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Monitoring Device Acceptance in Implantable Cardioverter Defibrillator Patients Using the Florida Patient Acceptance Survey

Authors

  • HENNEKE VERSTEEG Ph.D.,

    1. Department of Medical Psychology, CoRPS – Center of Research on Psychology in Somatic diseases, Tilburg University, Tilburg, The Netherlands
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  • ANNEMIEKE STARRENBURG M.Sc.,

    1. Department of Psychology, Medisch Spectrum Twente, Enschede, The Netherlands
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  • JOHAN DENOLLET Ph.D.,

    1. Department of Medical Psychology, CoRPS – Center of Research on Psychology in Somatic diseases, Tilburg University, Tilburg, The Netherlands
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  • JOB VAN DER PALEN Ph.D.,

    1. Medical School Twente, Medisch Spectrum Twente, Enschede, The Netherlands
    2. Department of Research Methodology, Measurement, and Data Analysis, University of Twente, Enschede, The Netherlands
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  • SAMUEL F. SEARS Ph.D.,

    1. Departments of Psychology and Cardiovascular Medicine, East Carolina University, Greenville, North Carolina
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  • SUSANNE S. PEDERSEN Ph.D.

    1. Department of Medical Psychology, CoRPS – Center of Research on Psychology in Somatic diseases, Tilburg University, Tilburg, The Netherlands
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  • Financial Support: This work was in part supported with a VENI grant (451–05-001) from the Netherlands Organisation for Scientific Research (NWO) and a VIDI grant (91710393) from the Netherlands Organisation for Health Research and Development (ZonMw) to Dr. Susanne S. Pedersen, The Hague, The Netherlands.

  • Conflicts of interest: Samuel F. Sears: advisor or consultant for Medtronic Inc.; grants for clinical research from Medtronic Inc.; and consultancy or speakers fees from Boston Scientific, St. Jude Medical, and Biotronik. Susanne S. Pedersen: consultancy or speakers fees from Cameron Health Corp., Medtronic Inc., St. Jude Medical, and Sanofi Aventis.

Susanne S. Pedersen, Ph.D., CoRPS, Department of Medical Psychology, Tilburg University, P.O. Box 90153, 5000 LE Tilburg, The Netherlands. Fax: 31-13-466 2370; e-mail: s.s.pedersen@uvt.nl

Abstract

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.

Conclusion: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. (PACE 2011;XX:1–10)

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