Development and validation of the diabetes fear of injecting and self- testing questionnaire (D-FISQ): First findings

F. J. Snoek, E. D. Mollema, R. J. Heine, H. M. Van Der Ploeg

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To quantify the degree of fear of self-injecting insulin and self- testing of blood glucose in adult insulin-treated diabetic patients, the Diabetes Fear of Injecting and Self-testing Questionnaire (D-FISQ) was developed. The D-FISQ is a 30-item self-report questionnaire consisting of two subscales that measure Fear of Self-Injecting (FSI) and Fear of Self- Testing (FST). To test validity and internal consistency, the D-FISQ was administered to a sample of 266 insulin-treated patients (Type 1 and Type 2); four diagnosed injection phobic insulin-requiring diabetic patients also completed the D-FISQ. The minimal score was obtained on the subscales by 62% (FSI) and 57% (FST) of the population. The D-FISQ demonstrated high internal consistency, with Cronbach's αs of 0.94 (D-FISQ), 0.94 (FSI), and 0.90 (FST). Spearman rho between fear of self-injecting and fear of self-testing was 0.59 (p < 0.001), justifying two separate subscales. Construct validity was confirmed by a correlation of 0.44 with Spielbergers Trait Anxiety Inventory (Spearman rho, p < 0.001). FSI-scores from the injection phobic patients were all ≤95th percentile, while three scored ≤95% on FST, indicating discriminative validity. Results confirm homogeneity and validity of the D-FISQ and suggest usefulness of this instrument in both clinical practice and research.

Original languageEnglish
Pages (from-to)871-876
Number of pages6
JournalDiabetic medicine
Issue number10
Publication statusPublished - 29 Oct 1997


  • Injection phobia
  • Insulin therapy
  • Questionnaire Adults
  • Selfmonitoring of blood glucose
  • Validation

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