ABSTRACT
Abstract Background: Patient education is an essential part of cardiovascular patients' care targeting self-management behavior to reduce risk factors and subsequent events. Herein, a short and reliable tool to assess patients' knowledge in Brazil is warranted. Objectives: To translate, culturally-adapt and psychometrically validate the Portuguese version of the Coronary Artery Disease Education Questionnaire Short Version (CADE-Q SV). Methods: The Portuguese CADE-Q SV - translated and culturally-adapted - was reviewed by five bilingual experts in cardiovascular disease. This version was then pre-tested in 21 patients, and clarity of items was checked using a Likert-type scale ranging from 1 = not clear to 10 = very clear. It was then psychometrically tested in 200 cardiovascular patients (41%women; mean age = 58.4 ± 11.6 years old). The internal consistency was assessed using Kuder-Richardson-20 (KR-20) and Cronbach's alpha, test-retest reliability through intraclass correlation coefficient (ICC), factor structure using confirmatory factor analysis, and construct validity regarding educational level, family income, and time of diagnosis. Results: All questions were considered clear by patients (clarity range:7.8-9.6). KR-20 was 0.70. All ICC values were > 0.70. Factor analysis revealed 6 factors, all internally consistent. Construct validity was supported by significant differences in total scores by educational level and family income (p < 0.001). The overall mean was 13.08 ± 2.61. The area with the highest knowledge was risk factors and the lowest was psychosocial risk. Conclusions: The Portuguese CADE-SV was demonstrated to have good validity and reliability. This tool can be applicable in clinical and research settings, assessing cardiovascular patients' knowledge as part of an education programming.
Resumo Fundamento: A educação é parte essencial do atendimento dos pacientes cardiovasculares, visando ao autocuidado, para reduzir os fatores de risco. Assim, uma ferramenta curta e confiável para avaliar o conhecimento dos pacientes no Brasil é necessária. Objetivo: Traduzir, adaptar culturalmente e validar psicometricamente a versão em português do Coronary Artery Disease Education Questionnaire Short Version (CADE-Q SV). Métodos: CADE-Q SV português foi revisado por cinco especialistas em doenças cardiovasculares bilíngues e testado em 21 pacientes, avaliando clareza dos itens por uma escala tipo Likert variando de 1 = não clara a 10 = muito clara. Foi testada psicometricamente em 200 pacientes cardiovasculares (41% mulheres; média de idade = 58,4 ± 11,6 anos). Consistência interna foi avaliada usando o Kuder-Richardson-20 (KR-20) e o alfa de Cronbach; teste-reteste de confiabilidade por meio do coeficiente de correlação intraclasse (ICC); estrutura de fatores usando análise fatorial; e validade de construto em relação ao nível educacional, renda familiar e tempo de diagnóstico. Resultados: Todas as perguntas foram consideradas claras pelos pacientes (faixa de clareza: 7,8-9,6). O KR-20 foi de 0,70. Todos os valores ICC foram > 0,70. A análise dos fatores revelou 6 fatores, todos consistentes. A validade do construto foi sustentada por diferenças significativas nas pontuações totais por nível educacional e renda familiar (p < 0,001). A média geral foi de 13,08 ± 2,61. A área com maior conhecimento foi fatores de risco e menor risco psicossocial. Conclusão: O CADE-SV português demonstrou ter boa validade e confiabilidade; podendo ser aplicado em contextos clínicos e de pesquisa, avaliando o conhecimento dos pacientes com doença cardiovascular.
