成人糖尿病患者低血糖恐惧评估工具的系统评价

doi:10.3761/j.issn.1672-9234.2024.07.017

摘要/Abstract

摘要：

目的系统评价成人糖尿病患者低血糖恐惧评估工具的测量属性及相关研究的方法学质量，为医护人员选择合适的评估工具提供循证依据。方法系统检索PubMed、Embase、CINAHL、Web of Science、中国知网、维普及万方数据库中有关成人糖尿病患者低血糖恐惧评估工具的研究，检索时限为建库至2023年8月23日。由2名研究者独立进行文献筛选和资料提取，按照健康测量工具选择的共识标准（consensus-based standards for the selection of health measurement instruments，COSMIN）对纳入评估工具的测量属性及相关研究的方法学质量进行评价，形成最终推荐意见。结果共纳入15项研究，涉及15种成人低血糖恐惧评估工具，均未评价工具的跨文化效度、测量误差及反应性。因有高质量证据证明低血糖恐惧筛选量表的内容效度、内部一致性均为“充分”，该评估工具为A类推荐工具，9种评估工具为B类推荐工具，5种评估工具为C类推荐工具。结论成人糖尿病患者低血糖恐惧评估工具多样，但整体质量不高。低血糖恐惧筛选量表内容简洁明了，截断值明确，测量属性得到较为全面的评价，信效度较好，可优先被推荐应用。

关键词: 糖尿病, 低血糖恐惧, 成年人, 评估工具, COSMIN指南, 系统评价

Abstract:

Objective To systematically evaluate the measurement properties and methodological quality of hypoglycemia fear assessment tools for adult diabetic patients，and to provide evidence-based support for healthcare professionals to select appropriate assessment tools. Methods Databases were systematically searched for studies on hypoglycemia fear assessment tools for adult diabetic patients，including PubMed，Embase，CINAHL，Web of Science，CNKI，VIP，and WanFang. Time limit was set from databases’ establishment to August 23，2023. After that，two researchers independently screened the literature and extracted the data. The measurement properties and methodological quality of the included assessment tools were evaluated according to the consensus-based standards for the selection of health measurement instruments（COSMIN） guideline，and final recommendations were decided. Results A total of 15 studies involving 15 hypoglycemia fear assessment tools for adults were included，none of which evaluated the cross-cultural validity，measurement error，or responsiveness of the tools. The Fear of Hypoglycemia Screener was recommended as Class A tools for its high-quality evidence supporting its content validity and internal consistency as “sufficient”. In addition，nine assessment tools were recommended as Class B tools，and five were rated as Class C tools. Conclusion There is a diversity of hypoglycemia fear assessment tools for adult diabetic patients，though the overall quality is not high. The Fear of Hypoglycemia Screener，with concise language expression，comprehensive content，clear cut-off values，comprehensively evaluated measurement properties，and good reliability and validity，can be recommended as priority in employment.

Key words: Diabetes mellitus, Fear of hypoglycemia, Adult, Assessment instruments, COSMIN guideline, Systematic review

刘素香, 张华芳, 石亚君, 刘青青, 张莹, 杨丽黎. 成人糖尿病患者低血糖恐惧评估工具的系统评价[J]. 中华护理教育, 2024, 21(7): 873-880.

LIU Suxiang, ZHANG Huafang, SHI Yajun, LIU Qingqing, ZHANG Ying, YANG Lili. A systematic review of hypoglycemic fear assessment tools in adult diabetic patients[J]. Chinese Journal of Nursing Education, 2024, 21(7): 873-880.

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