Disclosures: Dr. Sears: Medtronic, St. Jude Medical, Boston Scientific, and Biotronik. Dr. Fischer: Boston Scientific, Impulse Dynamics, Medtronic, St. Jude Medical, and Spectranetics. Julie Shea: Medtronic, Janssen Pharmaceuticals, and Spectranetics. This manuscript and the research described therein were supported by funding from Medtronic. No other authors have disclosures to report.
The Florida Shock Anxiety Scale (FSAS) for Patients with Implantable Cardioverter Defibrillators: Testing Factor Structure, Reliability, and Validity of a Previously Established Measure
Article first published online: 3 JUL 2012
©2012, The Authors. Journal compilation ©2012 Wiley Periodicals, Inc.
Pacing and Clinical Electrophysiology
Volume 35, Issue 9, pages 1146–1153, September 2012
How to Cite
FORD, J., FINCH, J. F., WOODROW, L. K., CUTITTA, K. E., SHEA, J., FISCHER, A., HAZELTON, G. and SEARS, S. F. (2012), The Florida Shock Anxiety Scale (FSAS) for Patients with Implantable Cardioverter Defibrillators: Testing Factor Structure, Reliability, and Validity of a Previously Established Measure. Pacing and Clinical Electrophysiology, 35: 1146–1153. doi: 10.1111/j.1540-8159.2012.03455.x
- Issue published online: 7 SEP 2012
- Article first published online: 3 JUL 2012
- Received January 17, 2012; revised March 14, 2012; accepted April 16, 2012.
- implantable cardioverter defibrillator;
Background: The implantable cardioverter defibrillator (ICD) reduces mortality in patients at risk for life-threatening arrhythmias via high energy shock. The Florida Shock Anxiety Scale (FSAS) was developed to measure ICD patient shock-related anxiety. Initial psychometric evaluation revealed good reliability and validity. The purpose of this study was to examine the psychometrics of the FSAS in a large US sample of ICD patients.
Methods: Participants were recruited via e-mail and the survey was completed online. Ultimately, 443 ICD patients (359 male and 421 White) completed the 10-item FSAS.
Results: Means for FSAS were comparable to previously published data (M = 15.18, SD = 6.5). Interitem reliability was good (Cronbach's α= 0.89). The FSAS was negatively correlated with single-item measures of emotional well-being (r =–0.378, P < 0.01), sense of security (r =–0.365, P < 0.01), perceived general health (r =–0.185, P < 0.01), and quality of life (r =–0.216, P < .01), demonstrating discriminant validity. Convergent validity was supported through significant correlations with number of shocks (r = 0.464, P < 0.01) and reported disruptiveness of shock (r = 0.484, P < 0.01). Confirmatory factor analysis revealed that a single (second-order) factor model (χ2  = 75.34, P < 0.05, comparative fit index = 0.98, root mean-square error of approximation = 0.05) had the best fit.
Conclusions: Shock anxiety as a construct can be measured in a reliable and valid method by the FSAS. These nationally representative data suggest that a single score for shock anxiety is an easy to use and appropriate method of assessment. (PACE 2012; 35:1146–1153)