AIMS: The Hypoglycemia Fear Survey (HFS)-II Behaviour and Worry subscales were developed to measure behaviours and anxiety related to hypoglycaemia in diabetes. However, previous studies found lower reliability in the HFS Behaviour subscale and inconsistent relationships with glucose control. The purpose of this study was to conduct extensive analyses of the internal structure of the HFS Behaviour subscale's internal structure and its relationships with diabetes outcomes, including HbA1c and episodes of severe hypoglycaemia. METHODS: HFS-II survey data from 1460 adults with Type 1 diabetes were collected from five countries. This aggregated sample underwent exploratory factor analysis and item analysis to determine the internal structure of the survey and subscales. RESULTS: A three-factor solution showed the best fit for the HFS, with two subscales emerging from the HFS Behaviour representing tendencies towards (1) maintenance of high blood glucose and (2) avoidance of hypoglycaemic risks by other behaviours, and a third single HFS Worry subscale. Subscale item analysis showed excellent fit, separation and good point-measure correlations. All subscales demonstrated acceptable (0.75) to excellent (0.94) internal reliability. HbA(1c) correlated with Maintain High Blood Glucose subscale scores, r = 0.14, P < 0.001, and severe hypoglycaemia frequency correlated with all subscales. CONCLUSIONS: The HFS Worry subscale measures one construct of anxiety about various aspects of hypoglycaemia. In contrast, the HFS Behaviour subscale appears to measure two distinct aspects of behavioural avoidance to prevent hypoglycaemia, actions which maintain high blood glucose and other behaviours to avoid hypoglycaemic risk. These results demonstrate the clinical importance of the HFS Behaviour subscales and their differential relationships with measures of diabetes outcome such as HbA1c .
AIMS: The Hypoglycemia Fear Survey (HFS)-II Behaviour and Worry subscales were developed to measure behaviours and anxiety related to hypoglycaemia in diabetes. However, previous studies found lower reliability in the HFS Behaviour subscale and inconsistent relationships with glucose control. The purpose of this study was to conduct extensive analyses of the internal structure of the HFS Behaviour subscale's internal structure and its relationships with diabetes outcomes, including HbA1c and episodes of severe hypoglycaemia. METHODS: HFS-II survey data from 1460 adults with Type 1 diabetes were collected from five countries. This aggregated sample underwent exploratory factor analysis and item analysis to determine the internal structure of the survey and subscales. RESULTS: A three-factor solution showed the best fit for the HFS, with two subscales emerging from the HFS Behaviour representing tendencies towards (1) maintenance of high blood glucose and (2) avoidance of hypoglycaemic risks by other behaviours, and a third single HFS Worry subscale. Subscale item analysis showed excellent fit, separation and good point-measure correlations. All subscales demonstrated acceptable (0.75) to excellent (0.94) internal reliability. HbA(1c) correlated with Maintain High Blood Glucose subscale scores, r = 0.14, P < 0.001, and severe hypoglycaemia frequency correlated with all subscales. CONCLUSIONS: The HFS Worry subscale measures one construct of anxiety about various aspects of hypoglycaemia. In contrast, the HFS Behaviour subscale appears to measure two distinct aspects of behavioural avoidance to prevent hypoglycaemia, actions which maintain high blood glucose and other behaviours to avoid hypoglycaemic risk. These results demonstrate the clinical importance of the HFS Behaviour subscales and their differential relationships with measures of diabetes outcome such as HbA1c .
Authors: Sue A Brown; Marc D Breton; Stacey M Anderson; Laura Kollar; Patrick Keith-Hynes; Carol J Levy; David W Lam; Camilla Levister; Nihat Baysal; Yogish C Kudva; Ananda Basu; Vikash Dadlani; Ling Hinshaw; Shelly McCrady-Spitzer; Daniela Bruttomesso; Roberto Visentin; Silvia Galasso; Simone Del Favero; Yenny Leal; Federico Boscari; Angelo Avogaro; Claudio Cobelli; Boris P Kovatchev Journal: J Clin Endocrinol Metab Date: 2017-10-01 Impact factor: 5.958
Authors: Morey W Haymond; Maria J Redondo; Siripoom McKay; Martin J Cummins; Brett Newswanger; John Kinzell; Steven Prestrelski Journal: Diabetes Care Date: 2016-02-09 Impact factor: 19.112
Authors: Jun Yang Lee; Carina Ka Yee Chan; Siew Siang Chua; Chirk Jenn Ng; Thomas Paraidathathu; Kenneth Kwing-Chin Lee; Shaun Wen Huey Lee Journal: BMC Health Serv Res Date: 2016-09-29 Impact factor: 2.655
Authors: J Kropff; J DeJong; S Del Favero; J Place; M Messori; B Coestier; A Farret; F Boscari; S Galasso; A Avogaro; D Bruttomesso; C Cobelli; E Renard; L Magni; J H DeVries Journal: Diabet Med Date: 2016-10-28 Impact factor: 4.359