Measuring Psychosocial Risk Factors in Cardiac Rehabilitation

PURPOSE: The psychosocial risk factors of depression, anxiety, anger/ hostility, and social isolation have a significant effect on cardiac disease comparable with other highly publicized risk factors. This study assesses the validity of the Psychosocial Risk Factor Survey (PRFS) to conveniently assess all of these primary risk factors in cardiac patients at once. METHODS: Two samples totaling 364 cardiac patients were administered the PRFS and various widely accepted independent-comparison tests measuring depression, anxiety, anger/hostility, social isolation, and emotional guardedness. The researchers also performed a principal components analysis, calculated PRFS intrascale consistency reliabilities, and examined the PRFS Emotional Guardedness scale to determine whether it measures patient tendencies to underreport risk factors. RESULTS: Concurrent validity correlations between the PRFS scales and their associated independent-comparison measures were statistically significant and substantial. The principal components analysis indicated that the Depression and Anxiety scale items loaded on a single factor whereas the Anger/Hostility, Social Isolation, and Emotional Guardedness scale items loaded as expected on their target factors. The scales evidenced sufficient levels of internal consistency, with the exception of the Emotional Guardedness scale. Finally, a scaled range of symptom severity for each measured construct was established. CONCLUSION: This analysis suggests that the PRFS has concurrent validity for assessing the primary psychosocial risk factors of depression, anxiety, anger/hostility, and social isolation in cardiac patients. This tool is a valid, convenient, and efficient measure of the prominent psychosocial risk factors and includes a scale that may help discern underreporting of risk factors.