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- Title
Development and validation of fear of hypoglycemia screener: results from the T1D exchange registry.
- Authors
Liu, Jingwen; Poon, Jiat-Ling; Bispham, Jeoffrey; Perez-Nieves, Magaly; Hughes, Allyson; Chapman, Katherine; Mitchell, Beth; Hood, Korey; Snoek, Frank; Fisher, Lawrence
- Abstract
Background: Fear of Hypoglycemia (FoH) in people with diabetes has a significant impact on their quality of life, psychological well-being, and self-management of disease. There are a few questionnaires assessing FoH in people living with diabetes, but they are more often used in research than clinical practice. This study aimed to develop and validate a short and actionable FoH screener for adults living with type 1 diabetes (T1D) for use in routine clinical practice. Methods: We developed an initial screener based on literature review and, interviews with healthcare providers (HCPs) and people with T1D. We developed a cross-sectional web-based survey, which was then conducted to examine the reliability and validity of the screener. Adults (aged ≥ 18 years) with diagnosis of T1D for ≥ 1 year were recruited from the T1D Exchange Registry (August–September 2020). The validation analyses were conducted using exploratory factor analyses, correlation, and multivariable regression models for predicting cut-off scores for the final screener. Results: The final FoH screener comprised nine items assessing two domains, "worry" (6-items) and "avoidance behavior" (three items), in 592 participants. The FoH screener showed good internal consistency (Cronbach's α = 0.88). The screener also demonstrated high correlations (r = 0.71–0.75) with the Hypoglycemia Fear Survey and moderate correlations with depression, anxiety, and diabetes distress scales (r = 0.44–0.66). Multivariable regression analysis showed that higher FoH screener scores were significantly associated with higher glycated hemoglobin (HbA1c) (b = 0.04) and number of comorbidities (b = 0.03). Conclusions: This short FoH screener demonstrated good reliability and validity. Further research is planned to assess clinical usability to identify patients with FoH and assist effective HCP-patient conversations.
- Subjects
EXPERIMENTAL design; WELL-being; RESEARCH; RESEARCH evaluation; RESEARCH methodology; RESEARCH methodology evaluation; SELF-management (Psychology); CROSS-sectional method; MULTIVARIATE analysis; MEDICAL screening; TYPE 1 diabetes; FEAR; REGRESSION analysis; INTERVIEWING; CRONBACH'S alpha; PSYCHOSOCIAL factors; HYPOGLYCEMIA; QUALITY of life; QUESTIONNAIRES; FACTOR analysis; RESEARCH funding; DESCRIPTIVE statistics; STATISTICAL correlation; PEOPLE with diabetes; MIDDLE age
- Publication
Journal of Patient-Reported Outcomes, 2023, Vol 7, Issue 1, p1
- ISSN
2509-8020
- Publication type
Article
- DOI
10.1186/s41687-023-00585-9