Aims and Objectives To conduct a concept analysis of self‐stigma among patients with diabetes and introduce an operational definition of self‐stigma. Background Due to fears of being monitored, patients with diabetes often conceal their disease and/or withdraw from social relationships. These behaviours negatively affect patients’ self‐care and socialisation. Design A concept analysis was conducted using a three‐phase (theoretical phase, fieldwork phase and final analysis phase) hybrid method by Schwartz‐Barcott and Kim (Nursing research methodology: Issues and implementations, 1986, Rockville, MD: Aspen). Methods During the theoretical phase, a literature search was conducted using PubMed and CINAHL. Using COREQ guidelines, in the fieldwork phase, in‐depth interviews were conducted with nine participants with diabetes. The recorded data were analysed using a grounded theory approach. Results from both were included in the analytic phase. Results In the fieldwork phase, nine patients with diabetes (four men and five women; mean age = 57.00 ± 21.93 years) participated in the interview. The mean duration of diabetes was 21.44 ± 12.39 years. The self‐stigma concept included three categories with nine attributes: affective (negative feelings and feeling sorry for others who have concerns about me), cognitive (low self‐esteem and self‐efficacy, perceived weakness, low expectations for the future, worry for children and disease burden) and behavioural factors (social withdrawal and avoiding disease disclosure). The nine attributes included 23 indicators. Conclusions Self‐stigma among patients with diabetes is defined as a state in which patients develop negative self‐feelings as they deal with the disease. This can cause diminished self‐esteem and self‐efficacy, as well as a tendency to avoid disclosing the illness along with social withdrawal. Relevance to Clinical Practice Based on this self‐stigma concept analysis, we clarified the attributes of diabetes self‐stigma and distinguished it from social stigma in nurse professionals during patient education and clinical assessment.

The purpose of this study was to compare factors influencing depression in elderly people who live alone and those who do not live alone. Methods: The data were obtained from the 6th and the 7th Korea National Health and Nutrition Examination Survey. Data for 3,218 elderly people were included. Variables related to general, physical and psychological characteristics were selected. Results: The results of the study were as follows. 1) The factors affecting depression in elders living alone were dinner frequency, presence of hypertension or stroke, walking time, Body Mass Index, activity limitation, stress, body image, and quality of life, and their explanatory power was 50.0%. 2) Factors influencing depression in elders not living alone were sex, economic level, educational level, frequency of breakfast and lunch, activity limitation, stress, subjective health status and quality of life, and the explanatory power was 35.2%. Conclusion: The results of this study show that factors affecting depression are different according to the elders' residence type. In order to prevent depression in elderly people, it is necessary to establish different strategies according to their residence type.

Aim To develop and initially validate the Diabetes Self‐Stigma Scale for assessing self‐stigma in people with diabetes. Design Scale development and evaluation. Methods Participants were 399 patients with diabetes. In phase 1, initial items were generated based on the concept analysis of diabetes self‐stigma. Moreover, content validity was established by diabetes experts. Phase 2 evaluated structural validity through item analysis, exploratory factor analysis and confirmatory factor analysis. Reliability was evaluated by examining stability and internal consistency. Results The findings revealed that the self‐stigma scale for patients with diabetes is a valid and reliable instrument. The Diabetes Self‐Stigma Scale was confirmed with 16 items. It consists of four domains: comparative inability, social withdrawal, self‐devaluation and apprehensive feeling. The scale developed in this study can measure self‐stigma in diabetes patients and can be used as an intervention to reduce self‐stigma.

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