Worry Subscale Research Articles

Athletic Identity Associations in Young Sports Medicine Patients.

Few studies have assessed athletic identity levels in young patients. This study examined athletic identity in adolescents and explored associations between athletic identity, patterns of sport participation, and coping skills. Patients aged 12 to 18 years who received sports medicine care completed a one-time, voluntary, anonymous survey. Surveys included demographics, sport participation information, Athletic Identity Measurement Scale (AIMS), and Athletic Coping Skills Inventory (ACSI). Statistical analysis included Fisher exact test, Student t test, Wilcoxon rank sum test, Kruskal-Wallis test, and Pearson correlation. Three hundred thirty-four patients (mean ± SD age 15.0 ± 1.8 years, 64.7% girls) completed questionnaires. The mean AIMS and ACSI scores were 45.2 ± 11.5 and 50.2 ± 10.9, respectively. No notable differences were observed in AIMS scores between age groups or sexes. An increase in mean AIMS scores (higher athletic identity) was seen with greater weekly hours of sport participation (P < 0.001) and months per year of primary sport participation (P < 0.001). Multisport per season athletes had higher AIMS scores than single-sport athletes (48.2 ± 10.1 vs. 43.0 ± 11.9, P < 0.001). Team sport athletes reported higher athletic identities than individual sport athletes (47.0 ± 10.7, 41.4 ± 11.4, P < 0.001). Athletic Identity Measurement Scale scores positively correlated with ACSI scores (r = 0.31, P < 0.0001). Athletes with the highest athletic identity had markedly higher scores on ACSI subscales of Coachability, Concentration, Confidence and Achievement Motivation, Goal Setting and Mental Preparation, and Peaking Under Pressure than athletes with the least athletic identity. However, those with the highest athletic identities reported significantly lower scores on the ACSI Freedom From Worry subscale (P < 0.001). Athletic identity did not differ among adolescents by age or sex. Athletic identity was higher in team sport athletes and those with increased sport participation volumes. While high athletic identity was associated with higher scores on favorable coping skill dimensions, these athletes may also worry more, potentially placing them at greater psychological risk after injury.

Associations of Sleep Quality and Physical Activity with Diabetes Quality of Life in Korean Americans with Type 2 Diabetes: A Cross-Sectional Study.

The cross-sectional study aimed to examine the associations of sleep quality and physical activity with diabetes quality of life in Korean Americans with type 2 diabetes. A total of 119 Korean American adults with type 2 diabetes were recruited from Korean communities in Arizona, USA. The Pittsburgh Sleep Quality Index for sleep quality, the International Physical Activity Questionnaire for physical activity, and the Diabetes Quality of Life (DQOL) for quality of life were assessed. Descriptive statistics, bivariate correlations, and multiple linear regressions were conducted. The mean score of the total DQOL was 1.85 (SD = 0.28). Approximately 70% of those had poor sleep quality and a third showed low physical activity. The findings demonstrated that both sleep quality and low physical activity were independent predictors of overall DQOL scores, indicating that poor sleep quality and low physical activity are associated with reduced Diabetes Quality of Life in this demographic. Specifically, the satisfaction subscale of DQOL showed significant associations with low physical activity levels, suggesting that enhancing physical activity could potentially improve satisfaction within DQOL. Furthermore, the impact subscale was positively related to sleep quality, suggesting that better sleep quality might significantly lower the perceived negative impact of diabetes on daily life. No significant associations were found between sleep quality, physical activity, and the worry subscale of DQOL in the adjusted models. The study indicates that addressing sleep quality and promoting physical activity are essential components of diabetes management strategies aimed at improving the quality of life for Korean Americans with type 2 diabetes. This underlines the need for tailored interventions that consider cultural preferences and individual needs to enhance diabetes outcomes and quality of life in this population.

Diabetes-related distress and quality of life among people with type 2 diabetes at primary care level in Brazil.

