A NOVEL TOOL FOR THE DETECTION OF NEEDLE FEAR IN PRE-DIALYSIS AND DIALYSIS PATIENTS – MEASURING NEEDLE FEAR (MNF) TOOL
Gorjana Radisic1,2, Adrian Esterman3, Richard Le Leu1,2, Fiona Donnelly1, Anna Chur-Hansen4, Kathryn L Collins4,5, Anne L J Burke4,5, Kathy Hill6, Stephen McDonald1,2, Luke Macauley2, Shyam Muthuramalingam8, Professor Shilpanjali Jesudason1
1Central Northern Adelaide Renal and Transplantation Service, Royal Adelaide Hospital, Adelaide, Australia, 2Adelaide Medical School, Faculty of Health and Medical Sciences, University of Adelaide, Adelaide, Australia, 3Clinical and Health Services, University of South Australia, Adelaide, Australia, 4School of Psychology, Faculty of Health and Medical Sciences, University of Adelaide, Adelaide, Australia, 5Psychology Department, Royal Adelaide Hospital, Adelaide, Australia, 6University of South Australia, Adelaide, Australia, 7Australia and New Zealand Dialysis and Transplant Registry (ANZDATA), South Australian Health and Medical Research Institute, Adelaide, Australia, 8Central Adelaide Local Health Network, Adelaide, Australia
Aim: To develop a validated tool for identifying needle fear in patients awaiting or already receiving haemodialysis.
Background: Needle fear is common among haemodialysis patients, particularly when starting treatment, and can impact their therapy choices, engagement, and quality of life. The lack of validated tools to identify needle fear before dialysis begins and paucity of management options leaves many patients unsupported.
Methods: Leveraging our background qualitative studies defining the physical and psychological elements of dialysis needle fear and utilising consumer-centred co-design, we performed a three-phase process to create and validate a survey tool for measuring needle fear (MNF tool). This process involved item generation, questionnaire development and testing, and questionnaire evaluation.
We validated and tested the MNF tool in 150 adult South Australian patients awaiting or receiving maintenance haemodialysis.
Results: Forty items were formatted into physical, cognitive, emotional and behavioural domains. The mean of the Content Validity Index across all items was: S-CVI=0.92. Inter-rater reliability was assessed in a convenience sample of 19 patients using Gwet’s AC1 measure of agreement. 36 items had Almost perfect (.61-.80) and 4 had substantial (.81-1.00) coefficient agreement range. Exploratory factor analysis revealed Pearson chi2(1) = 18.69 P <0.001. The area under the ROC curve was 0.966 (95% CI: 0.93-1.0). Percentage correctly classified is greatest at MNF Score ≥9, hence a cut-off score was set at >8.
Conclusion: The MNF tool was developed and validated, with a score >8 suggestive of patients at highest risk of clinically significant needle fear. The MNF tool can improve identification and management of this hidden treatment burden, and potentially be applied to other chronic disease cohorts with high needle burden.
Presentation Slides PDF – Click here
Biography:
Professor Shilpanjali Jesudason (MBBS PhD FRACP FISN), is an academic nephrologist at the Royal Adelaide Hospital’s Central Northern Adelaide Renal and Transplant Service (CNARTS ) where she is Director of Dialysis, lead of the CNARTS Clinical Research Group and Program Lead for Pregnancy and Kidney Research Australia. She is a Clinical Professor, at the University of Adelaide. From 2017- 2020 she was the National Clinical Director of Kidney Health Australia, the peak body for patients with kidney disease.