Development and psychometric validation of the second version of the Coronary Artery Disease Education Questionnaire (CADE-Q II).

OBJECTIVES

To develop and psychometrically-validate a revised version of the Coronary Artery Disease Education Questionnaire (CADE-Q)--a tool to assess patients' knowledge about CAD in cardiac rehabilitation (CR).

METHODS

After a needs assessment, a literature review and focus group with CR experts, the revised questionnaire was developed. It underwent pilot-testing in 30 patients, which lead to further refinement. The questionnaire was then psychometrically-tested in 307 CR patients. Internal consistency was assessed using Cronbach's alpha, the dimensional structure through exploratory factor analysis, and criterion validity with regard to educational level.

RESULTS

Cronbach's alpha was 0.91. Criterion validity was supported by significant differences in mean scores by educational level (p<0.001). Factor analysis revealed four factors, which were internally-consistent (0.65-0.77), and well-defined by items. The mean total score was 64.2±18.1/93. Patients with a history of heart failure, cardiomyopathy and percutaneous coronary intervention (p<0.05) had significantly higher knowledge scores compared with patients without such a history. Knowledge about exercise and their medical condition was significantly higher than risk factors, nutrition and psychosocial risk.

CONCLUSIONS

The CADE-QII has good reliability and validity.

PRACTICAL IMPLICATIONS: This tool may be useful to assess CR participants' knowledge gaps, and to evaluate the efficacy of educational delivery in CR.