Table 3 CDI item relationship with clinical status and Rasch psychometric characteristics

Fear and uncertainty

Thinking that I am not the person that I used to be

0.585

0.491

0.530

0.556

0.86

0.81

− 0.11

Thinking my condition might get worse

0.432

0.454

0.394

0.477

1.02

1.09

0.14

Being in places and situations that remind me of my heart event

0.368

0.329

0.314

0.321

1.45

1.08

0.11

Avoiding activities that make my heart beat faster

0.436

0.400

0.351

0.401

1.09

1.14

0.02

Dwelling on my heart condition

0.486

0.481

.466

0.516

1.09

0.92

− 0.17

Being unable to plan for the future

0.564

0.485

0.443

0.477

1.11

0.98

− 0.08

*Thinking I will never be the same again

0.575

0.522

0.465

0.556

0.79

0.84

− 0.05

*Not knowing what the future holds for me

0.590

0.539

0.455

0.557

0.86

0.84

0.13

Disconnection and hopelessness

Thinking my friends or family don’t understand how difficult it is living with heart disease

0.433

0.461

0.403

0.422

0.97

0.94

0.18

Being disconnected from people in my community

0.420

0.349

0.475

0.398

0.78

0.65

− 0.01

Being isolated from friends and family

0.376

0.339

0.422

0.366

0.98

0.68

− 0.08

Believing that others don’t have the same confidence in me as they did before my heart problem

0.377

0.321

0.286

0.348

1.34

1.32

− 0.15

Not being supported by my friends and family in my efforts to manage my heart condition

0.351

0.333

0.326

0.327

0.78

0.63

0.05

Being unable to accept help from others

0.428

0.354

0.377

0.403

1.46

1.56

0.09

*Feeling lonely

0.544

0.464

0.588

0.485

0.89

0.90

0.01

*Withdrawing from people

0.581

0.518

0.555

0.572

0.84

0.83

− 0.11

Changes to roles and relationships

Not being able to return to work or continue working

0.343

0.320

0.344

0.325

1.24

1.17

− 0.03

Not being able to go too far from home

0.457

0.370

0.383

0.364

1.03

0.98

0.06

Being unable to take care of family responsibilities

0.467

0.418

0.363

0.402

0.85

0.82

0.08

Being concerned about my capacity for sexual activity

0.321

0.301

0.326

0.269

1.30

1.48

− 0.37

Being unavailable to my family and friends

0.432

0.386

0.390

0.396

0.91

0.74

0.12

Being too dependent on others

0.390

0.293

0.314

0.316

0.90

0.76

0.06

Becoming a burden to my family

0.490

0.432

0.440

0.462

0.94

0.88

0.13

Thinking that my family is being overprotective of me

0.255

0.186

0.163

0.171

1.23

1.54

− 0.07

Thinking that my heart condition controls my life

0.506

0.460

0.473

0.456

0.84

0.82

0.06

*Having changes in my usual roles

0.525

0.448

0.430

0.405

0.72

0.76

0.12

*Lacking purpose or meaning in life

0.568

0.477

0.570

0.465

1.08

0.99

− 0.18

Overwhelm and depletion

Being tearful more easily than before

0.463

0.437

0.450

0.446

1.14

0.65

0.03

Avoiding situations and activities

0.534

0.500

0.502

0.546

0.97

1.01

0.05

Being irritated by little things

0.517

0.449

0.495

0.496

0.86

0.86

− 0.23

Not being able to sustain the lifestyle changes I need to make

0.487

0.440

0.429

0.413

1.22

1.15

0.05

Lacking energy

0.617

0.512

0.505

0.497

1.08

1.17

0.03

*Being unable to deal with stress

0.598

0.525

0.553

0.603

1.09

0.93

0.02

*Being emotionally exhausted

0.683

0.629

0.613

0.619

0.76

0.69

0.09

Cognitive challenges

Having difficulty making decisions

0.485

0.414

0.448

0.421

1.41

1.29

0.11

Having difficulty remembering things

0.417

0.360

0.397

0.390

0.94

0.91

0.08

Forgetting things more than before

0.426

0.370

0.417

0.382

0.73

0.72

− 0.07

*Having difficulty concentrating

0.541

0.475

0.502

0.507

0.99

1.03

0.02

Physical challenges

Being woken up at night by my racing heart

0.296

0.257

0.167

0.234

1.23

1.01

0.04

Having more pain than I can deal with

0.229

0.283

0.191

0.208

1.45

1.05

0.06

Having bad dreams or nightmares

0.409

0.315

0.370

0.336

1.42

1.17

− 0.09

Being overly aware of my heart in my chest

0.465

0.465

0.353

0.486

0.89

0.90

0.25

Having chest discomfort

0.399

0.353

0.357

0.350

0.79

0.76

0.10

Being short of breath

0.235

0.151

0.203

0.183

1.15

1.27

− 0.28

Not sleeping well

0.461

0.448

0.440

0.432

0.98

0.98

− 0.12

*Being physically restricted

0.544

0.506

0.503

0.479

0.74

0.74

0.05

Health system challenges

Not having access to the health care I need

0.273

0.287

0.268

0.223

1.08

0.97

− 0.11

Having difficulty getting to appointments that I need to attend

0.283

0.236

0.198

0.180

1.35

1.40

− 0.04

Not being able to get as much information as I want about my heart condition

0.299

0.293

0.263

0.303

0.96

0.91

0.07

Not having my concerns taken seriously by my health practitioner

0.275

0.244

0.211

0.239

1.01

0.90

0.12

*Not getting clear directions from my health practitioner on how to manage my heart condition

0.346

0.339

0.269

0.282

0.73

0.68

− 0.04

Death concern

Not knowing what will happen to other people if I die

0.543

0.387

0.306

0.425

1.03

0.93

− 0.21

Not knowing how my family will cope if something should happen to me

0.503

0.371

0.294

0.387

1.07

1.03

0.05

Being afraid of dying

0.529

0.408

0.355

0.464

1.00

0.95

0.11

*Thinking about dying

0.607

0.437

0.422

0.511

0.90

0.86

0.05