Living with diabetes can be challenging, particularly when it comes to dealing with psychological distress and requiring self-care directives. Patients may feel frustrated, angry, overwhelmed, and discouraged. This study aimed to investigate the diabetes-related distress and quality of life among people with type 2 diabetes mellitus (T2DM). A cross-sectional study carried out at the Clinical Research Centre at the University of Campinas, Brazil, between September 2020 and April 2021. Patients answered data regarding demographic and clinical variables, the Brazilian version of the Diabetes Distress Scale and the Diabetes Quality of Life (QOL) Measure by telephone contact. The data were managed using the RedCap System. For statistical analysis of the data, the Mann-Whitney and Kruskal-Wallis tests were applied for comparisons, and the Chi-square test for associations. The correlations were evaluated using the Spearman correlation coefficient. Out of the 302 participants we recruited, 50.33% exhibited significant diabetes-related distress. Those with elevated diabetes-related distress scores had shorter education levels (p < 0.05), lower HbA1c levels (p < 0.05), and lower total scores in Diabetes QOL Measure (p < 0.0001), particularly in the QOL impact (p < 0.0001), social/vocational worry (p < 0.05), and diabetes worry (p < 0.0001) subscales compared to the group with the lowest diabetes-related distress. Elevated diabetes-related stress scores significantly affect patients' QOL. Therefore, early screening of individuals at risk for this condition, using well-coordinated protocols, could mitigate adverse QOL effects and enhance their overall experience during disease management.

Psychometric properties of the Sport Anxiety Scale-2 for Chinese adolescent athletes taking the National Sports College Entrance Examination.

This study aims to evaluate the psychometric properties of the Sport Anxiety Scale-2 (SAS-2) in Chinese adolescent sports exam candidates. One day before the National Sports College Entrance Examination, 965 Chinese athletes rated the Chinese-language SAS-2. Confirmatory factor analysis was performed to test the three-factor structure. Factorial invariance was tested by comparing the configural invariance model to three more constrained models. Construct validity and reliability were determined. Fit indices meet the critical values: CFI = 0.953, TLI = 0.943, RMSEA = 0.048 [90% CI, 0.041-0.054], and SRMR = 0.042. All path factor loadings exceed 0.5. The changes in CFI and RMSEA across the configural, metric, scalar, and uniqueness invariance are within the critical values, demonstrating strict measurement invariance across gender, years of training, and type of sports. The average variance extracted of the worry sub-scale is above the cutoff criteria, and McDonald's omega coefficients are over 0.70. Significant correlations exist between the SAS-2, SCAT, and CSAI-2. Factor correlations are all below 0.8. The measurement also distinguishes the known gender effect, with females showing a probability of 58.6% higher anxiety levels. The intraclass correlation coefficient ranges from 0.706 to 0.801. This study validated the Chinese-language SAS-2 in measuring competitive anxiety among Chinese adolescent athletes taking the National Sports College Entrance Examination. The development of the scale's applicability in China is discussed.

Translation and Validation Study of the Hypoglycemia Fear Survey in a Greek Population of Children and Adolescents with Type 1 Diabetes Mellitus and their Parents.

The present study attempted to translate and culturally adapt an established research instrument, the Hypoglycemia Fear Survey (HFS) questionnaire, to the Greek population and evaluate its validity and internal consistency so that it can be used for the assessment of hypoglycemia fear in Greek children and adolescents with T1DM and their parents. One hundred Greek children and adolescents with T1DM, 54 males, 6-18 years old, and one of their parents participated in this validation study. The participants completed the translated Greek HFS, which includes one version for children (CHFS) and one for parents (PHFS). Exploratory Factor Analysis (EFA) was used to assess construct validity. Internal consistency was assessed using Cronbach's alpha, and convergent validity was established by estimating the correlation coefficients between the scores of the HFS scales/subscales and the different constructs of the Pediatric Quality of Life Inventory. The CHFS and PHFS exhibited adequate internal consistency for the total score and the Worry subscale, but lower consistency for the Behavior subscale. High test-retest reliability was also shown. We conclude that the Greek version of the HFS is a valid and reliable instrument to assess the fear of hypoglycemia in Greek children and adolescents with T1DM and their parents.

Short-term effects of the "I Spy Feelings" program on emotion regulation in 5- to 6-year-old children.

Mental health difficulties in early childhood can have a debilitating and ongoing impact throughout an individual's life; emotion regulation can serve as a protective factor. Therefore, evidence-based prevention programs that teach children effective skills and strategies for emotion regulation are needed. As part of the Aussie Optimism pilot study evaluating the "I Spy Feelings" program, this study aims to assess the short-term effects of the program on emotion regulation in pre-primary aged children after 2 months via a longitudinal cluster randomized controlled trial. Participants included parents (N = 73) of 5- to 6-year-old children attending four different Catholic primary schools. Children from two of the schools were allocated to the intervention group where they participated in the program (N = 33), while children from the other two schools were allocated to the control group where they did not (N = 40). At each time point, all parents completed abridged Children's Emotional Management Scales measuring how well parents believe their child is able to cope with anger, sadness and worry. A significant intervention effect 2 months after intervention was found for the outcome of anger coping such that parents whose children were in the intervention group reported significantly greater improvement in their children's ability to cope with anger compared to parents whose children were in the control group. No significant effect was found for the outcome of sadness, and results for the worry subscale were inconclusive due to unacceptable internal consistency. The present study provides insight into the benefit of programs designed to enhance the emotion regulation skills of very young children. Further follow-up is needed to assess whether the "I Spy Feelings" program has lasting effects.

