Versteeg Henneke, Starrenburg Annemieke, Denollet Johan, Palen Job van der, Sears Samuel F, Pedersen Susanne S
Department of Medical Psychology, Tilburg University, Tilburg, The Netherlands.
Pacing Clin Electrophysiol. 2012 Mar;35(3):283-93. doi: 10.1111/j.1540-8159.2011.03299.x. Epub 2012 Jan 9.
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.
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.
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.
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.
患者对设备的接受程度对于识别植入植入式心律转复除颤器（ICD）后有不良患者报告结局风险的患者可能至关重要。我们检验了佛罗里达患者接受度量表（FPAS）的有效性和可靠性，并在一组荷兰ICD患者中确定了设备接受度的相关因素。
从荷兰鹿特丹伊拉斯姆斯医学中心或恩斯赫德的特温特医学光谱中心招募的首次植入ICD的患者（N = 272，平均年龄 = 59.2 ± 11.9，82%为男性）完成了FPAS、D型量表和医院焦虑抑郁量表。
探索性和验证性因素分析表明，从FPAS中剔除三个项目，保留12个项目构成三个因素，等同于FPAS原来的四因素版本。简化后的FPAS在总量表和所有子量表中都具有较高的内部一致性，克朗巴哈系数范围为0.76至0.82。焦虑（优势比[OR]：9.75；95%置信区间[CI]：2.38 - 39.87；P = 0.002）、抑郁（OR：2.96；95% CI：0.98 - 8.93；P = 0.05）和苦恼型（D型）人格（OR：5.04；95% CI：1.50 - 16.92；P = 0.01），但不包括包括电击在内的人口统计学和临床因素，是设备接受度差的显著独立相关因素。
一个缩短为12项、三因素版本的FPAS被证明是评估荷兰ICD患者设备接受度的有效且内部一致的工具。心理因素而非临床因素是设备接受度的主要相关因素，这突出了在试图识别ICD植入后有适应困难风险的患者时考虑患者心理特征的重要性。