Subject(s)
Humans , Male , Female , Middle Aged , Aged , Coronary Artery Disease/rehabilitation , Health Knowledge, Attitudes, Practice , Patient Education as Topic/standards , Surveys and Questionnaires/standards , Psychometrics/standards , Socioeconomic Factors , Translations , Brazil , Cross-Cultural Comparison , Cross-Sectional Studies , Reproducibility of ResultsABSTRACT
Introduction: People with stroke commonly show low levels of physical activity and reduced functional capacity, independent of the severity of the impairments. The use of simple measures that are able to produce transferable information from clinical practice to life in society is crucial within clinic contexts. Objective: To compare the functional capacity of patients with chronic stroke based upon their physical activity levels. Methods: For this cross sectional study, functional capacity and levels of physical activity were assessed by the Duke Activity Status Index (DASI) and the adjusted activity score (AAS) of the Human Activity Profile (HAP), respectively. One-way analysis of variance (ANOVA), followed by LSD post-hoc tests were employed to investigate differences between the physical activity groups regarding their DASI scores. Results: Fifty-one individuals with mean age 58.8 ± 13.5 and a mean time since the onset of stroke of 25.5 ± 13.9 months participated. According to their HAP AAS, 18 individuals were classified as impaired, 28 as moderately active, and five as active. Between-group differences were observed for the DASI scores [F(2,48)=13.72; p < 0.01]. Conclusion: Increases in functional capacity were observed with increases in physical activity levels.(AU)
Introdução: Indivíduos pós acidente vascular cerebral (AVC) geralmente apresentam baixos níveis de atividade física e redução da capacidade funcional, independente da gravidade. O uso de medidas simples, capazes de transferir informações da prática clínica para a vida em sociedade, é crucial dentro do contexto clínico. Objetivo: Comparar a capacidade funcional dos indivíduos com AVC crônico estratificados pelo nível de atividade física. Métodos: Para este estudo transversal, a capacidade funcional e os níveis de atividade física foram avaliados pelo Duke Activity Status Index (DASI) e pelo escore de atividade ajustado (EAA) do Perfil de Atividade Humana (PAH), respectivamente. Análise de variância One-way (ANOVA), seguida de testes post-hoc LSD foram realizados para investigar diferenças entre os níveis de atividade física considerando os escores do DASI. Resultados: Cinquenta e um indivíduos com idade média de 58,8 ± 13,5 anos e tempo médio pós AVC de 25,5 ± 13,9 meses participaram. De acordo com o EAA PAH, 18 indivíduos foram classificados como inativos, 28 como moderadamente ativos, e 5 como ativos. Diferenças entre-grupos foram observadas para os escores do DASI [F(2,48) = 13,72; p < 0,01]. Conclusão: Aumentos na capacidade funcional foram observados com aumentos nos níveis de atividade física. (AU)
Subject(s)
Humans , Male , Female , Adult , Middle Aged , Stroke , Activities of Daily Living , Exercise , Physical Therapy SpecialtyABSTRACT
ABSTRACT Background Cardiovascular Disease (CVD) is the leading burden of disease worldwide. Moreover, CVD-related death rates are considered an epidemic in low- and middle-income countries (LMICs). Research shows that cardiac rehabilitation (CR) participation reduces death and improves disability and quality of life. Given the growing epidemic of CVD in LMICs and the insufficient evidence about CR programs in these countries, a Randomized Control Trial (RCT) in Latin America is warranted. Objective To investigate the effects of comprehensive CR on functional capacity and cardiovascular risk factors. Method The design is a single-blinded RCT with three parallel arms: comprehensive CR (exercise + education) versus exercise-based CR versus wait-list control (no CR). The primary outcome will be measured by the Incremental Shuttle Walk Test. Secondary outcomes are risk factors (blood pressure, dyslipidemia, dysglycemia, body mass index and waist circumference); tertiary outcomes are heart health behaviors (exercise, medication adherence, diet, and smoking), knowledge, and depressive symptoms. The CR program is six months in duration. Participants randomized to exercise-based CR will receive 24 weeks of exercise classes. The comprehensive CR group will also receive 24 educational sessions, including a workbook. Every outcome will be assessed at baseline and 6-months later, and mortality will be ascertained at six months and one year. Conclusion This will be the first RCT to establish the effects of CR in Latin America. If positive, results will be used to promote broader implementation of comprehensive CR and patient access in the region and to inform a larger-scale trial powered for mortality.