The development and validation of the multidimensional fear-of-injection scale

Background: Adults and children alike can feel anxious and afraid of needles. As a result, some people avoid necessary medical injections, leading to health problems. Assessing the fear of injections should consider fear factors, avoidance behaviors, and physical symptoms. We have developed a single scale that measures each of these variables. Conventional fear-of-injection scales do not simultaneously measure the aforementioned components, and thus may not adequately capture the fear of injections. Furthermore, no scale has been developed in Japan to measure the fear of injections. Method: A multidimensional fear-of-injection scale was developed in Study 1. The participants, 419 university students, were administered a questionnaire to check the reliability and validity of the scale. In Study 2, to establish the cut-off value of the scale, we conducted a questionnaire and analyzed the data of 771 university students. The outcome is the multidimensional fear-of-injection scale. Results: The results from factor analysis showed that this scale has a four-factor structure (direct fear, indirect fear, physiological response, and avoidance behaviors). The results of the receiver operating characteristic analysis showed that a cut-off value of 35 points identifies people with a subjective fear of injections. Conclusion: The multidimensional fear-of-injection scale is a comprehensive measure of the fear of injections and serves as an effective indicator for intervention and screening. Additionally, it provides a quantitative assessment of the fear of injection in Japan.