Measurement of patient fears about implantable cardioverter defibrillator shock: an initial evaluation of the Florida Shock Anxiety Scale

Pacing Clin Electrophysiol. 2006 Jun;29(6):614-8. doi: 10.1111/j.1540-8159.2006.00408.x.


Background: Psychological distress is both a precipitant and a consequence of ICD shock. Therefore, the assessment of patient anxiety and concerns related to receiving an ICD shock may prompt appropriate psychological referrals and treatment.

Methods: The purpose of this study is to assess the initial validity and clinical utility of the Florida Shock Anxiety Scale (FSAS). Seventy-two ICD recipients completed the FSAS.

Results: Exploratory factor analysis revealed a two-factor structure with items loading such that Factor 1 could be conceptualized as a Consequence Factor (e.g., fearing creating a scene if the device were to fire) and Factor 2 as a Trigger Factor (e.g., fearing sexual activity). Alpha coefficients suggest good reliability (Cronbach's alpha= 0.91, split-half = 0.92), and FSAS Total Score was moderately correlated (r =-0.65) with total score on the Multidimensional Fear of Death Scale.

Conclusions: Two subscales, labeled consequence of shock and trigger of shock, were established via factor analysis. Collectively the FSAS demonstrates potential utility to assess shock distress and warrants additional investigation.

MeSH terms

  • Anxiety / diagnosis*
  • Defibrillators, Implantable / psychology*
  • Electric Countershock / psychology*
  • Fear*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Reproducibility of Results
  • Surveys and Questionnaires*