Validity and Reliability of the Florida Patient Acceptance Survey and Florida Shock Anxiety Scale in Turkish Patients with Implantable Cardioverter Defibrillation

Abstract

Despite its established effectiveness, living with an implantable cardioverter defibrillator (ICD) is associated with ongoing psychosocial distress. Patient device acceptance and shock-related anxiety might be essential in identifying patients at risk for adverse patient-reported outcomes following implantation of an ICD. The purpose of study was to examine the validity and reliability of the Florida Patient Acceptance Survey (FPAS) and the Florida Shock Anxiety Scale (FSAS) of ICD patients. Methods: The sample included 180 participants (146 male, mean age=60.56 +/- 13.88). Patients completed the FPAS, the FSAS, the Beck Anxiety Inventory (BAI), the State Anxiety Inventory (STAI-TX1) and Trait Anxiety Inventory (STAI-TX2). Results: Confirmatory factor analysis (for FPAS) revealed that a four-factor structure: Return to Function, Device-Related Distress, Positive Appraisal and Body Image Concerns (chi(2)(84). = 157.75, p=0.00, comparative fit index (CFI)=0.91, root mean-square error of approximation (RMSEA)=0.07). Confirmatory factor analysis ( for FSAS) revealed that a two-factor structure with items loading such that Factor 1 could be conceptualized as a Consequence Factor and Factor 2 as a Trigger Factor chi(2)(34). = 81.48, p=0.00, comparative fit index (CFI)= 0.93, root mean-square error of approximation ( RMSEA)=0.09). The FPAS was negatively correlated with FSAS, BAI, STAI-TX1 and STAI- TX2 (p<0.01). The FSAS was positively correlated with BAI, STAI- TX1 and STAI-TX2 (p<0.01). We found satisfactory evidence of internal consistency (Cronbach's a was 0.81 for FPAS and Cronbach's a was 0.87 for FSAS). Conclusion: FPAS and FSAS are valid and reliable instruments to assess device acceptance and shock-related anxiety in Turkish patients with ICD.