Reliability Behaviour Research and Therapy, 38, 1039-1053. Secondary outcomes cover outcomes assessed by clinical examinations and medical assessments and a range of patient-reported outcome measures. Horn JL. Two of the removed items (10 and 13) originated from the factor Fear and one from the factor Attention (4) in Eiferts original model [4]. Four items (4, 10, 13 and 18) had salient cross-loadings and were removed sequentially, starting with the strongest cross-loading. However, in all previous studies of EFA on the CAQ this item has had a single salient loading on the factor describing Fear/Worry [4,5,6,7,8, 10]. A high score indicates a greater number of symptoms, greater intensity, or both. [The heart and anxiety. WebHeart-focused anxiety (HFA) is the fear about cardiac-related stimuli and sensations as of their perceived negative consequences. government site. Beitman BD, Mukerji V, Russell JL, Grafting M. J Psychiatr Res. Social and psychological responses to myocardial - ScienceDirect CFA was conducted for all factor solutions represented in previous literature, the model generated by the EFA as well as a 1-factor solution. About ScienceDirect 8600 Rockville Pike Prognostic association of anxiety post myocardial infarction with mortality and new cardiac events: a meta-analysis. Behav Res Ther. The study has been approved by the Regional Ethical Review Board in Uppsala (approval number: 2011/217). J Med Internet Res. Fear/Worry also correlated more strongly with other measures of anxiety, which could indicate that it is also closer to the general concept of anxiety than the other factors. [4]. Advances in resuscitation and medical technology have revolutionized care and improved survival outcomes for more than 350,000 adults who experience sudden cardiac arrest (SCA) in the United States each year [1].Although a majority of studies have focused on medical outcomes, the behavioral and psychosocial sequelae of Heart-focused and general illness fears in relation to parental medical history and separation experiences. As the aim if this study was to conduct both an exploratory factor analysis (EFA) and a confirmatory factor analysis (CFA), the sample was split in two random equal halves [19]. The cardiac anxiety questionnaire: development and preliminary the cardiac anxiety questionnaire Assessment. 2023 Jul;10(7):4676-4689. doi: 10.1002/nop2.1717. Accessibility The Cardiac Anxiety Questionnaire Methods: International Journal of Psychiatry in Medicine, 43, 349-364. Anxiety specifically triggered by fear of heart disease or heart malfunctioning is called cardiac anxiety (CA). Norlund F, Olsson EMG, Burell G, et al. Celano CM, Daunis DJ, Lokko HN, et al. WebIt is currently measured with the Cardiac Anxiety Questionnaire, which has conflicting findings regarding its factor structure, and it has not been validated in a Swedish The most common form of measuring CA in a clinical setting has been to use the Cardiac Anxiety Questionnaire (CAQ) [4]. Anxiety The cardiac anxiety questionnaire: cross-validation among van Bakel BMA, de Koning IA, Bakker EA, Pop GAM, Cramer E, van Geuns RM, Thijssen DHJ, Eijsvogels TMH. Bandalos DL, Gerstner JJ. Still, it could be criticised for its lack of specificity. coronary angiograms have no evidence of coronary heart disease (CHD). Validity When rotating the 4-factor solution these two items loaded on a fourth factor, but as only two items in a factor is unacceptable [26] this model was discarded. Open access funding provided by Uppsala University. The datasets generated and/or analysed during the current study are not publicly available due to the General Data Protection Regulation (2016/679) protecting privacy but are available from the corresponding author in an aggregated format on reasonable request. MADRS measures the most commonly occurring symptoms of depression [17]. By using the site you are agreeing to this as outlined in our privacy notice and cookie policy. A sudden onset of discomfort is also a common symptom of Panic Disorder, which an early study suggested CA to be a variation of [30]. Before The https:// ensures that you are connecting to the Int J Psychiatry Med. J Gen Intern Med. Both worrying and focused attention are cognitive processes, and while fear and worry are closely related concepts, so is hypervigilance and worry. How the intervention might work. Horizontal line