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      Reliability and validity of the Chinese version of the new fear of hypoglycemia scale: FH-15

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          Abstract

          Objective

          This study aimed to evaluate the reliability and validity of the Chinese version of the Fear of Hypoglycemia scale with 15 items (FH-15).

          Methods

          After obtaining the original author's authorization, the English version of the FH-15 scale was translated, back translated, and culturally debugged to obtain the Chinese version of FH-15. A convenient sampling method was used to extract patients with type 2 diabetes from four tertiary hospitals in Tianjin. A total of 408 patients with type 2 diabetes were investigated in the hospital to test the reliability and validity of Chinese version FH-15 scale.

          Results

          The content validity index of the scale was 0.92, and the content validity index of each item was 0.8–1.0. The exploratory factor analysis extracted three common factors (fear, avoidance, and interference), which contained 15 items, and the cumulative variance contribution rate was 71.245%. The confirmatory factor analysis results showed that the model fit was better at 1.981 χ 2/ df, GFI = 0.901, CGI = 0.962, TLI = 0.952, and RMSEA = 0.070. The cut-off value for the total hypoglycemia fear scale was 30.5. The Cronbach's α coefficient of the three dimensions of the scale was 0.918, the Cronbach's α coefficient of each dimension is 0.876–0.916, the test–retest reliability was 0.903, and the test–retest reliability of each factor was 0.733–0.930.

          Conclusion

          The Chinese version of the FH-15 scale can be considered reliable and valid. The item expression is concise, clear, and easy to understand. It is suitable for clinical practice as an initial screening tool to identify and evaluate the severity of fear of hypoglycemia in patients with type 2 diabetes.

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          Most cited references21

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          Fear of hypoglycemia: quantification, validation, and utilization.

          Hypoglycemia can lead to various aversive symptomatic, affective, cognitive, physiological, and social consequences, which in turn can lead to the development of possible phobic avoidance behaviors associated with hypoglycemia. On the other hand, some patients may inappropriately deny or disregard warning signs of hypoglycemia. This study presents preliminary reliability and validity data on a psychometric instrument designed to quantify this fear: the hypoglycemic fear survey. The instrument was found to have internal consistency and test-retest stability, to covary with elevated glycosylated hemoglobin, and to be sensitive to a behavioral treatment program designed to increase awareness of hypoglycemia.
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            Psychometric Properties of the Hypoglycemia Fear Survey-II for Adults With Type 1 Diabetes

            OBJECTIVE To perform the first comprehensive psychometric evaluation of the Hypoglycemia Fear Survey-II (HFS-II), a measure of the behavioral and affective dimensions of fear of hypoglycemia, using modern test-theory methods, including item-response theory (IRT). RESEARCH DESIGN AND METHODS Surveys completed in four previous studies by 777 adults with type 1 diabetes were aggregated for analysis, with 289 subjects completing both subscales of the HFS-II and 488 subjects completing only the Worry subscale. The aggregated sample (53.3% female, 44.4% using insulin pumps) had a mean age of 41.9 years, diabetes duration of 23.8 years, HbA1c value of 7.7%, and 1.4 severe hypoglycemic episodes in the past year. Data analysis included exploratory factor analysis using polychoric correlations and IRT. Factors were analyzed for fit, trait-level locations, point-measure correlations, and separation values. RESULTS Internal and test-retest reliability was good, as well as convergent validity, as demonstrated by significant correlations with other measures of psychological distress. Scores were significantly higher in subjects who had experienced severe hypoglycemia in the past year. Factor analyses validated the two subscales of the HFS-II. Item analyses showed that 12 of 15 items on the Behavior subscale, and all of the items on the Worry subscale had good-fit statistics. CONCLUSIONS The HFS-II is a reliable and valid measure of the fear of hypoglycemia in adults with type 1 diabetes, and factor analyses and IRT support the two separate subscales of the survey.
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              Predictors of Quality of Life and Other Patient-Reported Outcomes in the PANORAMA Multinational Study of People With Type 2 Diabetes

              PANORAMA, a nine-country cross-sectional type 2 diabetes study, investigated factors associated with quality of life (QoL), health status, and other patient-reported outcome measures (PROMs).
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                Author and article information

                Contributors
                Journal
                Int J Nurs Sci
                Int J Nurs Sci
                International Journal of Nursing Sciences
                Chinese Nursing Association
                2096-6296
                2352-0132
                21 September 2018
                10 October 2018
                21 September 2018
                : 5
                : 4
                : 343-351
                Affiliations
                [a ]Department of Graduate, Tianjin University of Traditional Chinese Medicine, Tianjin, China
                [b ]University of Malaga, Spain
                [c ]The Ministry of Health Key Laboratory of Hormone and Development, Metabolic Disease Hospital of Tianjin Medical University, China
                [d ]Department of Nursing, Tianjin University of Traditional Chinese Medicine, Tianjin, China
                Author notes
                []Corresponding author. Jing Hai District Health Industry Park, 301617, Department of Nursing, Tianjin University of Traditional Chinese Medicine, Tianjin, China. jcd1886@ 123456sina.cn 853245087@ 123456qq.com
                Article
                S2352-0132(18)30223-0
                10.1016/j.ijnss.2018.09.008
                6626267
                31406846
                4567c0aa-3534-4bcd-80b7-d1675bd9cec7
                © 2018 Chinese Nursing Association. Production and hosting by Elsevier B.V.

                This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).

                History
                : 6 May 2018
                : 8 September 2018
                : 17 September 2018
                Categories
                Original Article

                diabetes mellitus,type 2,fear,hypoglycemia,reliability,validity
                diabetes mellitus, type 2, fear, hypoglycemia, reliability, validity

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