Validation of the Brazilian Version of CADE-Q II to Assess Knowledge of Coronary Artery Disease Patients

Abstract Background: The Coronary Artery Disease Education Questionnaire (CADE-Q), an instrument aimed at assessing patients’ knowledge about coronary artery disease (CAD), was originally developed and psychometrically validated in Brazil. It was later translated, cross-culturally adapted, and validated to English. Although both versions demonstrated good reliability and validity, new studies in the area have pointed out the need of implementing the CADE-Q with other components of cardiac rehabilitation (CR) programs, such as psychologic factors, which had not been considered in previous version and were added in the subsequent, adapted version. Thus, a second version of CADE-Q was developed in English, the CADE-Q II. Objective: to translate, culturally adapt and psychometrically validate the CADE-Q II in Brazilian Portuguese. Methods: After translation and review by a Committee of specialists in CR, a version in Brazilian Portuguese was generated and tested in 307 patients in CR. Test-retest reliability was assessed by intraclass correlation coefficient (ICC) in 49 patients; internal consistency was assessed using Cronbach’s alpha (α); and, criterion validity was assessed regarding patients’ educational level and family income. The level of significance adopted for all tests was 5%. Results: After the ICC analysis, 4 items were excluded. The questionnaire was considered internally consistent (α > 0.7). Associations were found between the mean total scores and the variables schooling (p背景：冠状动脉疾病教育问卷（Coronary Artery Disease Education Questionnaire, CADE-Q）是一款用于评估冠心病（coronary artery disease, CAD）患者疾病认知的工具，最初于巴西研发并完成心理测量学验证。后续该问卷被翻译成英文并完成跨文化调适与效度验证。尽管两个版本均展现出良好的信效度，但该领域的新近研究指出，需将CADE-Q与心脏康复（cardiac rehabilitation, CR）项目的其他组成部分结合应用，例如此前版本未纳入的心理因素，而后续调适版已新增此类内容。据此，研发人员推出了英文版的CADE-Q第二版，即CADE-Q II。 研究目的：将CADE-Q II翻译成巴西葡萄牙语，并完成跨文化调适与心理测量学验证。 研究方法：首先由心脏康复专家委员会完成翻译与审核，生成巴西葡萄牙语版本，并纳入307名心脏康复患者开展测试。对49名患者采用组内相关系数（intraclass correlation coefficient, ICC）评估重测信度；采用克朗巴赫α系数（Cronbach’s alpha, α）评估内部一致性；并以患者受教育程度与家庭收入作为效标，评估效标效度。所有检验均采用5%的显著性水平。 研究结果：经ICC分析后剔除了4个条目。该问卷内部一致性良好（α>0.7）。研究发现问卷平均总得分与受教育程度变量之间存在关联（p