| ObjectiveAn English version of the Hypoglycemia Fear Survey-Parents(HFS-P)was introduced.Through localization,cross-cultural debugging,reliability and validity tests,the applicability and practicability of Chinese scale in parents of children with type 1 diabetes in China were analyzed,so as to provide an effective evaluation tool for domestic research on fear of hypoglycemia.Method1.The researcher contacted the author of the source questionnaire by E-mail to obtain the authorization for localization.The method of Brislin double translation and back translation was adopted for Chinese translation,and cross-cultural debugging was carried out to form Chinese version HFS-P(inspection version).2.A total of 255 parents of children with type 1 diabetes from 210 families of children with diabetes treated in a third-class A hospital from July 2020 to January 2021 were selected as the research subjects.The content validity,structure validity,internal consistency,retest reliability,half reliability,criterion validity and other indicators were used to evaluate the reliability and validity of the Chinese version of the fear questionnaire for parents with hypoglycemia.Results1.According to the strict scale introduction method,cross-cultural debugging of HFS-P was carried out.The Chinese version of the scale was reduced from 25 items in the source scale to 21 items,containing 4 dimensions,which were "Maintaining high BG(The act of keeping blood sugar high to prevent hypoglycemia:3 items)","Avoid/prevent low BG(The behavior of avoid hypoglycemia:3 items)","Helplessness/worry about low BG(Worry about feeling helpless:6 items)" and "Worry about negative social consequences(Negative social effects associated with hypoglycemia:9 items)".2.The correlation coefficients between each item in the behavior scale and the total score of its subscale were 0.282-0.699 and 0.197-0.512,both of which reached the significant level(P<0.05).The correlation coefficients of item 1 in the behavior scale,subscale and total scale were all less than 0.3.The correlation coefficient between item 6 in the behavior scale and the aggregate table is less than 0.3.The correlation coefficients between the 15 items in the worry scale and the total score of the subscale were between 0.490-0.832,and between the 15 items and the total score of the subscale were between 0.474 and 0.781,both reaching the significant level(P<0.05).The correlation coefficients between each item in the worry scale and the subscale and the total scale were>0.3.Item 6 of the behavioral scale showed significant differences among the high and low groups of the total scale,but the 95%confidence interval contained 0.The remaining items of the behavior scale and all items of the worry scale had significant differences between the high and low groups of the subscale and the high and low groups of the total scale(P<0.05),and the 95%confidence interval does not include 0.3.The Cronbach’s a coefficients of Chinese version of HFS-P scale,behavior scale and worry scale was 0.915,0.705 and 0.933,and the split reliability was 0.724,0.646 and 0.840.After 15 days of the initial survey,30 parents of children with diabetes were randomly selected for remeasurement.The retest reliability ICC of Chinese version of HFS-P,Behavior Scale and Worry Scale was 0.644,0.648 and 0.711.4.The I-CVI score of each item in the scale was 0.71-1.00,and the average S-CVI=0.90.The KMO value of Chinese version of HFS-P was 0.897.In Bartlett spherical test,the scale χ2=3252.516,and the degree of freedom was 210,P<0.001.Two common factors were extracted from the Chinese version of HFS-P Behavior Scale and Worry Scale,the total interpretation rate of variance was 64.625%.The two common factors of the Behavior Scale were named as "Maintaining high BG" and "Avoid/prevent low BG",the eigenvalues were 1.671 and 2.515,the interpretation rates were 8.0%and 12.0%.The two common factors of the Worry Scale were named as "Helplessness/worry about low BG" and "Worry about negative social consequences",the eigenvalues were 3.489 and 5.896,and the interpretation rates were 16.6%and 28.1%.The correlation coefficients among the factors ranged from 0.264 to 0.664.The correlation coefficients of each factor and the total amount table were between 0.500-0.906.5.The Worry Scale score was(32.00±13.88)and the SAS score was(37.74±10.06).The simultaneous validity coefficient between the Worry Scale and SAS was 0.401(P<0.05),there was a significant positive correlation.AUC of the Worry Scale was 0.665(P=0.004),the highest Youden index was 0.332 when the score was 30 points,the corresponding sensitivity was 0.724 and the specificity was 0.580.Conclusion1.The Chinese version of HFS-P scale can be understood and filled by people of different cultural levels,ages and occupations,indicating that the scale has good applicability,operability and practicability.2.The Chinese version of HFS-P scale has good differentiation in item analysis,as well as good internal consistency,content validity and structure validity.It can be used as an assessment tool for parents of children over 6 years old in China to fear hypoglycemia.The dimension structure of behavioral scale needs to be further verified.The worry scale can be used and popularized independently,and its predictive ability needs to be further verified. |
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