is set at eigenvalue=1. Heart anxiety was significantly related to progression anxiety and, to a lesser extent, trait anxiety and indicators of subjective symptoms of somatic illness and no association was found with medical ratings for prognosis, multimorbidity, or reduction in life expectancy. Anxiety Psychiatric disorders seem to play a role as risk factors to cardiovascular morbidity and mortality 1.They also seem to have a negative impact on disease stability 2, adherence to treatment 3 and quality of life 4 in cardiac patients. Multivariate data analysis 7th ed. An official website of the United States government. Cutoff criteria for fit indexes in covariance structure analysis: conventional criteria versus new alternatives. cardiac Anxiety Highly Influenced. 8600 Rockville Pike berg S, Johansson L, Georgsson M, Sandberg J, Brostrm A. Nurs Open. The CAQ is a reliable and valid instrument to assess cardiac anxiety in patients hospitalized with ACS. WebThe purpose of this study is to examine variables associated with cardiac anxiety in a sample of individuals self-referred for noninvasive coronary calcium screening. https://doi.org/10.1186/s12874-022-01820-5, DOI: https://doi.org/10.1186/s12874-022-01820-5. Due to the internal correlation of the factor structure, oblique (promax) rotation was used. The convergent correlations with PCL-C and HADS-anxiety, and the fact that the correlations with depressive indexes were lower, suggest that the CAQ still measures symptoms of anxiety. Sardinha A, Nardi AE, de Arajo CGS, et al. Preoperative optimization of patient expectations improves long Worst model fit statistics were demonstrated by the 1-factor solution. aPCA Principal Component Analysis, Common Common Factor Analysis, PAF Principal Axis Factoring, Yes EFA conducted but method not specified. In Study 1, 188 cardiology patients completed the CAQ. https://doi.org/10.1007/BF02289447. 2022 Nov 25;12(11):e066435. Europe PMC is an archive of life sciences journal literature. Psychometric properties and factor structure of the Greek version of the cardiac anxiety questionnaire (CAQ). All tests of reliability and validity were performed on the new factor solution generated by the EFA and the original model by Eifert. BMC Med Res Methodol. The Cardiac Anxiety Questionnaire: development and preliminary validity A high score indicates a greater number of symptoms, greater intensity, or both. A factor was considered adequate when it consisted of at least 3 items with salient loadings, a Cronbachs alpha of .70 and deemed theoretically meaningful [26]. BMI was calculated (kg/m2) and Obesity was defined as a BMI equal to or higher than 30. Fear/Worry was the factor that had the highest correlations with other anxiety measures (HADS-A =.61 and PCL =.62). Cornelius T, Mendieta M, Cumella RM, Lopez Veneros D, Tincher IM, Agarwal S, Kronish I. PLoS One. In Study 1, 188 cardiology patients completed the CAQ. 1983;67:36170. The factor structure of the cardiac anxiety questionnaire, and validation in a post-MI population. conditionsPrivacy policy. and transmitted securely. Res. Disclaimer. Behav Res Ther 2000; 38:1039-53. 2015;16:154. It consists of three subscales (Re-experiencing, 5 items; Avoidance or numbing, 7 items; Arousal, 5 items) and the 17 items are rated on a 5-point Likert scale from 1 (not at all) to 5 (extremely), total score range 17-85. The items dont specify the reason for avoidance of physical activity. 2018;20. https://doi.org/10.2196/jmir.9710. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data. In light of this, this study aims to present the preliminary results of the validity and reliability of the Foreign Language Teaching Anxiety Scale (FLTAS). The factor structure of the cardiac anxiety questionnaire, and It consists of 9 items, rated on a Likert scale ranging from 0 to 6, total score range 0-54. J Med Internet Res. Whether or not waking up at night is a part of attention, the remaining items seem to be a valid part of CAQ. DeepDyve 2000;38:103953. The Cardiac Anxiety Questionnaire has eight removed items and its superior fit to the data could be a reasonable suggestion for a short-form of the CAQ. As the aim if this study was to conduct both an exploratory factor analysis (EFA) and a confirmatory factor analysis (CFA), the sample was split in two random equal halves [19]. WebCVD-patients through higher layer away cardiac anxiety suffer psychology, as well as being to increased exposure for cardiac morbidity and fatality. Due to the ordinal level of the data, a polychoric correlation matrix was calculated for the basis of the EFA [20]. This study was part of the U-CARE Heart trial, a multi-centre randomised control trial that evaluated the effect of internet-based cognitive behavioural therapy in patients with a recent MI. Furthermore, this items has been found in varying factors or been deleted in previous analyses [5, 8, 10]. 