Psychometric Properties of the Polish Version of the Sports Anxiety Scale-2 (SAS-2).

The main aim of the study was to assess the psychometric properties of the Polish version of the Sports Anxiety scale-2 (SAS-2). The study covered 396 athletes, ages ranging from 18 years to 35 years. The task and ego orientation in sport questionnaire (TEOSQ) and State and Trait Anxiety Inventory (STAI) were used for validation of the scale. Cronbach's alpha for the somatic anxiety subscale was 0.88, for the worry subscale was 0.95, and for the concentration disruption was 0.86, respectively. The three-factor model and hierarchical model fits perfectly as CFI > 0.95, TLI > 0.95, and RMSEA < 0.08. Satisfactory results in measurement invariance show the use of the tool for any gender or athlete (high-performance, recreational) group. The internal consistency (α = 0.86-0.95) and the test-retest reliability (ICC = 0.87-0.90) were satisfactory. There was a statistically significant negative correlation between task orientation and total anxiety along with its three subscales, and a weak positive correlation between ego orientation and worry subscale. Meanwhile, a weak to moderate positive correlation was exhibited between total anxiety and its subscales with the STAI-T and STAI-S. Additionally, female, recreational, and female recreational athletes' groups had weak negative associations between worry and concentration disruption trait anxiety and task orientation, and a weak positive association between somatic anxiety and ego orientation.

388-P: The Impact of Routine CGM on Hypoglycemia Rates and Psychological Outcomes in the Hypo-METRICS Study

We aimed to compare weekly rates of sensor detected hypoglycemia (SDH), person reported hypoglycemia (PRH) and psychological outcomes in people with type 1 (T1D) and insulin treated type 2 diabetes (T2D) using routine continuous glucose monitoring (CGM) or capillary blood glucose monitoring (BGM) in the prospective observational Hypo-METRICS study. Participants (T1D/CBG=67, T1D/CGM=210, T2D/CBG=192, T2D/CGM=133, 55% men, median (IQR) age 56 (45-66) years) completed person reported outcomes measures, wore a blinded study CGM and reported PRH in real time on the Hypo-METRICS app for 10 weeks. We used the Wilcoxon rank sum test. Median weekly PRH rates were higher in CGM vs BGM users in both T1D (4.5 (2.4-6.3) vs 2.6 (1-3.9) Z=-5.1, p&amp;lt;0.005) and T2D (1.7 (0.6-2.3) vs 1.0 (0.2-1.2), Z=-5.8 p&amp;lt;0.005). There were no differences in SDH rates at 70 or 54mg/dl for CGM or BGM users with T1D or T2D (Table 1). Diabetes distress (Problem Areas In Diabetes) was higher in CGM vs BGM users with T1D (25 (10-36) vs 19 (5-26), Z=-3.2, p=0.008), but not T2D. There were no significant differences between CGM and BGM users in Hypoglycaemia Fear Survey Behaviour or Worry subscales, depression (PHQ-9) or anxiety (GAD-7) in either group. Despite similar SDH rates, T1D CGM users have higher PRH and diabetes distress scores; this may reflect populations with greater access to CGM. Further research is needed to investigate these findings. Disclosure N.Zaremba: None. M.Evans: Advisory Panel; Zucara Therapeutics, Pila Pharma, Dexcom, Inc., Other Relationship; Novo Nordisk, AstraZeneca, Abbott Diabetes, Speaker's Bureau; Eli Lilly and Company. E.Renard: Consultant; Abbott Diabetes, Dexcom, Inc., AstraZeneca, Boehringer-Ingelheim, Eli Lilly and Company, Insulet Corporation, MannKind Corporation, Novo Nordisk, Sanofi, Roche Diabetes Care. S.R.Heller: Advisory Panel; Zealand Pharma A/S, Zucara Therapeutics, Other Relationship; Eli Lilly and Company, Research Support; Dexcom, Inc., Speaker's Bureau; Novo Nordisk, Medtronic. J.Speight: Research Support; Sanofi, Medtronic, Abbott Diabetes, Lilly, Novo Nordisk A/S, Speaker's Bureau; Sanofi. S.A.Amiel: Advisory Panel; Medtronic, Other Relationship; Sanofi, Novo Nordisk. P.Choudhary: Advisory Panel; Medtronic, Novo Nordisk, Dexcom, Inc., MannKind Corporation, Insulet Corporation, Research Support; Abbott Diabetes, Speaker's Bureau; Sanofi, Lilly. P.Divilly: None. G.Martine-edith: Other Relationship; Novo Nordisk A/S. Z.Mahmoudi: Employee; Novo Nordisk. U.Soeholm: Employee; Novo Nordisk A/S. B.E.De galan: Research Support; Novo Nordisk. U.Pedersen-bjergaard: Advisory Panel; Novo Nordisk A/S, Sanofi, Vertex Pharmaceuticals Incorporated. R.J.Mccrimmon: Advisory Panel; Sanofi, Speaker's Bureau; Novo Nordisk A/S. J.K.Mader: Advisory Panel; Novo Nordisk A/S, Abbott Diabetes, Roche Diabetes Care, Eli Lilly and Company, Sanofi, Medtronic, Becton, Dickinson and Company, Pharmasense, embecta, Research Support; A. Menarini Diagnostics, Abbott Diabetes, Roche Diabetes Care, Dexcom, Inc., Profusa, Inc., Speaker's Bureau; Novo Nordisk A/S, A. Menarini Diagnostics, Abbott Diabetes, Roche Diabetes Care, Eli Lilly and Company, Sanofi, Boehringer Ingelheim Inc., Becton, Dickinson and Company, Ypsomed AG, Viatris Inc., Servier Laboratories, Medtrust, Stock/Shareholder; Decide Clinical Software GmbH. Funding Innovative Medicines Initiative 2 Joint Undertaking (777460)

