Department of Personality, Assessment, and Psychological Treatment, Faculty of Psychology, University of Malaga, Spain.
Psychol Assess. 2011 Jun;23(2):398-405. doi: 10.1037/a0021927.
Hypoglycemia is the most common adverse event associated with insulin treatment in diabetes. The consequences of hypoglycemia can be quite aversive and potentially life threatening. The physical sequelae provide ample reason for patients to fear hypoglycemia and avoid episodes. For these reasons, our purpose in this study was to develop a new measure that explores specific fear of hypoglycemia (FH) in adult patients with type 1 diabetes and to examine its psychometric properties. The instrument developed to assess FH was initially made up of 20 items, of which 18 were negative and 2 were positive, assessed on a 5-point Likert scale (1-5). This scale was completed by 229 patients with type 1 diabetes. Additionally, a structured interview and a closed question called subjective fear of hypoglycemia were included as diagnostic criteria. A factor analysis employing the principal-components method and promax rotation was carried out, resulting in a new scale composed of 15 items. Three factors (fear, avoidance, and interference) were obtained and explained 58.27% of the variance. The scale showed good internal consistency (Cronbach's α = .891) and test-retest reliability (r = .908, p < .001), as well as adequate concurrent and predictive validity. The cutoff score that provided the highest overall sensitivity and specificity was set at 28 points. The Fear of Hypoglycemia 15-item scale (FH-15) demonstrated good reliability and validity. This study suggests that the new instrument may serve as a valuable measure of specific FH for use in research and clinical practice.
低血糖是糖尿病患者接受胰岛素治疗最常见的不良事件。低血糖的后果可能非常令人不快，并有潜在的生命威胁。身体上的后遗症足以让患者害怕低血糖并避免发作。基于这些原因，我们在这项研究中的目的是开发一种新的方法来评估 1 型糖尿病成年患者的特定低血糖恐惧，并检验其心理测量学特性。用于评估 FH 的仪器最初由 20 个项目组成，其中 18 个为负面，2 个为正面，采用 5 点李克特量表（1-5）进行评估。该量表由 229 名 1 型糖尿病患者完成。此外，还包括结构化访谈和一个名为“低血糖主观恐惧”的封闭问题作为诊断标准。采用主成分法和 promax 旋转进行因子分析，得出一个由 15 个项目组成的新量表。得到了三个因子（恐惧、回避和干扰），解释了 58.27%的方差。该量表显示出良好的内部一致性（Cronbach's α =.891）和重测信度（r =.908，p <.001），以及足够的同时效度和预测效度。设定总分最高的敏感性和特异性的截断值为 28 分。15 项低血糖恐惧量表（FH-15）具有良好的信度和效度。本研究表明，新仪器可能成为研究和临床实践中评估特定 FH 的一种有价值的方法。