2000;38:103953. The Cardiac Anxiety Questionnaire (CAQ) is validated for use when asking about a person's own health [32] and was modified for this study to query family members' Behav Res Ther. World Health Organization. Leissner P, Held C, Rondung E, Olsson EMG. Humphries S, Mars K, Hofmann R, Held C, Olsson EMG. Biostatistics: the bare essentials: PMPH USA (BC Decker). anxiety 2000 Georg Eifert. Two hundred thirty-seven patients admitted for an acute coronary syndrome (ACS) and a control group of 49 patients admitted for an exacerbation of rheumatoid arthritis (RA) completed the CAQ, the Agoraphobic Cognitions Questionnaire, Mobility Inventory, Beck Depression Inventory, Beck Anxiety Inventory, and the State-Trait Anxiety Inventory. Using percentiles based on a normative sample allows screening for heart However, in this case, the advantages of adhering to theory and not underfactoring outweighs the disadvantages of a slightly lower internal consistency (.67<.70). 2020 sharing sensitive information, make sure youre on a federal It is right measured with the Cardiac Anxiety Questionnaire, which has conflicting findings regarding its factor structure, and it does not been validated However, in all previous studies of EFA on the CAQ this item has had a single salient loading on the factor describing Fear/Worry [48, 10]. Heart-Focused Anxiety in Patients With Noncardiac Chest Pain: This is possibly the result of it being the smallest factor, as fewer items makes internal consistency go down. This is an instrument that has shown good psychometric properties in patients with and without CVD and in several different countries [410]. Bandalos DL, Gerstner JJ. Avoidance showed a weaker correlation with the other two avoidance-scales (BADS - Avoidance =.35 and PCL - Avoidance or numbing =.47). Kaiser HF. The Short Form consists of nine items that can be divided in two subscales (Avoidance, 3 items; Activation, 6 items). As such, factor solutions containing 2-8 factors were rotated and compared. surgical anxiety questionnaire (SAQ): development and validation Provided by the Springer Nature SharedIt content-sharing initiative. The original 3-factor structure proposed by Eifert et al. Anxiety disorders and cardiovascular disease. Although HFA is common to a wide variety of 2Uppsala Clinical Research Center, Uppsala, Sweden, 3Uppsala University Hospital, Uppsala, Sweden, 4Mid Sweden University, stersund, Sweden. Second, to test the validity and reliability of the Swedish translation of the CAQ. It is currently metrical with the Cardiac Anxiety Questionnaire, which has conflicting findings regarding its favorability structure, Internal consistency for all the items in CAQ was =0.89 and for Eiferts 3 subscales it was for Fear =.89; for Attention =.70 and for Avoidance =.87. Worst model fit statistics were demonstrated by the 1-factor solution. Hair JF, Black WC, Babin BJ, Anderson RE. Item and factor analyses Cookies policy. Panic disorder in cardiology patients: a review of the Missouri Panic/Cardiology Project. The cardiac anxiety questionnaire: development and preliminary validity. An official website of the United States government. The Cardiac Anxiety Questionnaire: Development and preliminary validity. Received 2022 Jun 21; Accepted 2022 Dec 13. The factor Fear/Worry was reduced by two items from the original model. Google Scholar. doi: 10.1136/bmjopen-2022-066435. Item and factor analyses indicated a three-factor solution pertaining to heart-related fear, avoidance, and attention. Res. https://orcid.org As such, this is the first study of the CAQ that has combined both EFA and CFA and followed proper statistical considerations. Three of them were removed and one lost its cross-loading (item 18) during this process, and was thus retained in the model. sharing sensitive information, make sure youre on a federal See Tables2 and and33. The total score for the 15 item solution generated by the EFA had a test-retest correlation of =.75, while its subscales Fear/Worry, Avoidance and Attention had a test-retest correlation of =.63, .74, .75, respectively. 