Fear of hyperglycemia in parents of children with type 1 diabetes mellitus - a multi-center multi-national study.

Study aims: (1) developing and validating a novel questionnaire for measuring fear of hyperglycemia among parents of children with type 1 diabetes (T1D) - the Hyperglycemia Fear Survey - Parent version (FoHyper-P); (2) investigating correlations between parental fear of hyperglycemia and objective measures of glycemic control. A multi-center, multi-national study of 152 parents of children with T1D was conducted in three large diabetes clinics from Israel, Poland, and Greece. Inclusion criteria were parents of children aged 6-16 years, at least 6 months from diagnosis, at least 3 months of CGM use and parental involvement in care. Parents filled the FoHyper-P and the Hypoglycemia Fear Survey - Parent Version (HFS-P). Patient data were obtained via electronic medical records and informative questionnaires. Bonferroni correction was performed to counteract multiple comparisons. Significant strong-moderate correlations were found between FoHyper-P and HFS-P including total questionnaires scoring (r=0.747, PBonf. <0.001), worries subscales (r=0.735, PBonf <0.001), and behavior subscales (r=0.532, PBonf <0.001). Using linear regression models we found a positive association between the worry subscale and HbA1C. Weak correlations (P<0.05, not significant after Bonferroni correction) were found between time in range, time above range and parental fear of hyperglycemia as well as between worry subscales and a higher HbA1C in the past year, percent of hyperglycemia and lower TIR. The FoHyper-P is a novel, validated tool for assessing parental fear of hyperglycemia. Integrating it into clinical practice addresses an underestimated aspect of parental diabetes management, enabling better care for children with T1D.

Effectiveness of educational and behavioural interventions for reducing fear of hypoglycaemia among adults with type 1 diabetes: Systematic review and meta-analyses.

To summarize and critically appraise evidence regarding the effectiveness of educational and/or behavioural interventions in reducing fear of hypoglycaemia among adults with type 1 diabetes. Systematic searches of medical and psychology databases were conducted. Risk-of-bias was assessed using the Joanna Briggs Institute Critical Appraisal Tools. Data were synthesized using random-effects meta-analyses for randomized controlled trials (RCTs) and narrative synthesis for observational studies. Five RCTs (N=682) and seven observational studies (N=1519) met the inclusion criteria, reporting on behavioural, structured education and cognitive-behavioural therapy (CBT) interventions. Most studies assessed fear of hypoglycaemia using the Hypoglycaemia Fear Survey Worry (HFS-W) and Behaviour (HFS-B) subscales. Mean fear of hypoglycaemia at baseline was relatively low across studies. Meta-analyses showed a significant effect of interventions on HFS-W (SMD=-0.17, p=0.032) but not on HFS-B scores (SMD=-0.34, p=0.113). Across RCTs, Blood Glucose Awareness Training (BGAT) had the largest effect on HFS-W and HFS-B scores, and one CBT-based program was as effective as BGAT in reducing HFS-B scores. Observational studies showed that Dose Adjustment for Normal Eating (DAFNE) was associated with significant fear of hypoglycaemia reductions. Current evidence suggests that educational and behavioural interventions can reduce fear of hypoglycaemia. However, no study to date has examined these interventions among people with high fear of hypoglycaemia.

