The Application Of Chinese Version Hypoglycemia Fear Survey In Type 2 Diabetes Patients

Objective To develop the reliability and validity of the Chinese Version Hypoglycemia Fear Survey II(CHFSII) and evaluate its psychometric properties, and to provide a psychological assessment tool for type 2 diabetes mellitus. To investigate the current status of the fear of hypoglycemia in hospitalized type 2 diabetes mellitus with the history of hypoglycemia in order to provide the evidence to stuff for clinical assessment.Methods The original HFSII was translated into Chinese by adopting the Back-translation skill and applied to measure type 2 diabetes patients who had experience hypoglycemia.Content validity was evaluated by the content validity index(CVI) and the average agreement CVI(S-CVI/Ave).The construct validity was evaluated by undertaking exploratory factor analysis. Riliability was examined by using test-retest reliability and Cronbach’s alpha.396 type 2 diabetes patients with the history of hypoglycemia were recruited by multi-centers purposive sampling method. They were investigated with Chinese version of Hypoglycemia Fear Survey II-Worry Scale(CHFSII-WS), Self-rating depression scale(SDS), Self-rating anxiety scale(SAS) and Demographic survey questionnaire. T test and one-way AVOVA and multiple linear regression analysis were used to analyze the data.Results The content validity was supported by CVI and S-CVI/Ave with the value of 0.71~1.0 and 0.92 respectively. Through the exploratory factor analysis four factors were extraced which accounted for 52.959% of the total variance in the 23-item scale. The test-retested reliability and Cronbach’s alpha for the total scale were excellent with the value of 0.96 and 0.89 respectively.The median score of CHFSII-WS was 9.00 point(interquartile range, 5-16 point). The single factor analysis showed that the scores of CHFSII-WS was significantly associated with age, gender, marital status, family history, frequency of hypoglycemia, severity of hypoglycemia, anxiety and depression(t=-3.797,2.010,3.809,3.479;F=6.617,2.644,3.327,3.246; P<0.05). Regression analysis showed that severe hypolycemia, anxiety, female, divorced and the frequency of hypoglycemia were significant factors of patients’ fear of hypoglycemia(Adjusted R2=0.229,F=5.905,P<0.05).Conclusions The study demonstrated the CHFSII had an excellent reliability and content validity but the factor structure of the CHFSII-BS needed to be verified in the further study. The CHFSII-WS has the reasonable psychometric properties that can be used as a valid tool for type 2 diabetes mellitus patients in Chinese. The fear of hypoglycemia exited in T2 DM patients who have the experiment of hypoglycemia. In the clinical practice, the nursing stuff should pay attention to the evaluation of the patients’ fear of the hypoglycemia and provide the health education of hypoglycemia...