The Design And Clinical Application Of The Hypoglycemia Fear-Behavior Scale In Type 2 Diabetes Patients

Objective:1.Based on the preliminary exploration of the behaviors caused by fear of hypoglycemia in type 2 diabetes patients,to design the Hypoglycemia Fear-Behavior Scale suitable for domestic type 2 diabetes patients,and test its reliability and validity.2.The scale was preliminary applied to clinical to investigate the current status and influencing factors of the behavior of hypoglycemia fear in the patients with type 2 diabetes mellitus,so as to provide the evidence to stuff for the clinical education.Methods: 1.Based on the theory of knowledge-attitude-belief-practice and social cognitive theory,this article constructs an item pool based on qualitative interviews with type 2 diabetes patients with hypoglycemia,the contents of foreign scales,literatures and experts opinions.After group discussion,patients opinions collection and experts consultation,the test version of the scale was obtained.2.The type 2diabetes patients who had hypoglycemia within 6 months were selected for questionnaires.The items were selected by the method of item analysis,coefficient of variability,the cronbach’s α coefficient and the factor analysis.The reliability and validity of the scale were evaluated from the test-retest reliability,internal consistency reliability,content validity and construct validity.3.The scale was tested in type 2 diabetes patients who had hypoglycemia within 6 months to detailed analyze the current status and influencing factors of the behavior of hypoglycemia fear.Results:1.The Hypoglycemia Fear-Behavior Scale which we designed consists of19 items,the item level content validity index(I-CVI)of the Hypoglycemia Fear Survey-Behavior Scale was 0.84~1.00,the scale-level content validity index(S-CVI)was 0.97,through the exploratory factor analysis 3 factors were extracted,named avoidance,caution,and maintain high blood glucose,respectively,which accounted for 46% of the total variance.The test-retested reliability of the scale was 0.924,Cronbach’s α coefficient was 0.845.2.The scores of the Hypoglycemia Fear-Behavior Scale were between 20 and 91,with an average of(47.65 ± 13.02)points.The three dimensions according to the average score from high to low order as:caution,avoidance,maintain high blood glucose.3.The single factor analysis showed that there were significant differences in scores of diffierent gender,duration,living style,residence,medical expenses,diabetes education,diet control,weekly exercise time,daily insulin injections,smoking,drinking,nocturnal hypoglycemia and asymptomatic hypoglycemia(P <0.05).4.Multiple linear regression analysis showed that dietary control,diabetes education,asymptomatic hypoglycemia,medical expenses and gender were the influencing factors of hypoglycemia fear behavior(P<0.05).Conclusion:The results show that patients have fear of hypoglycemia and have made some changes in behavior to avoid hypoglycemia,manifested as caution,avoidance,maintain high blood glucose.In the survey results,dietary control,diabetes education,asymptomatic hypoglycemia,medical expenses and gender were the influencing factors of hypoglycemic fear behavior.Medical staff should attach importance to the inner feelings and behaviors of diabetes patients with hypoglycemia,carry on the individualized education in view of the above factors based on comprehensive assessment,working together with patients to realize the effective management of blood glucose.In the meanwhile,the Hypoglycemia Fear-Behavior Scale which we designed has excellent reliability and validity,and can be used to evaluate the hypoglycemia fear behavior in type 2 diabetes patients,so as to provide the evidence to stuff for the clinical education of patients with hypoglycemic fear.