Reexamining the Hypoglycemia Fear Survey for Parents of Young Children in a Sample of Children Using Insulin Pumps

Abstract

Background: We update the psychometric properties of the Hypoglycemia Fear Survey-Parents of Young Children (HFS-PYC), a 26-item measure of parents' hypoglycemia fear for young children using an insulin pump. Methods: We combined three similar datasets for the analyses. The data analyzed included parents' responses to the HFS-PYC and a demographic form. For a subset of children (n = 91), we also analyzed self-monitoring of blood glucose data. We used confirmatory factor analysis (CFA) to confirm the measure's original factor structure. Additional analyses examined reliability and validity of a revised HFS-PYC for parents of young children using pumps. Results: We analyzed data from 116 parents (93% mothers). Mean child age and HbA1c were 5.2 -1.3 years and 8.2% -1.1%, respectively. CFA identified a 22-item two-factor solution (v 2 (208, n = 116) = 368.688, P < 0.001, root mean square error of approximation = 0.08, comparative fit index = 0.94, and Tucker-Lewis index = 0.93) with factors corresponding to the original subscales: worry and behavior. The revised subscales demonstrated at least adequate internal consistency (Cronbach's alpha >0.65). Correlations revealed significant negative associations between current HFS-PYC worry scores and children's mean daily blood glucose and percent of very high glucose levels per day, suggesting less fear among parents of young children with elevated glycemic levels. In addition, there was a positive association with the percent of glucose levels in target, suggesting greater hypoglycemia fear among parents of children who have better control. Conclusions: Results provide preliminary evidence for the reliability and validity of a reduced 22-item HFS-PYC for parents of children using insulin pumps.

Challenges and Considerations for Reducing Diabetes Distress and Fear of Hypoglycemia in Parents of Youth With Type 1 Diabetes During the COVID-19 Pandemic (Preprint)

“…Further, parents who report maladaptive coping strategies also report decreases in mental and physical health [7]. In our own work, we found that nearly 60% of parents of young children with T1D (<6 years) report at least a moderate level of hypoglycemia fear (FH) [8,9]. In addition, our data and the results of published studies suggest that between 10%-74% of parents report diabetes distress (DD) [5,6,10,11].…”

Funcionamento Psicológico Parental e Controle Glicêmico de Crianças com Diabetes Mellitus Tipo 1: Uma Revisão de Escopo

“…Três estudos só revelaram a faixa etária como critério de inclusão 24,26,27 . Houve maior predominância de crianças do sexo feminino, mas em quatro estudos 16,17,28,29 o percentual de meninos e meninas foi igualitário. A média de tempo de DM1 das crianças foi de 2,86 anos (DP = 0,96), no entanto, sete estudos não informaram esse dado 16,[27][28][29][30][31][32] .…”

“…Houve maior predominância de crianças do sexo feminino, mas em quatro estudos 16,17,28,29 o percentual de meninos e meninas foi igualitário. A média de tempo de DM1 das crianças foi de 2,86 anos (DP = 0,96), no entanto, sete estudos não informaram esse dado 16,[27][28][29][30][31][32] . A maioria das crianças estavam em regime de tratamento convencional (injeções) e cerca de 38,46% do total de crianças usavam bomba de insulina na ocasião dos estudos que relataram essa informação.…”

“…A maioria das crianças estavam em regime de tratamento convencional (injeções) e cerca de 38,46% do total de crianças usavam bomba de insulina na ocasião dos estudos que relataram essa informação. Três estudos 17,28,31 incluíram exclusivamente crianças que usavam bomba de insulina, enquanto que dois 20,27 incluíram somente crianças em regime de tratamento convencional.…”

Challenges and Considerations for Reducing Diabetes Distress and Fear of Hypoglycemia in Parents of Youth With Type 1 Diabetes During the COVID-19 Pandemic

“…Further, parents who report maladaptive coping strategies also report decreases in mental and physical health [ 7 ]. In our own work, we found that nearly 60% of parents of young children with T1D (<6 years) report at least a moderate level of hypoglycemia fear (FH) [ 8 , 9 ]. In addition, our data and the results of published studies suggest that between 10%-74% of parents report diabetes distress (DD) [ 5 , 6 , 10 , 11 ].…”