Phobia of self‐injecting and self‐testing in insulin‐treated diabetes patients: opportunities for screening

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Abstract
Aims  To define clinically relevant cut‐off points for severe fear of self‐injecting (FSI) and self‐testing (FST) (phobia) in insulin‐treated patients with diabetes, and to estimate the magnitude of these phobias in our research population.Methods  FSI and FST were assessed in a cross‐sectional survey using the Diabetes Fear of Injecting and Self‐testing Questionnaire (D‐FISQ). A sample of 24 insulin‐treated adult diabetic patients was selected from the high‐scorers on FSI and/or FST (≥ 95th percentile). FSI and FST were re‐assessed, after which patients participated in a behavioural avoidance test (BAT), thereby determining the current level of avoidance of either self‐injecting or self‐testing. FSI and FST scores were linked to the outcome of the BATs. Cut‐off scores for severe FSI/FST were determined and extrapolated to the total study population (n = 1275).Results  Seven patients participated in the self‐injecting BAT: two patients refused to perform an extra injection. In the self‐testing BAT (n = 17) four patients declined to perform the extra blood glucose self‐test. Extrapolation of FSI and FST cut‐off scores to the total research population showed that 0.2–1.3% of the population scored in the severe FSI range. In FST, 0.6–0.8% of the total study population obtained scores in the cut‐off range.Conclusions  Severe FSI and FST, characterized by emotional distress and avoidance behaviour, seems to occur in a small group of insulin‐treated patients with diabetes. The D‐FISQ can be of use to health care professionals (physicians, nurse specialists) in quickly providing valuable information on levels of FSI and FST in diabetes patients.Diabet. Med. 18, 671–674 (2001)

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