Translation, Cultural Adaptation, and Validation of a Korean Version of the Information Needs in Cardiac Rehabilitation Scale

Objective@#To translate and culturally adapt the Information Needs in Cardiac Rehabilitation (INCR) questionnaire into Korean and perform psychometric validation. @*Methods@#The original English version of the INCR, in which patients are asked to rate the importance of 55 topics, was translated into Korean (INCR-K) and culturally adapted. The INCR-K was tested on 101 cardiac rehabilitation (CR) participants at Kangwon National University Hospital and Seoul National University Bundang Hospital in Korea. Structural validity was assessed using principal component analysis, and Cronbach’s alpha of the areas was computed. Criterion validity was assessed by comparing information needs according to CR duration and knowledge sufficiency according to receipt of education. Half of the participants were randomly selected for 1 month of re-testing to assess their responsiveness. @*Results@#Following cognitive debriefing, the number of items was reduced to 41 and ratings were added to assess participants’ sufficient knowledge of each item. The INCR-K structure comprised eight areas, each with sufficient internal consistency (Cronbach’s alpha>0.7). Criterion validity was supported by significant differences in mean INCR-K scores based on CR duration and knowledge sufficiency ratings according to receipt of education (p<0.05). Information needs and knowledge sufficiency ratings increased after 1 month of CR, thus supporting responsiveness (p<0.05). @*Conclusion@#The INCR-K demonstrated adequate face, content, cross-cultural, structural, and criterion validities, internal consistency, and responsiveness. Information needs changed with CR, such that multiple assessments of information needs may be warranted as rehabilitation progresses to facilitate patient-centered education.

Older Adults' Attitudes Regarding COVID-19 and Associated Infection Control Measures in Shanghai, and Impact on Well-Being

This cross-sectional study investigated health management, well-being, and pandemic-related perspectives in Shanghainese adults [≥]50 years during early and strict COVID-19 control measures. A self-report survey was administered via Wenjuanxing between March-April/2020. Items from the Somatic Symptom Scale, Patient Health Questionnaire-9 and Generalized Anxiety Disorder-7 were administered, as well as pandemic-specific questions. 1181 primarily married, retired females participated; Many had hypertension (n=521, 44.1%), coronary artery disease (CAD; n=201, 17.8%) and diabetes (n=171, 14.5%). While most respondents (n=868; 73.5%) were strictly following control measures (including limiting visits with children; n=390, 33.0%) and perceived they could tolerate that beyond 6 months (n=555;47.0%), they were optimistic about the future if control measures were continued (n=969;82.0%), and perceived impact would be temporary (n=646;64.7%). 52 of those with any condition (8.2%) and 19 of those without a condition (3.5%) reported the pandemic was impacting their health. Somatic symptoms were high (29.4{+/-}7.1/36), with Sleep & Cognitive symptoms highest. 24.4% and 18.9% of respondents had elevated depressive and anxious symptoms, respectively; greater distress was associated with lower income (p=0.018), having hypertension (p=0.001) and CAD (p<0.001), more negative perceptions of global COVID-19 control (p=0.004), COVID-19 spread (p[≤]0.001), impact on life and health (p<0.001), compliance with control measures (p<0.001), and shorter time control measures could be tolerated (p<0.001) in adjusted analyses. In the initial COVID-19 outbreak, most older adults were optimistic and resilient with regard to the epidemic and control measures. However, the distress of older adults is not trivial, particularly in those with health issues.

On the frontlines in Shanghai: Stress, burnout and perceived benefit among COVID-19 testers and other personnel during the Omicron wave lockdown

BackgroundCOVID-19 control measure stringency including testing has been among the highest globally in China. Psychosocial impact on pandemic workers in Shanghai, and their pandemic-related attitudes were investigated. MethodsParticipants in this cross-sectional study were healthcare providers (HCP) and other support workers. A Mandarin self-report survey was administered via Wenjuanxing between April-June 2022 during the omicron-wave lockdown. The Perceived Stress Scale (PSS) and Maslach Burnout Inventory were administered, as well as pandemic-specific questions. Results887 workers participated, of which 691 (77.9%) were HCPs. They were working a mean of 6.25{+/-}1.24 days/week for 9.77{+/-}4.28 hours/day. Most participants were burnt-out, with 143(16.1%) moderately and 98(11.0%) seriously. Total PSS was 26.85{+/-}9.92/56, with 353(39.8%) participants having elevated stress. Workers perceived their families primarily as fully supportive (n=610, 68.8%), or also extremely concerned (n=203, 22.9%). Most wanted counselling and stress relief, but half(n=430) reported no time for it; indeed, 2/3rds wanted a few days off to rest (n=601).Many workers perceived benefits: that they fostered more cohesive relationships (n=581, 65.5%), they will be more resilient (n=693, 78.1%), and were honored to serve (n=747, 84.2%).Negative impacts were greater in HCPs, those with economic insecurity, and that did not perceive benefit (all p<.05).In adjusted analyses, those perceiving benefits showed significantly less burnout (OR=0.573, 95% CI=0.411 - 0.799), among other correlates. ConclusionsPandemic work, including among non-HCP, is stressful, but some can derive benefits.

