Feasibility and validity of Ecological Momentary Assessment in patients with acute coronary syndrome
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RESEARCH ARTICLE
Feasibility and validity of Ecological Momentary Assessment in patients with acute coronary syndrome François A. M. Jean1, Igor Sibon2, Mathilde Husky3, Thierry Couffinhal4 and Joel Swendsen5,6*
Abstract Background: In recent years, Ecological Momentary Assessment (EMA) has expanded rapidly in healthcare research but its application specifically to the field of cardiology has been limited. This study presents essential information concerning the feasibility and validity of EMA in patients with acute coronary syndrome. Methods: Four months after a first-ever acute coronary syndrome, 47 patients completed EMA five times a day for seven consecutive days concerning their current activities, mood and perceived negativity or positivity of daily events. Results: Compliance with the repeated electronic assessments was high, and no evidence was found for timedependent biases such as fatigue or practice effects. The resulting EMA data were found to have high internal validity, high reliability when considering average scores, and low reliability when considering within-person variance. Conclusions: We found evidence for the feasibility and intrinsic validity of EMA in patients with acute coronary syndrome. Research examining daily life experiences, symptoms and therapeutic adherence in this population can be reinforced through the use of mobile technologies. Keywords: Acute coronary syndrome, Ecological Momentary Assessment, Validity, Feasibility Background Ambulatory monitoring techniques such as Ecological Momentary Assessment (EMA) have been validated in the investigation of a wide range of diseases and disorders [1–5] as well as in samples ranging from young adolescents to the elderly [6–8]. The contributions of this approach include its capacity to study phenomena in ecologically-valid contexts of daily life, and its ability to collect real-time data overcomes retrospective memory biases associated with traditional and non-electronic research instruments [9, 10]. Importantly, EMA can also be used to provide real-time therapeutic interventions including medication reminders and specific exercises at *Correspondence: Joel.Swendsen@u‑bordeaux.fr 5 Centre national pour la recherche scientifique (INCIA, CNRS 5287), 146 rue Léo Saignat, Bordeaux, France Full list of author information is available at the end of the article
the moments that they are most needed by patients [11, 12]. It is well-documented that behavioral and psychological variables play a role in the onset as well as recovery from heart disease [13–15], and such variables can have an important impact on the degree to which patients engage in rehabilitation [16]. Ambulatory monitoring of these variables provides an important source of information for both research and clinical intervention. EMA has previously been used in community samples to monitor risk for cardiovascular disease [17], mobile health interventions following cardiac events [18, 19], and non-computerized versions of EMA have been used to examine how mood patt
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