{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T11:30:32Z","timestamp":1791199832542,"version":"4.2.0"},"reference-count":36,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2022,9,1]],"date-time":"2022-09-01T00:00:00Z","timestamp":1661990400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J of Diabetes Invest"],"published-print":{"date-parts":[[2022,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Aims\/Introduction<\/jats:title><jats:p>The aim of this study was to develop a scale to evaluate disease stigma in patients with lifestyle\u2010related chronic non\u2010communicable diseases (LCNCDs), which we named the Kanden Institute Stigma Scale (KISS), and to consider its possible clinical application for patients with diabetes.<\/jats:p><\/jats:sec><jats:sec><jats:title>Materials and methods<\/jats:title><jats:p>An initial 90 questions were drafted and categorized into six subscales according to the manifestations of stigma. The final version of the KISS was developed as a 24\u2010item questionnaire comprising four items for each subscale.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 539 outpatients including 452 patients with diabetes and 87 patients without diabetes were recruited. Construct validity was confirmed by assessing the correlation with previously established measures. Confirmatory factor analysis showed the KISS to have good model fitness (adjusted goodness\u2010of\u2010fit index\u2009=\u20090.856). Test\u2013retest reproducibility analysis showed that the intraclass coefficient of the first and a second KISS was 0.843 (<jats:italic>P<\/jats:italic>\u2009&lt;\u20090.001), indicating excellent reproducibility. The KISS showed higher scores for patients with diabetes than for patients without diabetes (12.23\u2009\u00b1\u20090.49 vs 5.76\u2009\u00b1\u20090.73, <jats:italic>P<\/jats:italic>\u2009&lt;\u20090.05). The KISS score was significantly higher in type\u20091 and type\u20092 diabetes patients taking insulin therapy than in type\u20092 diabetes patients not taking insulin (<jats:italic>P<\/jats:italic>\u2009&lt;\u20090.05).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>The KISS is a validated and reliable questionnaire for assessment of stigma among patients with diabetes as well as other lifestyle\u2010related chronic non\u2010communicable diseases, and might contribute to identifying and rectifying diabetes stigma, as well promoting awareness among health care professionals of this very consequential health problem.<\/jats:p><\/jats:sec>","DOI":"10.1111\/jdi.13894","type":"journal-article","created":{"date-parts":[[2022,9,1]],"date-time":"2022-09-01T09:12:07Z","timestamp":1662023527000},"page":"2081-2090","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":13,"title":["Stigma evaluation for diabetes 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