Cross-cultural adaptation and validation of Diabetes Quality of Life Brief Clinical Inventory in Turkish patients with type 2 diabetes mellitus

Purpose To translate and culturally adapt the Diabetes Quality of Life Brief Clinical Inventory (DQoL-BCI) into Turkish and assess the psychometric properties of the translated version. Methods A forward–backward translation process was conducted in conformity with international guidelines. A total of 150 patients with type 2 diabetes mellitus (T2DM) completed the Turkish version of DQoL-BCI (DQoL-BCI-Tr). The factor structure, test–retest reliability, and construct validity were evaluated. Results In the DQoL-BCI-Tr, the three-factor structure was found optimal and explained 68.7% of the variance. The DQoL-BCI-Tr showed excellent internal consistency (Cronbach’s alpha = 0.90) and test–retest reliability (ICC = 0.98). Cronbach’s alpha values ranged from 0.85 to 0.91 for subscales (satisfaction, worry, impact). A negative correlation was found between the total scores of the DQoL-BCI-Tr and the EuroQoL-5 dimensions (EQ-5D) indexes (r= −0.22, p < 0.01). The DQoL-BCI-Tr total score and satisfaction and worry subscale scores differentiated between groups defined by glycated hemoglobin (HbA1c>9%) and the use of insulin. Conclusions The study results showed that the DQoL-BCI-Tr can be served as a reliable and valid instrument to obtain information from Turkish patients with T2DM diagnosis, including satisfaction with treatment, the impact of the disease, and worry about the social/vocational issues. Implications for rehabilitation The Turkish version of the Diabetes Quality of Life Brief Clinical Inventory (DQoL-BCI) is a valid and reliable instrument. The DQoL-BCI Questionnaire in Turkish (DQoL-BCI-Tr) is an easy and quick way to determine satisfaction with treatment, impact of disease, and worry about the social/vocational issues. The DQoL-BCI-Tr is a reliable instrument for assessing disease-specific effects, emotional loads, and satisfaction of Turkish patients with type 2 diabetes in clinical and research settings.

Associations between Students’ Test Preparation Strategies and Test Anxiety: Gender, Age, and Parents’ Level of Education as Control Variables

Although students’ test preparation tendencies are related to their test-taking confidence, empirical evidence on how students’ test preparation strategies relate to their test anxiety is still lacking. Framed within the skills deficit model, we examined the associations between students’ test preparation strategies (cognitive, metacognitive, and social preparation strategies) and their test anxiety (worry, cognitive, tension, and physiological test anxiety). Students’ gender, age, and parents’ level of education served as control variables. Participants were 248 students in two randomly selected secondary schools in Awka, Anambra state, Nigeria. Survey questionnaires were used for data collection. Major findings revealed that cognitive and metacognitive test preparation strategies significantly predicted worry and physiological indicators components of test anxiety, respectively. When the sociodemographic variables were controlled, the ΔR2 was significant only in the worry and physiological subscale. We concluded that test preparation strategies could be more associated with the worry subscale than the affective-physiological subscale. Furthermore, test preparation strategies involving monitoring and regulation could be associated to physiological indicators of test anxiety.

Higher scanning frequency is correlated with less fear of hypoglycemia in type 1 diabetes patients using isCGM.

BackgroundFrequent scanning of intermittently scanned continuous glucose monitoring (isCGM) devices is associated with improvements in glycemic indices. Limited data is available for its correlation with fear of hypoglycemia (FOH), an established factor affecting quality of life and glycemic control in type 1 diabetes (T1DM).AimThe aim of the study was to analyze the association of sensor scanning frequency with FOH and glycemic indices in T1DM patients using isCGM.Subjects and methodsT1DM patients using isCGM were eligible. Clinical data and Ambulatory Glucose Profile (AGP) reports were obtained from medical records. At outpatient visits, AGP of last 14 days prior to visit were analyzed and FOH was assessed using Hypoglycemia Fear Survey II (HFS II).ResultsWe included 77 consecutive T1DM patients (58 females, 19 males). Mean age was 34.1 ± 10.2 years and mean T1DM duration was 14.7 ± 12.0 years. Baseline mean glycemic indices were as follows: mean glucose - 155.8 ± 29.8 mg/dL; GMI - 53.3 ± 7.5 mmol/mol; TIR - 66.4 ± 17.8%; TBR70 - 4.5 ± 4.1%; TBR54 - 0.6 ± 1.2%; TAR180 - 29.2 ± 17.9%; TAR250 - 9.6 ± 10.4%; %CV - 36.7 ± 8.3. Average scanning frequency was 13.8 ± 7.8 scans/day. Mean HFS II scores were 16.1 ± 7.2 and 18.7 ± 12.2 in behavior and worry subscale, respectively. Correlation was confirmed between scanning frequency and mean glucose, GMI, TIR, TBR70, TAR180, TAR250, %CV and HFS II total, and HFS II - B (p<0.05 for all statistics).ConclusionsFor the first time, we report that higher scanning frequency is associated not only with better glycemic indices but also with less FOH in T1DM adult patients using isCGM.

