Cultural adoption, and validation of the Persian version of the coronary artery disease education questionnaire (CADE-Q): a second-order confirmatory factor analysis

Abstract

Background: Evaluating knowledge in patients with coronary artery disease requires a specific measure. The aim of the present study was to translate and evaluate the CADE-Q in patients with coronary artery disease in Iran. Methods: Forward-backward procedure was applied to translate the questionnaire from English into Persian. Then a cross-sectional study was conducted to evaluate psychometric properties of the questionnaire. A sample of patients with coronary artery disease attending to cardiac departments of teaching hospitals affiliated to medical universities in Tehran, Iran completed the 19-item CADE-Q from April to December 2017. Structural validity of CADE-Q was assessed using both exploratory and confirmatory factor analyses. Reliability was examined using Cronbach's alpha coefficient. Stability was evaluated by estimation intraclass correlation coefficient. Results: In all 500 patients participated in the study. The mean age of patients was 53.63. (SD = 14.36) years, and 57% were male. The results obtained from the exploratory factor analysis showed a four factor solution (lifestyle habits and exercise, risk factors, diagnosis and treatment, signals & symptoms and medicine) that jointly explained 48.9% of the total variance observed. However, the second-order confirmatory factor analysis supported the threefactor solution while convergent and divergent validity were not confirmed. Finally, the Cronbach's alpha coefficient of 0.84 ranging from 0.50 to 0.82 was obtained for the scale and its subscales. In addition, the ICC value of 0.88 showed satisfactory stability for the questionnaire. Conclusion: The Coronary Artery Disease Education Questionnaire was found to be a multidimensional instrument. The results confirmed the factor structure of the questionnaire with a second-order analysis. Since the convergent and divergent validity of the scale were not confirmed, further assessment is essential to establish fitness of the questionnaire in Iran.

Translation, Cross-Cultural Adaptation, and Psychometric Validation of the Russian Coronary Artery Disease Education Questionnaire II (CADE-Q II) in chronic coronary syndrome patients

“…The analysis of criterion validity was based on a previous study [26], with higher knowledge about the disease associated with higher educational level. These results are consistent with previous studies [16,24,27], as well as the validation of the other 3 versions of CADE-Q II [16,24,25]. Although weak, the correlation between "self-care confidence" scale of the SC-CHDI and CADE-Q II scores aligns with previous studies that report that knowledge can be associated with better behaviors 2 .…”

An Evaluation of Psychometric Properties of Needs Assessment Instruments in Patients with Coronary Artery Disease Undergoing Cardiac Rehabilitation Programs: A Systematic Review

“…The number of tool items and factors of involved studies were different. The maximum item number was 60 (De Melo Ghisi, Grace et al, 2013), the minimum number of dimensions were three (Marofi et al, 2020) and the maximum number was 11 dimensions in one study (Phelan et al, 1989).…”

“…All studies were peer-review original articles. Majority of the studies (n=5) were showed in the Canada (De Melo Ghisi et al, 2016;De Melo Ghisi et al, 2015;De Melo Ghisi, Grace et al, 2013;De Melo Ghisi & Oh, 2021; followed by Iran (n=2) (Marofi et al, 2020;Sayadi et al, 2021), Brazil (n=4) (De Melo Ghisi et al, 2010;De Melo Ghisi et al, 2018;De Melo Ghisi et al, 2014Santos et al, 2019 , China (n=1) (Chen et al 2018), Australia (n=1) (Smith et al, 2015), Netherlands (n=1) (Van Engen-Verheul et al, 2012) and USA (n=1) (Phelan et al, 1989).…”

“…Overall the CADEQ questionnaire was good based on psychometric properties. Respecting to the study design, seven articles were cross-cultural assessment studies (Chen et al, 2018;De Melo Ghisi et al, 2014;De Melo Ghisi et al, 2018;De Melo Ghisi & Oh, 2021;Marofi et al, 2020;Santos et al, 2019) and others were studied about design and psychometric properties of questionnaires (De Melo Ghisi et al, 2010;De Melo Ghisi et al, 2015;De Melo Ghisi et al, 2016;De Melo Ghisi, Grace et al, 2013;Phelan et al, 1989;Sayadi et al, 2021;Smith et al, 2015;Van Engen-Verheul et al, 2012).…”

“…Educational level, family income, CR duration, and time of diagnosis were used as a criterion for criterion validity. Majority of studies had construct validity; exploratory factor analysis (n=6) (De Melo Ghisi et al, 2015;De Melo Ghisi et al, 2010;De Melo Ghisi et al, 2018;De Melo Ghisi & Oh, 2021;Sayadi et al, 2021), confirmatory factor analysis (n=1) (Chen et al, 2018), and exploratory and confirmatory factor analysis (n=1) (Marofi et al, 2020) while other studies did not report it. Other psychometric characteristics of involved studies are reviewed in Table 1.…”