Guilt and Reproductive Decision‐Making in Patients With Inherited Cardiac Diseases

This paper aims to systematically review the use and performance of the Brief Illness Perception Questionnaire (Brief IPQ).

We constructed a new type of global quality of life (QOL) scale deriving from the Borg symptom scales and compared four versions of this new type of scale (H scale) with four category rating (CR) scales and four visual analogue (VA) scales. Mean self-ratings and mean scenario ratings on different scales showed small but significant differences, and intercorrelations were higher amongst the H scales than amongst the CR or VA scales. H scales were on average most preferred (by undergraduates and elderly subjects) followed by CR and lastly VA scales in terms of case of use and perceived accuracy of representation. We investigated the preferred polarity of the scales: subjects preferred 'Perfect quality of life' to be indicated by 20 or 100 (with slight preference for the latter) rather than 0. The H scales have eight additional quantifiers between the end labels and there was good agreement about the perceived magnitude of these quantifiers.

Background Implantable cardioverter-defibrillators (ICDs) are an effective treatment in some patients with inherited heart disease, including inherited channelopathies, yet they have also been shown to impact patients’ psychological health. Objective We sought to improve understanding of the level of anxiety and depression as well as device acceptance among inherited channelopathy patients with an ICD. Methods Eligible patients seen at Johns Hopkins Hospital were sent a survey, which included the Hospital Anxiety and Depression Scale (HADS), Cardiac Anxiety Questionnaire (CAQ), and the Florida Patient Acceptance Survey (FPAS). Student t tests and χ 2 tests were used to identify associations with abnormal anxiety and depression scores. Results Among eligible patients (n = 65), 32 individuals (49%) completed the survey. The rate of device-related complications was 34%, and 41% of patients experienced 1 or more ICD shocks. Twelve patients (38%) had an abnormal HADS anxiety subscore and 5 patients (16%) had an abnormal HADS depression subscore (score ≥ 8). Secondary-prevention ICDs were associated with an abnormal HADS anxiety subscore ( P = .03). Experiencing ICD shock(s), device complications, age, sex, and family history of sudden cardiac death were not statistically associated with anxiety or depression. Overall, respondents demonstrated high device acceptance by FPAS (79.9 ± 2.9, maximum total score 100) and moderately high cardiac-specific anxiety by CAQ total score (1.53 ± 0.12). Conclusion A high prevalence of generalized anxiety was identified among inherited channelopathy patients with ICDs. High device acceptance and lack of association with ICD shocks or complications indicate that further research is necessary to understand this increased incidence.