Determining Clinical Comfort, Worry and Status of Liking Children among Pediatric Nursing Students: Case of Two Different Universities

Purpose: The aim of this study is to determine clinical comfort, worry and status of liking children among pediatric nursing students studying in universities located in east and west of Turkey. &#x0D; Methods: The data of this descriptive and correlational study were collected in nursing faculties located in east (A University) and west (B University) provinces between April-May 2020. The sample of the study consisted of 211 students who participated in the online survey voluntarily between the specified dates. The data of the study were collected using “Sociodemographic Characteristics Form”, “Clinical Comfort and Worry Assessment Tool of Pediatric Nursing Students” and “Barnett Liking of Children Scale (BLCS)”. &#x0D; Results: In the study, the comfort subscale mean score was higher in the nursing students studying in the University B and the difference was found to be statistically significant (p0.05). It was determined that there was a statistically positive moderate significant correlation between levels of liking children and the comfort subscale and a statistically negative moderate significant correlation between levels of liking children and the worry subscale in nursing students studying in the Universities A and B. &#x0D; Conclusions: It was found that the liking of children status of the students studying in the Universities A and B was high. Students' levels of stress, anxiety and liking children in the pediatric clinic rotation should be determined.

The Impact of Baseline User Characteristics on the Benefits of Real-Time Versus Intermittently Scanned Continuous Glucose Monitoring in Adults With Type 1 Diabetes: Moderator Analyses of the ALERTT1 Trial.

ALERTT1 showed that switching from intermittently scanned continuous glucose monitoring (isCGM) without alerts to real-time CGM (rtCGM) with alert functionality improved time in range (TIR; 70-180 mg/dL), glycated hemoglobin (HbA1c), time <54 mg/dL, and Hypoglycemia Fear Survey version II worry subscale (HFS-worry) score after six months in adults with type 1 diabetes (T1D). Moderator analyses aimed to identify certain subgroups that would benefit more from switching to rtCGM than others. Post hoc analyses of ALERTT1 evaluated the impact of 14 baseline characteristics on the difference (delta) in mean TIR, HbA1c, time <54 mg/dL, and HFS-worry score at six months between rtCGM and isCGM. Therefore, the delta was allowed to depend on each of these variables by including interactions in the moderator analysis model. Analyses were performed separately for each variable; variables with P < .10 in the univariable analysis were combined into a single model. Univariable analyses showed no dependency of delta TIR, HbA1c, or time <54 mg/dL on variables other than CGM type. Only delta HFS-worry score depended on baseline HbA1c (P = .0059), indicating less worries with rtCGM in people with baseline HbA1c <6.5% or ≥8%. Given P < .10 for dependency of delta TIR on insulin therapy type (favoring multiple daily injections), baseline HbA1c, and baseline TIR, these variables were combined into a multivariable analysis; interactions were not statistically significant. Except for HFS-worry score, no interactions between 14 baseline characteristics and the six-month intervention effect of rtCGM on TIR, HbA1c, or time <54 mg/dL were observed, supporting the conclusion of ALERTT1 that switching from isCGM without alerts to rtCGM with alert functionality is beneficial for a wide range of people with T1D.

Examination of User Engagement and Subjective States in an Online Tetris Game

Engagement, as a multidimensional construct, fluctuates due to various factors. Previous research that examined engagement as a subjective experience was mainly concerned with the qualitative structure of engagement in different contexts (e.g., task difficulty, aesthetics). Few studies have examined the user’s subjective engagement as a given task progresses over time. This paper reports findings from an online study that aimed to assess the usefulness of subjective measures in capturing momentary feelings related to task engagement, under varying task duration and difficulty conditions. The Short Stress State Questionnaire (SSSQ) and the User Engagement Scale (UES) were used to capture self-reported engagement during a Tetris game. The sensitivity of scales to task conditions and relationships among subscales were examined. Results showed that changes in SSSQ were sensitive to difficulty levels, and Engagement obtained from the SSSQ was highly correlated with UES subscales. SSSQ may be a particularly useful tool to capture participants’ momentary feelings during a task via its Engagement, Distress, and Worry subscales.

