Development and validation of the Pediatric Needle Worry questionnaire

Needle fear is common in youth and associated with a myriad of challenges (e.g., procedural injuries, healthcare avoidance). Although effective interventions for youth with differing degrees of needle fear have been characterized, and despite recommendations for screening, there are no validated measures of pediatric needle fears. This gap contributes to challenges in equitable referral for clinical intervention and potentially disparate clinical outcomes. Thus, a novel, caregiver-report screening measure of Pediatric Needle Worry (PNW) was developed.

The initial measure included 11 unpublished questions used in clinical and research settings related to pediatric needle fear, anxiety, avoidance behaviors, and impairment. Interdisciplinary expert reviewers assessed face validity and developmental appropriateness. The measure was then tested on 234 caregivers of youth 6- to 18-year-old.

Interdisciplinary expert review resulted in eliminating one question and revising another. Two items were then removed from further analysis due to very small intercorrelations; one item was removed due to strong correlation with the total score. Exploratory and confirmatory factor analysis of the final 7-item PNW measure yielded a one-factor structure with excellent internal consistency (a = .90), strong convergent validity with a measure of adult needle fear (r = .70), and moderate correlation with general anxiety symptoms (r = .36).

The PNW questionnaire is a promising novel screening measure for needle fear. Research can build on this foundational reliability and validity data to test the PNW for use in clinical settings to improve access to quality, evidence-based care for youth with needle fears.