Blood/Injection Fear Scale: Portuguese version, cultural adaptation and psychometric properties in a large sample of primary health care users

Abstract

BackgroundBlood/injection phobia may have important consequences for health. These phobic individuals, in most cases, avoid contact with health systems, postpone or avoid medical procedures, avoid invasive treatments and do not participate in health promotion and early detection of disease initiatives such as vaccination, consultations, preventive exams or blood donation. Thus, specific and validated instruments are necessary to assess this variable. In addition, a lack of studies on this theme may be associated with the low availability of instruments. This study aimed to propose a Portuguese version of the Blood/Injection Fear Scale (BIFS-P) and assess its psychometric properties.MethodsTranslation and back-translation were performed. Content validity was assessed in two steps by a panel of 20 experts. The psychometric properties were assessed in a stratified and representative sample of primary health care service users of Ribeirão Preto, southeastern Brazil. Exploratory and confirmatory factor analyses were conducted using a polychoric correlation matrix.ResultsA total of 1054 primary health care users participated; 79.7% were female and the mean age was 40.6 (standard deviation = 15.16) years. According to the exploratory factor analysis, the items can be grouped into three or five factors with best fits being detected for the three- and five-factor models in confirmatory factor analysis.ConclusionBlood/Injection Fear Scale (Portuguese version) is easy to understand and apply in the general population, showed adequate psychometric properties, and represents an alternative in the assessment of blood/injection phobia for future studies.

Investigation of Psychometric Properties of Blood/Injection Fear Scale-Persian Version (BIFS-PV)

“…Consistent with the results of previous studies (6,7,21), the findings of the present study substantiate that BIFS has an acceptable internal consistency, indicating the desirable validity of the scale. Confirmatory factor analysis of BIFS specified two factors of blood fear and injection fear.…”

“…It has two dimensions: the first 12 items constitute the injection subscale and analyze injection fear and the last 8 items form the blood subscale and examine blood fear. The answers are based on a five-point Likert scale (1 = strongly agree; 2 = agree; 3 = neither agree nor disagree; 4 = disagree; 5 = strongly disagree) (7). The final score of this questionnaire varies between 20 and 100, representing the minimum and maximum fear.…”

“…This could be followed by tachycardia, bradycardia, hypotension, shock, vertigo, syncope, diaphoresis, and nausea. These individuals might rarely develop asystole and die (6,7). In 8% -75% of cases, the phobic response to BII phobia stimuli is associated with syncope or presyncope (3,5).…”

“…BII may also restrict personal choices such as having a medical and nursing profession. Besides, the willingness of individuals to donate blood decreases due to this type of phobia (7). Developing and validating specific tools for assessing BII phobia are fundamental in identifying this kind of phobia and tackling its possible implications.…”

Fear of blood, injections and fainting as barriers to blood donation in Brazil

“…The prevalence of this phobia in the general population of São Paulo in 2005 was approximately 4%, with higher levels among women and individuals with low educational status . Fear of blood or injections may lead to individuals avoiding contact with health systems, postponing or avoiding medical procedures and invasive treatments, thus undermining the health of communities . Furthermore, blood or injection phobias are generally trivialized by individuals in middle‐ to low‐income countries, with few individuals seeking psychological treatment and counselling for these phobias .…”