Abstract
Purpose
Fear of physical activity (FoPA) has been suggested as a psychological barrier to exercise-based cardiac rehabilitation and everyday physical activity (PA) in patients with heart failure (HF). We evaluated the recently developed Fear of Activity in Situations-Heart Failure (FActS-HF) questionnaire that assesses affective/cognitive fear reactions to situations of varying PA intensities.
Methods
The FActS-HF was given to 132 ambulatory patients with stable HF (67 ± 12 years, 80% men). In 121 participants with valid FActS-HF data, the questionnaire’s dimensionality was investigated. Psychometric properties were determined in terms of reliability and validity. We assessed convergent and discriminant correlations of FoPA with anxiety, kinesiophobia, and depression. External validation criteria encompassed clinical variables and objectively assessed accelerometer measures of everyday PA in a subsample of 61 participants.
Results
The FActS-HF measures a unidimensional construct (i.e., FoPA) based on items presenting varying PA intensities (i.e., the more intense the PA, the stronger the fear response). The scale demonstrated good 2-week stability (r tt = 0.82) and excellent internal consistency reliability (α = 0.97). FoPA was moderately to strongly associated with anxiety and kinesiophobia, and weakly to moderately associated with state/trait depression, supporting convergent and discriminant validity, respectively. High FoPA was associated with feeling uninformed about HF, comorbidities, non participitation to cardio fitness groups, and less stair climbing, as measured by accelerometry.
Conclusion
The FActS-HF is a reliable and valid instrument to measure FoPA in patients with HF and provides a promising tool for further research and practice.
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Acknowledgements
The authors thank PD Dr. Ralf Westenfeld (Medical Faculty, University of Düsseldorf), Dr. Armin Jansen (Cardiowell Wuppertal), Diane Hennig, Bianca Liebrand, Lisa Morck, Olena Shyshova, and Züleya Abanoz (all University of Wuppertal) for participant recruitment, and Dr. Stefan Hey and Panagiota Anastasopoulou (Karlsruhe Institute of Technology) for their assistance in analyzing the accelerometer data.
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All procedures performed in the study involving human participants were in accordance with the ethical standards of the institutional research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.
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Informed consent was obtained from all individual participants included in the study.
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Hoffmann, J.M., Hellwig, S., Brandenburg, V.M. et al. Measuring Fear of Physical Activity in Patients with Heart Failure. Int.J. Behav. Med. 25, 294–303 (2018). https://doi.org/10.1007/s12529-017-9704-x
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DOI: https://doi.org/10.1007/s12529-017-9704-x