THE RELATIONSHIP BETWEEN HYPOGLYCEMIC CONFIDENCE AND HYPOGLYCEMIA FEAR IN TYPE 2 DIABETES MELLITUS PATIENTS

Objective: This study aims to identify the relationship between hypoglycemic confidence and hypoglycemia fear in type 2 diabetes mellitus patients.&#x0D; Method: Designed as a descriptive and cross-sectional study, this research was conducted with 306 type 2 diabetes patients who visited the diabetes polyclinic to have an examination in period December 2021 and February 2022. The research data were collected by using the “Patient Identification Form”, the “Hypoglycemic Confidence Scale”, and the “Hypoglycemia Fear Survey”. Descriptive statistics, the Independent Samples t-test, the One-Way ANOWA test, the Pearson’s correlation test, and the linear regression analysis were used in the evaluation of research data.&#x0D; Results: In the research, 60.8% of the participant type 2 diabetes patients were female, their mean age was 55.14±8.10 years, and their mean duration of having the disease was 10.35±4.77 years. Means of type 2 diabetes patients’ Hypoglycemic Confidence Scale (HCS)’ score 1.65±0.47 and ‘Hypoglycemia Fear Survey (HFS)’ scores were 3.02±0.56 points. Type 2 diabetes patients’ HCS scores had moderately negative relationships with scores obtained by them from the HFS and its Behavior Sub-scale and Worry Sub-scale (p

Quality-of-life results in adults with epilepsy using diazepam nasal spray for seizure clusters from a long-term, open-label safety study

BackgroundThe impact of seizure clusters and the use of intermittent rescue therapy for clusters on the quality of life (QoL) of patients with epilepsy has not been widely studied. The present analysis assessed QoL as a secondary endpoint among adult patients with seizure clusters enrolled in a long-term, phase 3, open-label safety study (NCT02721069) of diazepam nasal spray (Valtoco®). The QoL aspect of patients in this study has not been previously published. MethodsThe 12-month safety study of diazepam nasal spray enrolled patients aged 6–65 years with seizure clusters. Adults aged ≥18 years completed the Quality of Life in Epilepsy (QOLIE)-31-P at baseline (day 0) and days 30, 150, 270, and 365. This instrument includes questions about patient health and daily activities with numeric values (1–100) assigned to responses; higher scores indicate better QoL. The QOLIE-31-P includes 7 subscales: Seizure Worry, Overall QoL, Emotional Well-Being, Energy/Fatigue, Cognitive Functioning, Medication Effects, and Social Functioning; an Overall Score is calculated as a weighted composite of the 7 subscales. Comparisons were made between subgroups of patients who had frequent (≥2) and infrequent (<2) monthly dosing of diazepam nasal spray and those whose doses were administered by the patient or a care partner. This safety study was not powered to assess efficacy endpoints; descriptive statistics were calculated across time points. In addition, safety measures, including treatment-emergent adverse events, are reported. ResultsSeventy-two adults who responded to the QOLIE-31-P were included in the analyses. Mean QOLIE-31-P scores were stable or increased across time points. The mean total scores increased from day 0 to day 365 by 5.2 among patients providing data for ≥1 time point (follow-up group) and 2.2 among patients providing data at all time points (QOLIE all-assessments subgroup). Subscale means for Seizure Worry and Social Functioning showed the greatest numeric increase from baseline. Mean QOLIE-31-P scores were similar in all subgroups. The safety profile in the follow-up group was similar to that seen in all study adults. ConclusionsAdults with refractory epilepsy who were treated with diazepam nasal spray for seizure clusters maintained or improved QOLIE subscale scores across the 12-month study period. Seizure Worry and Social Functioning subscale scores increased over time, suggesting improvement in these domains for this population with intractable epilepsy. Changes among subscale results suggest differences in sensitivity to the use of an intermittent treatment. The potential to improve patient function with treatment for seizure clusters warrants further study.

Household Food Insecurity and Fear of Hypoglycemia in Adolescents and Young Adults With Diabetes and Parents of Youth With Diabetes.

