Reliability and validity of the Chinese version of the Worry Scale

This article presents the findings on the development and validation of a Chinese version of the Worry Scale (WS), a measure of worry about hypoglycemia. A previously developed 16-item WS was back-translated and applied to 117 Chinese diabetic patients living in Hong Kong. An iterative process of factor and item analyses identified a unidimensional 10-item Chinese WS (WS-10), which accounted for 57.15% of the total variance. Cronbach's alpha was 0.91. Strong correlation was demonstrated between the WS-10 and WS with 16 items (r = 0.97, p = 0.000). Comparing the level of worry about hypoglycemia between Type 1 and Type 2 diabetic patients established a contrast-group validity of the WS-10 (p = 0.002). Criterion validity was established by correlating the WS-10 with the respondents' glycosylated hemoglobin (r = -0.29, p = 0.002). Test-retest reliability using intraclass correlation (ICC) was established, ICC(1, 1) = 0.68. As the clinical administration of this scale takes less than 5 min, the Chinese WS-10 offers a useful instrument to identify patients with high levels of worry about hypoglycemia for clinical and education interventions. It also provides public health nurses with a reliable and valid prepost measure of intervention effectiveness. The Chinese WS-10 will facilitate further research about the effects of worry concerning hypoglycemia on self-care behaviors with the Chinese populations.