Cultural Adaptation and Psychometric Validation of a Cardiac Knowledge Questionnaire for Chinese Immigrants

Abstract

Background: Disease-related knowledge deficits are common in Chinese immigrants living in Western countries, putting them at risk of disease progression and mortality, particularly those with a coronary heart disease (CHD) diagnosis. However, no measurement instrument is available to assess CHD-related knowledge in this population. Objectives: The aim of this study was to culturally adapt and examine the psychometric properties of the short version of Coronary Artery Disease Education Questionnaire (CADE-Q SV) (simplified Chinese version) in Chinese immigrants with CHD. Methods: Mandarin-speaking people recruited from medical centers and cardiology clinics across metropolitan Sydney completed the 20-item CADE-Q SV (5 domains; potential scores: 0-20). Internal consistency was assessed using Cronbach α. A subgroup (n = 40) repeated the survey 2 weeks later for test-retest reliability by intraclass correlation coefficient. Factor structure (confirmatory factor analysis) and discriminant (known-groups) validation using education and English proficiency (univariate general linear model) were also undertaken. Results: Participants (n = 202) had a mean (SD) age of 66.08 (10.93) years, 45.1% were male, and the mean (SD) total CADE-Q SV score was 13.07 (4.57). Reliability and consistency were good (intraclass correlation coefficient > 0.70; Cronbach α coefficients > 0.70, for total and per domain, respectively). The 5-domain structure was validated by confirmatory factor analysis. The scale demonstrated discriminant validity, with low education (P < .001) and low English proficiency (P = .017) associated with lower knowledge scores. Conclusion: The CADE-Q SV (simplified Chinese version) can be used as a valid and reliable instrument, either paper based or digital, to evaluate the CHD-related knowledge of Chinese immigrants. This scale can be adapted to other migrant populations in the future.

Translation, cultural adaptation and psychometric validation of the Arabic short version of the coronary artery disease education questionnaire (CADE-Q SV) in Saudi Arabia

“…In the current study, nutrition and psychosocial health were the areas with the highest and lowest knowledge scores, respectively. These results are similar to the ones observed in the Persian and Chinese for immigrants' versions [ 33 , 34 ]. The total mean knowledge score of the Arabic-speaking sample was 11.3 (SD = 3.8), the lowest among all previous studies using the CADE-Q SV.…”

“…The alpha of the Arabic CADE-Q SV was 0.84, which is within the range of other versions (0.72–0.85). The number of factors extracted from the confirmatory factor analysis is also similar to 7/8 previous studies assessing the psychometric properties of CADE-Q SV [ 21 , [29] , [30] , [31] , [32] , [33] , [34] ].…”

“…The short version of CADE-Q was needed, so knowledge assessments could be incorporated into busy clinical practices. In total, there are 21 languages available in all 3 CADE-Q versions, including 11 from CADE-Q SV (8 studies evaluating psychometric properties of the following languages: English [ 21 ], Portuguese [ 29 ], Spanish [ 30 ], French [ 31 ], Chinese [ 32 , 33 ], Persian [ 34 ], and Vietnamese) [ 35 ]. The alpha of the Arabic CADE-Q SV was 0.84, which is within the range of other versions (0.72–0.85).…”