title: Cultural adaptation, validation and development of a spanish brief version of the diabetes fear of injecting and self-testing questionnaire.
abstract: OBJECTIVE
  To develop and validate in Spain a test to measure fear of injecting and selftesting [HIAT-I](c) in diabetic patients by translating and adapting the original English version of the Diabetes Fear of Injecting and Self-Testing Questionnaire (D-FISQ).
  
  
  METHODS
  Forward-backward translations in duplicate were carried out and were revised by an expert and a nonexpert panel. Men and women with type 1 and type 2 diabetes aged more than 18 years old were enrolled in three primary care centers. The Spanish version of the D-FISQ was administered on two separate occasions at a 15-day interval. The trait-anxiety scale of the Stait-Trait Anxiety Inventory (STAI) and five specific questions on glycemic control, insulin injection, pain and worry were administered. Sociodemographic and clinical data were also collected. Feasibility, construct validity, concept validity and reliability were assessed.
  
  
  RESULTS
  A 32-item version of the D-FISQ was developed by an expert panel and was administered to 93 (35 Type 1, 58 Type 2) insulin-treated diabetic patients. Ninetynine per cent of the patients answered all items in 5 minutes (median). Item-total correlation and factor analysis led to an abridged, 19-item version, maintaining the two original dimensions, and explaining 47.4% percent of the total variance: fear of self-injecting (FSI), accounting for 29.5% of the variance, and fear of self-testing (FST), accounting for 17.9%. Test-retest correlation coefficients were 0.85 (FSI) and 0.94 (FST). The correlations between STAI and FSI and FST were not statistically significant (p=0.771). The correlation coefficient between FSI and time under insulin treatment was -0.546 (p=0.023).
  
  
  CONCLUSIONS
  We developed a newrecalibrated version of the Spanish D-FISQ called the MIAT-D. The feasibility, dimensionality, construct validity and reliability of this questionnaire were accurate. The concept validity of this test should be explored in further studies.
authors.affiliation: Centro de Atención Primaria Cervera. Cervera. Lleida. España. Electronic address: Silvia.Diaz@pfizer.com.
authors.forename: Pilar
authors.initials: P
authors.lastname: Baillo
authors.forename: Felix
authors.initials: F
authors.lastname: Laporta
authors.forename: Joan
authors.initials: J
authors.lastname: Martorell
authors.forename: Paloma
authors.initials: P
authors.lastname: González
authors.forename: Pablo
authors.initials: P
authors.lastname: Rebollo
authors.forename: Joaquín
authors.initials: J
authors.lastname: Moris
authors.forename: Javier
authors.initials: J
authors.lastname: Rejas
authors.forename: Silvia
authors.initials: S
authors.lastname: Díaz