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