ABSTRACT
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.
Subject(s)
Coronary Artery Disease/rehabilitation , Health Knowledge, Attitudes, Practice , Patient Education as Topic , Psychometrics/instrumentation , Surveys and Questionnaires/standards , Cross-Sectional Studies , Factor Analysis, Statistical , Female , Humans , Male , Reproducibility of ResultsABSTRACT
OBJECTIVE: To (1) describe cardiac rehabilitation (CR) participant information needs, (2) investigate whether CR providers are cognizant of patient's information needs and preferred delivery formats, and (3) investigate whether patient information needs change over the course of CR. METHODS: In this cross-sectional study, 306 CR patients and 28 CR providers completed a survey. The survey consisted of the Information Needs in CR (INCR) questionnaire, and items about preferred education delivery formats. RESULTS: Low-income CR participants had significantly greater information needs than high-income participants. CR providers were cognizant of patient information needs, except patients did desire more information on diagnosis and treatment than providers perceived (p<0.01). Books, lectures and discussion were identified as the preferred delivery formats by both patients and providers. There were some significant differences in patient information needs over the course of the program, particularly in relation to concerns and risk factors. CONCLUSION: CR patients desire information in many areas, particularly regarding emergency/safety and diagnosis/treatment. CR providers were highly cognizant of patient information needs; however, these do change over time. PRACTICE IMPLICATIONS: These findings could inform evaluation and improvement of CR education programming, to ensure programs are meeting patient information needs across all stages of recovery.
Subject(s)
Health Knowledge, Attitudes, Practice , Health Personnel , Heart Diseases/rehabilitation , Needs Assessment , Patient Education as Topic/methods , Aged , Aged, 80 and over , Cross-Sectional Studies , Female , Humans , Male , Middle Aged , Socioeconomic Factors , Surveys and QuestionnairesABSTRACT
OBJECTIVE: To develop and psychometrically validate a tool to assess information needs in cardiac rehabilitation (CR) patients. METHODS: After a literature search, 60 information items divided into 11 areas of needs were identified. To establish content validity, they were reviewed by an expert panel (N=10). Refined items were pilot-tested in 34 patients on a 5-point Likert-scale from 1 "really not helpful" to 5 "very important". A final version was generated and psychometrically tested in 203 CR patients. Test-retest reliability was assessed via the intraclass correlation coefficient (ICC), the internal consistency using Cronbach's alpha, and criterion validity was assessed with regard to patient's education and duration in CR. RESULTS: Five items were excluded after ICC analysis as well as one area of needs. All 10 areas were considered internally consistent (Cronbach's alpha>0.7). Criterion validity was supported by significant differences in mean scores by educational level (p<0.05) and duration in CR (p<0.001). The mean total score was 4.08 ± 0.53. Patients rated safety as their greatest information need. CONCLUSION: The INCR Tool was demonstrated to have good reliability and validity. PRACTICE IMPLICATIONS: This is an appropriate tool for application in clinical and research settings, assessing patients' needs during CR and as part of education programming.
