Study On Psychological Flexibility And Its Influencing Factors In Patients With Atrial Fibrillation

Objective 1.To translate the Comprehensive Assessment of Acceptance and Commitment therapy Scale into Chinese,and to test its reliability and validity in patients with atrial fibrillation(AF).2.To investigate the current status of psychological flexibility in AF patients and to explore the influencing factors based on Shelley stress process model.Methods 1.Obtaining the authorization of the English version of the Comp ACT from professor Francis of the University of Lincoln,and doing translations according to the Brislin translation principles and the ISPOR cultural adaptation guidelines.2.A total of 474 AF patients who were admitted to the department of cardiology or visited arrhythmia clinic in a tertiary general hospital in Tianjin were selected for a questionnaire survey to test the reliability and validity of the Chinese version of Comp ACT.Reliability was tested by the internal consistency reliability and test-retest reliability.Validity was evaluated by the content validity,construct validity,and criterion correlative validity.3.The Chinese version of Comp ACT,general information questionnaire,the General Big Five Scale,the Perceived Social Support Scale,the Trait Coping Style Questionnaire,and Regulatory Emotional Self-efficacy Scale were used to investigate 309 patients with AF in a tertiary general hospital in Tianjin.Independent sample t-test,one-way ANOVA,Welch test and correlation analysis were used for univariate analysis,and multivariate analysis was performed by multiple linear stepwise regression analysis.Results 1.Translation results: The expert modified some items of Chinese version of Comp ACT and removed item 13,which was consistent with the source scale in dimension.2.Psychometric test results: exploratory factor analysis extracted three common factors,with a cumulative variance contribution rate of 52.46%;confirmatory factor analysis showed that the fitting index basically met the criteria except for AGFI and RMR.The content validity of each item ranged from 0.83 to 1.00 and the content validity of the scale was 0.87;the criterion correlative validity was 0.713.The internal consistency of the overall scale and three dimensions were 0.907,0.877,0.872,and 0.892,respectively;the test-retest reliability of the total scale and each dimension at 1-week intervals were 0.877,0.880,0.729,and 0.851,respectively.3.The average score of psychological flexibility in AF patients was 79.67±7.42,which was at a moderate level.The results of univariate analysis showed that psychological flexibility scores among patients with different gender,education level,average monthly family income,number of radiofrequency ablation procedures,and number of comorbidities had significant differences;correlation analysis showed that open personality traits,perceived social support,self-efficacy for emotion regulation,and positive coping were positively correlated with psychological flexibility,and negative coping was negatively correlated with psychological flexibility.The results of multivariate analysis showed that the average monthly family income≥5,000 yuan,number of radiofrequency ablation procedure more than three times,open personality traits,perceived social support,self-efficacy for emotion regulation,trait coping styles had a predictive effect on psychological flexibility,explaining a total of 54.3% of the total variation.Conclusions 1.The Chinese version of Comp ACT has a clear expression,reasonable dimension division and good reliability,which can be used for the assessment of psychological flexibility in AF patients.2.The level of psychological flexibility in AF patients is at a moderate level and still needs to be improved.The main factors affecting the psychological flexibility of AF patients were average family income≥5,000 yuan,number of radiofrequency ablation procedure more than three times,open,personality traits,perceived social support,selfefficacy of emotion regulation,and trait coping styles.