        "Steno Diabetes Center Odense, Odense, Denmark"
      ],
      "name": "Dorte M Jensen"
    },
    {
      "affiliations": [
        "Steno Diabetes Center Odense, Odense, Denmark",
        "Department of Gynaecology and Obstetrics, Odense University Hospital, Odense, Denmark"
      ],
      "name": "Christina Vinter"
    },
    {
      "affiliations": [
        "Steno Diabetes Center Aarhus, Aarhus, Denmark",
        "Department of Clinical Medicine, Aarhus University, Aarhus, Denmark"
      ],
      "name": "Ulla Kampmann"
    },
    {
      "affiliations": [
        "Steno Diabetes Center Aarhus, Aarhus, Denmark",
        "Department of Clinical Medicine, Aarhus University, Aarhus, Denmark"
      ],
      "name": "Per G Ovesen"
    },
    {
      "affiliations": [
        "Steno Diabetes Center Copenhagen, Herlev, Capital Region of Denmark, Denmark"
      ],
      "name": "Karoline Kragelund Nielsen"
    }
  ],
  "title": "Psychometric validation of the Internalised Stigma Scale for Gestational Diabetes Mellitus (ISS-GDM): a cross-sectional study",
  "uid": "1256cd9b-cc33-5562-9a54-38443c89e433"
}