Abstract
Background:Patient education is the first step in implementing a cardiac rehabilitation (CR) program and a powerful tool for promoting behavioral changes in cardiac patients. In China, the clinical workload is so heavy that a short and reliable tool for assessing disease-related knowledge is needed for targeted patient education.Objective:The aim of this study was to translate, adapt and validate the Chinese version of the Coronary Artery Disease Education Questionnaire – Short Version (CADE-Q SV).Methods:The CADE-Q SV was translated to simplified Chinese and culturally adapted to the Chinese context. The translated version was reviewed by a committee of seven experts in cardiovascular disease, and the content validity of the questionnaire was established. The psychometric properties of the questionnaire were analyzed considering the responses of 240 CR patients. The Kuder-Richardson-20 (KR-20) coefficient and Cronbach’s alpha were used to assess internal consistency. The intraclass correlation coefficient (ICC) was used to assess test-retest reliability. The criterion-related validity was evaluated by determining whether there were differences in the total scores of patients with different educational levels. Confirmatory factor analysis (CFA) was used to assess the factor structure.Results:Three items from the original version were adapted to reflect Chinese culture. The content validity index was 0.94. The KR-20 score was 0.856. All ICC values were > 0.70. The knowledge scores of patients with different educational levels were significantly different, indicating that the criterion-related validity of the Chinese CADE-Q-SV was acceptable. CFA validated the five-factor structure of the Chinese CADE-Q-SV.Conclusion:The Chinese CADE-Q SV questionnaire has good reliability and validity. This short, efficient tool can be completed quickly, assess disease-related knowledge in cardiovascular patients and serve as a reference for individualized patient education in China. It can also be used to evaluate the effectiveness of CR-related patient education interventions.
Highlights
The incidence of cardiovascular disease (CVD) is still increasing worldwide, especially in low- and middleincome countries, and CVD remains the leading cause of death in China and worldwide [1, 2]
The results showed that the knowledge scores of patients with different educational levels were different (P < 0.001); the more educated the patients were, the higher their knowledge scores (P < 0.001), indicating that the criterion-related validity of the Chinese Coronary Artery Disease Education Questionnaire (CADE-Q) SV was acceptable (Table 2)
The results showed that the model has good data fitting (x2/df = 1.766; root mean square error of approximation (RMSEA) = 0.056; comparative fit index (CFI) = 0.930; goodness-of-fit index (GFI) = 0.900; root mean square residual (RMR) = 0.011)
Summary
The incidence of cardiovascular disease (CVD) is still increasing worldwide, especially in low- and middleincome countries, and CVD remains the leading cause of death in China and worldwide [1, 2]. In China, the clinical workload is so heavy that a short and reliable tool for assessing disease-related knowledge is needed for targeted patient education. Objective: The aim of this study was to translate, adapt and validate the Chinese version of the Coronary Artery Disease Education Questionnaire – Short Version (CADE-Q SV). The criterion-related validity was evaluated by determining whether there were differences in the total scores of patients with different educational levels. The knowledge scores of patients with different educational levels were significantly different, indicating that the criterion-related validity of the Chinese CADE-Q-SV was acceptable. Conclusion: The Chinese CADE-Q SV questionnaire has good reliability and validity. This short, efficient tool can be completed quickly, assess disease-related knowledge in cardiovascular patients and serve as a reference for individualized patient education in China. It can be used to evaluate the effectiveness of CR-related patient education interventions
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