The Measuring Needle Fear Tool: A Newly developed Approach to Early Detection and Support for Dialysis Patients

Ms Fiona Donnelly¹, Ms GORJANA RADISIC

¹Royal Adelaide Hospital, Adelaide, Australia

Biography:

Fiona Donnelly is a Nephrology Nurse Practitioner, Haemodialysis at the Royal Adelaide Hospital.

She has over 30 years’ experience in renal nursing in the UK, Singapore and Australia. She is passionate about improving the journey and care of patients with kidney disease.

Abstract:

Introduction:
Needle fear is a common issue among haemodialysis patients, impacting both treatment decisions and engagement with therapy. This study aimed to develop and validate a tool designed to identify needle fear in both pre-dialysis and dialysis populations.

Methods:
The Measuring Needle Fear (MNF) tool was created using both deductive and inductive approaches, organising items into four domains to ensure comprehensive coverage of symptoms. Content validity was evaluated using the Content Validity Index (CVI), while reliability was assessed through Gwet’s AC1 coefficient and Cronbach’s alpha. Exploratory factor analysis (EFA) was conducted using Principal Axis Factoring with oblimin rotation, supported by the Kaiser–Meyer–Olkin (KMO) statistic and Bartlett’s test. The tool’s discriminative ability and optimal cut-off point were determined via ROC analysis.

Results:
A total of 120 participants completed the questionnaire. Test–retest reliability was excellent for most MNF items (30 items; AC1 = 0.81–1.00) and good for the remaining items (9 items; AC1 = 0.61–0.80). EFA revealed three factors—Fear, Avoidance, and Embarrassment—with strong sampling adequacy (KMO = 0.908) and a significant Bartlett’s test (p < 0.001). Internal consistency was high (Cronbach’s alpha = 0.895). ROC analysis showed excellent discrimination (AUC = 0.959), with a cut-off score of ≥5 identifying 31% of patients as likely to experience needle fear.

Conclusion:
The Measuring Needle Fear tool is a validated, reliable instrument for detecting needle fear in pre-dialysis and dialysis patients. Its use supports early identification and enables timely, targeted interventions.