To evaluate the relation between household food insecurity (HFI) and fear of hypoglycemia among young adults with type 1 and type 2 diabetes and adolescents with type 1 diabetes and their parents. We analyzed cross-sectional data of 1,676 young adults with youth-onset diabetes (84% type 1, 16% type 2) and 568 adolescents (<18 years old; mean age 15.1 years) with type 1 diabetes from the SEARCH for Diabetes in Youth study. Adult participants and parents of adolescent participants completed the U.S. Household Food Security Survey Module. Adults, adolescents, and parents of adolescents completed the Hypoglycemia Fear Survey, where answers range from 1 to 4. The outcomes were mean score for fear of hypoglycemia and the behavior and worry subscale scores. Linear regression models identified associations between HFI and fear of hypoglycemia scores. Adults with type 1 diabetes experiencing HFI had higher fear of hypoglycemia scores (0.22 units higher for behavior, 0.55 units for worry, 0.40 units for total; all P < 0.0001) than those without HFI. No differences by HFI status were found for adolescents with type 1 diabetes. Parents of adolescents reporting HFI had a 0.18 unit higher worry score than those not reporting HFI (P < 0.05). Adults with type 2 diabetes experiencing HFI had higher fear of hypoglycemia scores (0.19 units higher for behavior, 0.35 units for worry, 0.28 units for total; all P < 0.05) than those in food secure households. Screening for HFI and fear of hypoglycemia among people with diabetes can help providers tailor diabetes education for those who have HFI and therefore fear hypoglycemia.

657-P: Frequency Scanning Correlates Not Only with Glycemic Indices but Also with Fear of Hypoglycemia in Type 1 Diabetes Patients Using is-CGMS

Frequency scanning with intermittently scanned CGMS (is-CGMS) is associated with glycemic indices. No data is available for its correlation with fear of hypoglycemia (FOH) , a well-known factor affecting quality of life and glycemic control in type 1 diabetes (T1DM) . The aim of the study was to analyze the association of scanning frequency with glycemic indices and FOH in T1DM patients using is-CGMS. T1DM patients using is-CGMS were eligible. Clinical data, Ambulatory Glucose Profile (AGP) reports were obtained from medical records. FOH was assessed using Hypoglycemia Fear Survey II (HFS-II) . We included 77 consecutive patients (58 females) , 38 were treated with insulin pump, 39 with multiple daily injections. Their mean age was 34.1+/-10.2 years and T1DM duration 14.7 +/-12.0 years. Mean glycemic indices were as follows: mean glucose - 155.8+/-29.8 mg/dl; GMI - 53.3+/-7.5 mmol/mol; TIR - 66.4+/-17.8%; TB70 - 4.5+/-4.1%; TB54 - 0.6+/-1.2%; TA180 - 29.2 +/-17.9%; TA250 - 9.6+/-10.4%; %CV - 36.7+/-8.3. The average scanning frequency was 13.8+/-7.8 scans/d. Mean HFS II scores were 16.1+/-7.2 and 18.7+/-12.2 in behavior and worry subscale, respectively. Correlation was found between scanning frequency and mean glucose, GMI, TIR, TB70, TA180, TA250, %CV and HFS-B (p&amp;lt;0.for all statistics) . In summary, for the first time, we report that higher scanning frequency is associated not only with better glycemic indices but also with less FOH in T1DM patients using is-CGMS. This constitutes a new argument for advising T1DM patients frequent scanning when using is-CGMS. Disclosure J.Hohendorff: Advisory Panel; Abbott. M.Malecki: Consultant; Abbott Diabetes, Boehringer Ingelheim International GmbH, Lilly Diabetes, Novo Nordisk, Speaker's Bureau; Ascensia Diabetes Care, AstraZeneca, Bayer AG, Merck &amp; Co., Inc., Mundipharma, Servier Laboratories. P.W.Witek: Other Relationship; Abbott, Berlin-Chemie AG, Boehringer Ingelheim International GmbH, Medtronic, Merck &amp; Co., Inc., Novo Nordisk, Roche Diabetes Care, Sanofi-Aventis Deutschland GmbH. M.Kania: None. M.Sudol: None. K.Hajduk: None. A.Stepien: None. K.Cyganek: Speaker's Bureau; Abbott Diabetes, Ascensia Diabetes Care, Bausch Health, Canada, Boehringer Ingelheim International GmbH, Lilly Diabetes, Medtronic, Novo Nordisk, Roche Diabetes Care. B.Kiec-wilk: n/a. T.Klupa: Advisory Panel; Abbott, BIOTON S.A., Sanofi, Research Support; Medtronic, Speaker's Bureau; Ascensia Diabetes Care, Boehringer Ingelheim International GmbH, Eli Lilly and Company, Novo Nordisk.