ABC | Volume 114, Nº5, May 2020

Original Article Silva et al. Florida Shock Anxiety Scale Arq Bras Cardiol. 2020; 114(5):764-772 adequate values of Cronbach’s alpha, McDonald’s Omega and GLB. The adoption of these three indications aimed to increase the accuracy of interpretation, since the Cronbach’s coefficient alpha is affected by the nature of data distribution and by sample size. Besides, its values may be increased by extensive scales, parallel and/or redundant elements or limited coverage of the construct under analysis, decreasing the reliability of the measurement. 33 In general, the results observed in the present study showed that the instrument is reliable and valid for application in Brazil, meeting the quality requirements for patient-reported outcome measurements. Study limitations Although the population studied is larger than the samples of several other studies which have used the FSAS, further studies with more robust samples are crucial for the consolidation of its validity and for attesting its stability in the various possible scenarios and profiles of ICD patients. Table 3 – Descriptive analysis of the FSAS-Br items Item Average SD Inferior threshold Superior threshold 5 % trimmed average Median Range IQR Asymmetry Kurtosis KS Sig. 1 2.95 1.86 2.66 3.25 2.95 3.00 4.00 4.00 0.12 -4.80 0.29 0.01 2 2.46 1.72 2.19 2.74 2.40 1.00 4.00 4.00 2.84 -3.67 0.33 0.01 3 2.26 1.69 1,99 2,53 2,18 1,00 4,00 3,00 4,06 -2,90 0,37 0,01 4 2,47 1,69 2,20 2,74 2,41 1,00 4,00 3,00 2,63 -3,69 0,33 0,01 5 2,43 1,62 2,17 2,69 2,37 2,00 4.00 3.00 2.97 -3.21 0.30 0.01 6 1.54 1.25 1.34 1.74 1.38 1.00 4.00 0.00 10.81 7.67 0.48 0.01 7 2.36 1.68 2.09 2.63 2.29 1.00 4.00 3.00 3.34 -3.30 0.34 0.01 8 2.74 1.72 2.47 3.02 2.71 3.00 4.00 4.00 1.30 -4.14 0.28 0.01 9 2.07 1.59 1.81 2.32 1.96 1.00 4.00 2.00 5.37 -1.56 0.39 0.01 10 1.54 1.24 1.34 1.74 1.37 1.00 4.00 0.00 10.87 7.84 0.49 0.01 Table 4 – Construct validity of the FSAS-Br: factor loading, communalities and item description Item Factor loading Communalities (h 2 ) Item description (a) 1 0.76 0.58 1.17 2 0.77 0.60 1.22 3 0.76 0.59 1.19 4 0.81 0.65 1.37 5 0.68 0.46 0.93 6 0.71 0.50 1.00 7 0.67 0.46 0.91 8 0.73 0.53 1.05 9 0.86 0.74 1.71 10 0.74 0.55 1.11 Further studies, evaluating the association of the FSAS-Br scores with the occurrence of ICD shock therapies and other clinic parameters will be useful to identify factors which may be associated with increased anxiety levels and, therefore, allow for the establishment of specific and personalized interventions for these patients. Conclusions The FSAS-Br instrument presented consistent validity and reliability evidence and, therefore, its use can be recommended for the ICD population in Brazil, both in clinical practice and in scientific research. Author contributions Conception and design of the research: Silva KR, Costa R; Acquisition of data: Melo GRGO, Benedetto MS; Analysis and interpretation of the data: Silva KR, Rebustini F; Statistical analysis: Rebustini F; Obtaining financing and writing of the manuscript: Silva KR; Critical revision of the manuscript for intellectual content: Costa R, Rebustini F, Nagumo MM, Sears SF. 770