학술논문
Development and validation of fear of hypoglycemia screener: results from the T1D exchange registry
Research
Research
Document Type
Academic Journal
Author
Source
Journal of Patient-Reported Outcomes. December 2023, Vol. 7 Issue 1
Subject
Language
English
Abstract
Author(s): Jingwen Liu [sup.1], Jiat-Ling Poon [sup.2], Jeoffrey Bispham [sup.1], Magaly Perez-Nieves [sup.2], Allyson Hughes [sup.1], Katherine Chapman [sup.1], Beth Mitchell [sup.2], Korey Hood [sup.3], Frank Snoek [sup.4], Lawrence Fisher [...]
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 [greater than or equal to] 18 years) with diagnosis of T1D for [greater than or equal to] 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 [alpha] = 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.
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 [greater than or equal to] 18 years) with diagnosis of T1D for [greater than or equal to] 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 [alpha] = 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.