Monitoring device acceptance in implantable cardioverter defibrillator patients using the Florida Patient Acceptance Survey.
BACKGROUND
Patient device acceptance might be essential in identifying patients at risk for adverse patient-reported outcomes following implantation of an implantable cardioverter defibrillator (ICD). We examined the validity and reliability of the Florida Patient Acceptance Scale (FPAS) and identified correlates of device acceptance in a Dutch cohort of ICD patients.


METHODS
Patients with a first-time ICD (N = 272, mean age = 59.2 ± 11.9, 82% men) recruited from the Erasmus Medical Center, Rotterdam, or the Medisch Spectrum Twente, Enschede, The Netherlands completed the FPAS, the Type D Scale, and the Hospital Anxiety and Depression Scale.


RESULTS
Exploratory and confirmatory factor analyses indicated that eliminating three items from the FPAS, leaving 12 items contributing to three factors, is equivalent to the original four-factor version of the FPAS. The abbreviated FPAS had a high internal consistency both for the total scale and all subscales, with Cronbach's alphas ranging from 0.76 to 0.82. Anxiety (odds ratio [OR]: 9.75; 95% confidence interval [CI]: 2.38-39.87; P = 0.002), depression (OR: 2.96; 95% CI: 0.98-8.93; P = 0.05), and the distressed (Type D) personality (OR: 5.04; 95% CI: 1.50-16.92; P = 0.01), but not demographic and clinical factors including shocks, were significant independent correlates of poor device acceptance.


CONCLUSIONS
A shortened 12-item, three-factor version of the FPAS was shown to be a valid and internally consistent instrument to assess device acceptance in Dutch ICD patients. Psychological but not clinical factors were the primary correlates of device acceptance, which underlines the importance of taking into account the patient's psychological profile when seeking to identify patients at risk for adjustment difficulties after ICD implantation.
Department of Medical Psychology, Tilburg University, Tilburg, The Netherlands.
Henneke
H
Versteeg
Annemieke
A
Starrenburg
Johan
J
Denollet
Job van der
Jv
Palen
Samuel F
SF
Sears
Susanne S
SS
Pedersen
D000368:Aged; D001007:Anxiety / Q000453:epidemiology / Q000523:psychology; D015331:Cohort Studies; D017147:Defibrillators, Implantable / Q000523:psychology* / Q000706:statistics & numerical data; D003863:Depression / Q000453:epidemiology / Q000523:psychology; D005260:Female; D019538:Health Care Surveys / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010342:Patient Acceptance of Health Care / Q000523:psychology* / Q000706:statistics & numerical data; D015203:Reproducibility of Results; D016896:Treatment Outcome