6. Mental symptoms in patients with cardiac symptoms and normal Cardiac Anxiety Questionnaire, 34 the MacNew Quality of . Each item is rated on a 7-point Likert scale, ranging from 0 (not at all) to 6 (completely), total score range 0-54. A rationale and test for the number of factors in factor analysis. Zigmond AS, Snaith RP. The exploratory analysis found a model with the factors Fear/Worry, Avoidance and Attention. Multivariate Behav Res. Behav Ther. Cunningham JL, Wernroth L, Von Knorring L, et al. The cardiac anxiety questionnaire: development and preliminary validity. The authors declare no conflict of interest. Many of these studies have also explored the factor structure of CAQ and proposed varying factor solutions and removal of items [58, 10]. 2017;176:13948. Bethesda, MD 20894, Web Policies Behaviour Research and Therapy, 38, 1039-1053. Item and factor analyses indicated a three-factor solution pertaining to heart-related fear, avoidance, and attention. The items dont specify the reason for avoidance of physical activity. The .gov means its official. An index of factorial simplicity*; 1974. Psychometrika. Out of the 930 individuals who completed the CAQ, there were missing values (1-3) for PCL, BADS and MADRS-S. Those who were participating in the clinical RCT answered questionnaires at several time points. Eur Heart J Open. and the model generated from the EFA had close to an acceptable fit to the data. Although HFA is common to a wide variety of persons who experience chest pain and distress, it often is unrecognized and misdiagnosed, particularly in cardiology and emergency room patients without and with heart disease. Results: Additionally, the CAQ showed acceptable psychometric properties in a Swedish population of post-MI patients. Using factor analysis in test construction. To address these concerns, this article reports on the development and preliminary psychometric evaluation of the Cardiac Anxiety Questionnaire (CAQ) designed to measure HFA. CVD-patients with higher levels of cardiac anxiety suffer psychologically, as well as being at increased risk for cardiac morbidity and mortality. The cardiac anxiety questionnaire: development and preliminary validity. This website requires cookies, and the limited processing of your personal data in order to function. Psychometrika. FOIA Standard psychometric tests were performed for the CAQ to test its validity and reliability. Watkins MW. Eifert GH, Thompson RN, Zvolensky MJ, et al. WebThe CAQ is a reliable and valid instrument to assess cardiac anxiety in patients hospitalized with ACS. J Affect Disord. 1 Altmetric Metrics Abstract Background CVD-patients with higher levels of cardiac anxiety suffer psychologically, as well as being at increased risk for cardiac Additionally, it is concluded that the CAQ shows acceptable psychometric properties in a Swedish population of post-MI patients. BMI was calculated (kg/m2) and Obesity was defined as a BMI equal to or higher than 30. When I have chest discomfort or I feel my heart is beating fast I worry that I may have a heart attack, 15. Development and validation of a German-language version of the Interpersonal Competence Questionnaire (ICQ). Gosselin P, Dugas MJ, Ladouceur R, Freeston MH. Anxiety specifically triggered by fear of heart disease or heart malfunctioning is called cardiac anxiety (CA). A high score indicates a greater number of symptoms, greater intensity, or both. Patients and methods This prospective 2:1 randomised controlled trial The cardiac anxiety questionnaire: development and preliminary validity Additionally, the CAQ showed acceptable psychometric properties in a Swedish population of post-MI patients. Cardiac anxiety in people with and without coronary atherosclerosis. WebCVD-patients with higher planes out cardiac anxiety leiden psychologically, for well as creature at increased peril for card morbidity and mortality. Please enable it to take advantage of the complete set of features! The authors would also like to acknowledge the statistical support from Philip Fowler and Mathias Berggren. Heart-focused anxiety, illness beliefs, and behavioral