Decisional Balance for Insulin Injection: Scale Development and Psychometric Testing.
Hui-Chun Hsu, Shi-Yu Chen, Yu-Chi Huang and 3 others
PMID 30807441WHAT IT FOUND
A new 13-item scale measures both the pros and cons of insulin injection for patients.
It distinguishes between those who have started insulin and those who have not, and higher scores for pros predict willingness to begin treatment.
Key findings
01The scale successfully distinguished between insulin-naive and insulin-treated patients, with insulin-naive patients reporting significantly lower pros and decisional balance scores, and significantly higher cons.
02For insulin-naive patients, higher pros scores were associated with being in more advanced stages of considering insulin therapy, suggesting that emphasizing benefits may help move patients toward initiation.
03For insulin-treated patients, higher cons scores were significantly associated with higher HbA1c levels, indicating that negative perceptions of injection are linked to poorer glycemic control.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
Participants were recruited from only two clinics in Taiwan, so results may not apply to other cultures or healthcare systems. The sample included more men and younger patients than typical national averages, which may limit generalizability. The scale was developed from literature review rather than patient interviews, so it may miss some patient-specific concerns. The study was cross-sectional, so it could not track how individual patients' attitudes changed over time as they moved from insulin-naive to insulin-treated status.
Declared interests
The authors declare no conflicts of interest.
The easy way to misread this
Do not assume that emphasizing benefits will improve blood sugar control in patients already taking insulin. The study found that for insulin-treated patients, it was the reduction of barriers (cons), not the increase of benefits (pros), that was associated with lower HbA1c levels.