Validation of French versions of scales for evaluating the fear of hypoglycemia in children with type 1 diabetes and their parents.

Abstract

Hypoglycemia can be a major obstacle to obtaining satisfactory metabolic control for patients with type 1 diabetes (T1D) and their parents. It is essential that patients and/or parents with fear of hypoglycemia be identified (FOH), to offer them therapeutic or educational support to reduce this apprehension. To assess fear of hypoglycemia, the most widely used tool is the Hypoglycemia Fear Survey (HFS), and its three pediatric versions (HFS-Child (HFS-C), HFS-Parents (HFS-P), and HFS-Parents Young Children (HFS-PYC)). There are no similar validated questionnaires in French to assess fear of hypoglycemia. Our main objective was to translate and validate the French translation of the three pediatric versions of the HFS. Between January 2017 and December 2020, we carried out a prospective, non-interventional, multicenter, cross-sectional psychometric study in children with T1D and their parents, the aim of which was to translate and validate the French version of these surveys. The pediatric HFS were translated and adapted to French, using the forward-backward translation method. The psychometric propriety of the resulting questionnaires was then evaluated: internal consistency (Cronbach's alpha), concurrent validity (correlating a validated survey assessing anxiety about diabetes), and stability (by means of scale scores at inclusion and at 3 months). The internal consistency of the French version of HFS-C, HFS-P and HFS-PYC was very good, with respective Cronbach coefficients of 0.86, 0.85 and 0.90. There were no differences between the Hypoglycemia Fear Survey at inclusion and at 3 months. Each French version was correlated with the anxiety questionnaire. With this study, we developed a French translation of the three pediatric versions of the Hypoglycemia Fear Survey, which can be used to assess the fear of hypoglycemia in children with T1D and their parents.