Views of People with Diabetes Regarding Their Experiences of the Facilitators and Barriers in Type 1 Diabetes Inpatient Care: An Interpretative Phenomenological Analysis

Psychometric evaluation of the Chinese version of fear of hospitalization scale among outpatients: A validation study

Background

In China, some patients avoid seeking medical care and are highly sensitive to subsequent medical care because of fear of possible hospitalization after a diagnosis has been established. Early identification of fear of hospitalization is essential for clinical staff to develop targeted education and interventions. However, there are currently no tools to assess outpatients' fear of hospitalization in mainland China. This study aimed to translate the Fear of Hospitalization (FH) scale into Chinese and verify its reliability and validity in outpatients.

Methods

Through convenience sampling, 664 outpatients who required hospitalization were recruited from two cities in Liaoning Province, China. The reliability of the translated scale was measured by internal consistency, split-half reliability, and test-retest reliability. The validity of the translated scale was evaluated by expert consultation, exploratory factor analysis, and confirmatory factor analysis. Data were analyzed using SPSS 25.0 (IBM Corp., Armonk, NY, United States) and AMOS 23.0 (IBM Corp., Armonk, NY, United States).

Results

The Cronbach's α value of the Chinese version of the FH scale was 0.849, and the Cronbach's α value of the dimensions ranged from 0.857 to 0.902. The test-retest reliability value of 0.868 shows good temporal stability. The split-half reliability value of 0.910 indicates a high degree of measuring the same content. The content validity index of the scale (S-CVI) was 0.924, indicating a good level of content validity. The 3-factor structure supported by eigenvalues, total variance explained, and scree plot was obtained using exploratory factor analysis. In addition, all recommended fit indicators were within the acceptable range by confirmatory factor analysis.

Conclusion

The Chinese version of the FH scale is valid and reliable in outpatients. The developed three-factor structured scale will help identify outpatients with a high fear of hospitalization and can inform the development of educational intervention plans for care managers, physicians, and nurses. In addition, it helps clinicians and nurses take action to reduce this fear of hospitalization in patients and prevent avoidance of using health care services due to fear of hospitalization.

Non-Specialized Nurses Roles in Diabetes Inpatient Care in Cyprus: An Interpretive Phenomenological Analysis

Aim: The aim of the study was to understand how non-specialized nurses and people with diabetes understand nurses’ roles in diabetes inpatient care. Background: Diabetes mellitus is a major public health issue that places a significant burden on patients and healthcare systems and world leaders have targeted it for priority action. Design: An interpretative phenomenology approach (IPA). Methods: A total of 24 non-specialized nurses working in medical, surgical and nephrology wards and 24 people with type 1 diabetes who use the services of the state hospitals in Cyprus. The data were collected in two phases: firstly, focus groups with nurses (n = 1) and people with diabetes (n = 2) were conducted and analysed and then individual semi-structured interviews with nurses (n = 18) and with people with diabetes (n = 12) were conducted. Findings: It is evident from the study findings that nurses experience several roles in diabetes inpatient care. Most of these roles have been identified by people with diabetes as well. These roles are summarized as follows: medication administration, patient education, screening of complications, diet and psychological support. However, most of the participants raised concerns about nurses’ ability to conduct such roles. Conclusion: Participants suggest that nurses experience several roles in caring for diabetes inpatients and this view was also shared by people with diabetes. However, it was obvious that these roles differ between specialities. The findings showed that even though participants recognized a number of roles in diabetes inpatient care, their description of how they perform these roles was vague, and they raised concerns about their readiness to take on some of these roles.