impairment: comparing healthy heart-anxious patients with cardiac and surgical inpatients. The EFA resulted in a new model with only minor alterations in regard to the original factor structure of CAQ [4], in the removal of three items. The role of specific cardiac anxiety, however, is still unknown. As some of the items in the factor Fear/Worry describes a more emotional aspect of anxiety, rather than cognitive, this could be an explanation of the shared relation with the more cognitive factor Attention. Adding Reassurance Seeking as a fourth factor did not improve the fit of the model, nor was this structure supported by exploratory analysis. To describe demographic, physical and psychological characteristics associated with insomnia in patients with cardiovascular disease (CVD) participating in nurse-led Internet-based cognitive behavioural therapy for insomnia (I-CBTI), and their motives and expectations regarding participation in I-CBTI. The EFA resulted in a new model with only minor alterations in regard to the original factor structure of CAQ [4], in the removal of three items. Factor 2, Avoidance, was identical to the same factor in all previous models (containing items 2, 5, 7, 9 and 12). Before The CAQ had moderate correlations with the other anxiety and depression questionnaires. statement and PL has performed the statistical analyses and drafted the manuscript. The Cardiac Anxiety Questionnaire: Development and preliminary validity. By clicking accept or continuing to use the site, you agree to the terms outlined in our. HADS assesses symptoms of anxiety and depression in a clinical setting [13]. Int J Psychiatry Med. Both versions have reported good reliability and validity [14, 15]. Heart failure is one of the major challenges in the healthcare systems of all countries [].The American Heart Association has reported that heart disease is responsible for 22% of deaths every year [2, 3].In Iran, heart failure is the most common cause of hospitalization because about 3,700 per 100,000 Iranians suffer from heart failure WebTo address these concerns, this article reports on the development and preliminary psychometric evaluation of the Cardiac Anxiety Questionnaire (CAQ) designed to measure HFA. Heart It also describes a sudden onset of chest pain/discomfort. If a participant had a missing value for a questionnaire or a subscale, they were excluded from any analysis including that questionnaire or subscale. Cardiac anxiety in people with and without coronary atherosclerosis. Cardiac Anxiety It consists of 14 items, where 7 measure symptoms of anxiety and 7 measure symptoms of depression. Item and factor analyses indicated a three-factor solution pertaining to heart-related fear, avoidance, and Bressler R, Erford BT, Dean S. A systematic review of the posttraumatic stress disorder checklist (PCL). Family-authored ICU diaries to reduce fear in patients experiencing a cardiac arrest (FAID fear): A pilot randomized controlled trial. Heart-focused anxiety (HFA) is the fear of cardiac-related stimuli and sensations because of their perceived negative consequences. WebThe cardiac anxiety questionnaire: development and preliminary validity. The 3-factor solution by Dragioti et al. Shuttle versus six-minute walk test in the prediction of outcome in chronic heart failure. 2011;42:72639. Edwards K, Frazer NL, Haddad JW, et al. J Couns Dev. [8]. Dragioti E, Vitoratou S, Kaltsouda A, et al. Behaviour Research and Therapy. The various 4-factor solutions were slightly superior to the original model by Eifert et al. Behav Res the Cardiac Anxiety Monitoring Patients With Implantable Cardioverter Defibrillators We administered self-report measures to 80 Emergency Department (ED) patients with a primary complaint of doi: 10.1161/JAHA.122.028700. The Short Form consists of nine items that can be divided in two subscales (Avoidance, 3 items; Activation, 6 items). Furthermore, we assessed the reliability of the CAQ and investigated the influence Accessibility Velicers map criteria suggested retaining two factors and the parallel analysis determined the upper limit of factors to rotate and evaluate at 8 (see Fig. We also assessed physical activity with the International Physical Activity Questionnaire (IPAQ), which allows the computation of metabolic equivalents of physical exercise . Two of the removed items (10 and 13) originated from the