ABSTRACT

Background and Objectives: Anxiety and stress influence the onset and prognosis of cardiovascular disease (CVD), but little is known about what CVD patients do when experiencing stress/anxiety. This study aimed to identify the behavioral strategies CVD patients use to regulate these emotions. Design: Instrumental and longitudinal. Methods: A theoretically-guided scale, the Stress and Anxiety Regulation Strategies (STARTS), was developed considering the target population’s characteristics. CVD patients were recruited at three different points (N_T1= 721, N_T2= 566, N_T3= 311). Results: At T1 exploratory factor analysis was conducted (random sample 1). The validity of the most parsimonious three-factor solution was subsequently found via confirmatory factor analysis at T1 (random sample 2), T2, and T3, revealing good and stable model fit. The factors represented strategies differentiated by the type and level of activity required (passive, intellectual, and physical strategies). The scale showed good test-retest reliability and internal consistency. Correlation and regression analyses with positive and negative affect, psychological wellbeing (stress, anxiety, depression), and cardiac self-efficacy provided evidence for the validity of STARTS score. Physical and passive strategies showed opposite patterns. Conclusions: The scale shows adequate psychometric properties for assessing the strategies used by CVD patients to regulate stress and anxiety.

摘要

背景和目的：焦虑和压力会影响心血管疾病 (CVD) 的发病和预后，但人们对 CVD 患者在经历压力/焦虑时的反应知之甚少。本研究旨在确定 CVD 患者用来调节这些情绪的行为策略。设计：工具和纵向。方法：考虑到目标人群的特征，制定了一个理论指导的量表，压力和焦虑调节策略（STARTS）。CVD患者在三个不同点（招募Ñ _T1 = 721，Ñ _T2 = 566，Ñ _T3= 311）。结果：在 T1 进行了探索性因素分析（随机样本 1）。随后通过 T1（随机样本 2）、T2 和 T3 的验证性因子分析发现了最简约的三因素解决方案的有效性，揭示了良好且稳定的模型拟合。这些因素代表了根据所需活动的类型和水平（被动、智力和身体策略）而不同的策略。该量表显示出良好的重测信度和内部一致性。与积极和消极情绪、心理健康（压力、焦虑、抑郁）和心脏自我效能的相关性和回归分析为 STARTS 评分的有效性提供了证据。物理和被动策略显示出相反的模式。结论：