factor Fear and one from the factor Attention (4) in Eiferts original model [4]. For Eiferts three subscales, Fear, Avoidance and Attention the correlations were =.64, .76 and .75 respectively. Possibly this item describes a shared trait with Panic Disorder. Eur Arch Psychiatry Neurol Sci. The CAQ total score correlated significantly with other anxiety questionnaires (HADS Anxiety, =.66; PCL-C, =.70) and also significantly but to a lesser degree with depressive questionnaires (HADS Depression, =.60; BADS, =.56; MADRS-S, =.63). Cardiac Anxiety These findings point to that the CAQ works psychometrically well in a Swedish post-MI population. The Cardiac Anxiety Questionnaire (CAQ) is a measure designed to assess HFA. 1). PatientReported Outcomes in a Multidisciplinary Electrophysiology An individual who avoids exercise may get high scores even if they do not avoid it for anxiety-related reasons. the cardiac anxiety questionnaire Treatment of depression and anxiety with internet-based cognitive behavior therapy in patients with a recent myocardial infarction (U-CARE heart): study protocol for a randomized controlled trial. Br J Psychiatry. This construct is associated with the development, exacerbation, and maintenance, View 9 excerpts, cites background, methods and results, International journal of psychiatry in medicine. p 4664. Therefore it is major to will able to assess CA in a clinical setting. Cardiophobia: A paradigmatic behavioural model of heart-focused anxiety and non-anginal chest pain. Zigmond AS, Snaith RP. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. HHS Vulnerability Disclosure, Help The https:// ensures that you are connecting to the The Swedish version used in this study was translated by the authors of the RCT, through translation and back-translation. Validao da verso brasileira do questionrio de ansiedade cardaca. Bandalos, Deborah L.: Assessment and Measurement PhD Program, James Madison University, 821 S. Main Street, Harrisonburg, VA, US, 22801, bandaldl@jmu.edu: Hogrefe Publishing, 2016, 2651. As such, this is the first study of the CAQ that has combined both EFA and CFA and followed proper statistical considerations. Cardiac Anxiety in Family Members GH Eifert, RN Thompson, MJ Zvolensky, K Edwards, NL Frazer, Behaviour research and therapy 38 (10), 1039-1053, 2000. The cardiac anxiety questionnaire: Development and preliminary validity. The 3-factor solution by Dragioti et al. Many of these studies have also explored the factor structure of CAQ and proposed varying factor solutions and removal of items [5,6,7,8, 10]. Reliability of the questionnaire was further examined by test-retest, using the Spearman correlation coefficient (control group of RCT, 5 weeks between measurement points). Epub 2023 May 9. WebIn this study of people undergoing electron beam tomography screening for CHD, support was found for the three-factor model of the CAQ originally described by Eifert, Thompson, Med. A high score indicates a greater number of symptoms, greater intensity, or both. The Cardiac Anxiety Questionnaire: development and preliminary validity. [10] and interestingly the original model by Eifert et al. Heart Behav Res Ther. Thus, there were two main aims with the current study. Cardiac Anxiety in Patients Self-Referred 10.1016/S0005-7967(99) A 12-Item short-form health survey: construction of scales and preliminary tests of reliability and validity. [4]. However, in regard to the psychometric properties, the instrument has been found valid and reliable in groups with non-cardiac chest pain as well [5, 7,8,9]. Behav Res Ther, 38 Privacy The confirmatory factor analysis indicated that a 3-factor solution best fitted the data, but with certain items removed. It is suggested [4] to divide the total score by the number of items, making the score range from 0 to 4. Sampling adequacy was measured with the Keyser-Meyer-Olkin (KMO) test, and was used to determine if the correlation matrix was factorable. has eight removed items and its superior fit to the data could be a reasonable suggestion for a short-form of the CAQ. The CAQ total score correlated significantly with other anxiety questionnaires (HADS Anxiety, =.66; PCL-C, =.70) and also significantly but to a lesser degree with depressive questionnaires (HADS Depression, =.60; BADS, =.56; MADRS-S, =.63).
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