Impacts of the COVID-19 Pandemic on Cardiac Rehabilitation Delivery around the World

BackgroundTo investigate impacts of COVID-19 on CR delivery around the globe, including effects on providers and patients. MethodsIn this cross-sectional study, a piloted survey was administered to CR programs globally via REDCap from April-June/2020. The 50 members of the ICCPR and personal contacts facilitated program identification. ResultsOverall, 1062(18.3% program response rate) responses were received from 70/111(63.1% country response rate) countries in the world with existent CR programs. Of these, 367(49.1%) programs reported they had stopped CR delivery, and 203(27.1%) stopped temporarily (mean=8.3{+/-}2.8weeks). Alternative models were delivered in 322(39.7%) programs, primarily through low-tech modes (n=226,19.3%). 353(30.2%) respondents were re-deployed, and 276 (37.3%) felt the need to work due to fear of losing their job, despite the perceived risk of contracting COVID-19 (mean=30.0%{+/-}27.4/100). 266(22.5%) reported anxiety, 241(20.4%) were concerned about exposing their family, 113(9.7%) reported increased workload to transition to remote delivery, and 105(9.0%) were juggling caregiving responsibilities during business hours. Patients were often contacting staff regarding grocery shopping for heart-healthy foods (n=333,28.4%), how to use technology to interact with the program (n=329,27.9%), having to stop their exercise because they have no place to exercise (n=303,25.7%), and their risk of death from COVID-19 due to pre-existing cardiovascular disease (n=249,21.2%). Respondents perceived staff (n=488,41.3%) and patient (n=453,38.6%) personal protective equipment, as well as COVID-19 screening (n=414,35.2%) and testing (n=411,35.0%) as paramount to in-person service resumption. ConclusionApproximately 4400 programs ceased service delivery. Those that remain open are implementing new technologies to ensure their patients receive CR safely, despite the challenges. Highlights- COVID-19 has impacted cardiac rehabilitation (CR) delivery around the globe. - In this cross-sectional study, a survey was completed by 1062 (18.3%) CR programs from 70 (63.1%) countries. - The pandemic has resulted in cessation of [~]75% of CR programs, with others ceasing initiation of new patients, reducing components delivered, and/or changing of mode delivery with little opportunity for planning and training. - There is also significant psychosocial and economic impact on CR providers. - Alternative CR model (e.g. home-based, virtual) reimbursement advocacy is needed, to ensure safe, accessible secondary prevention delivery.

Correction: Translation, Cross-cultural Adaptation and Psychometric Validation of the Korean-Language Cardiac Rehabilitation Barriers Scale (CRBS-K)

The second affiliation of the authors, Sora Baek and Hee-won Park, was not added in the article.

Translation, Cross-cultural Adaptation and Psychometric Validation of the Korean-Language Cardiac Rehabilitation Barriers Scale (CRBS-K)

OBJECTIVE: To perform a translation and cross-cultural adaptation of the Cardiac Rehabilitation Barriers Scale (CRBS) for use in Korea, followed by psychometric validation. The CRBS was developed to assess patients' perception of the degree to which patient, provider and health system-level barriers affect their cardiac rehabilitation (CR) participation. METHODS: The CRBS consists of 21 items (barriers to adherence) rated on a 5-point Likert scale. The first phase was to translate and cross-culturally adapt the CRBS to the Korean language. After back-translation, both versions were reviewed by a committee. The face validity was assessed in a sample of Korean patients (n=53) with history of acute myocardial infarction that did not participate in CR through semi-structured interviews. The second phase was to assess the construct and criterion validity of the Korean translation as well as internal reliability, through administration of the translated version in 104 patients, principle component analysis with varimax rotation and cross-referencing against CR use, respectively. RESULTS: The length, readability, and clarity of the questionnaire were rated well, demonstrating face validity. Analysis revealed a six-factor solution, demonstrating construct validity. Cronbach's alpha was greater than 0.65. Barriers rated highest included not knowing about CR and not being contacted by a program. The mean CRBS score was significantly higher among non-attendees (2.71±0.26) than CR attendees (2.51±0.18) (p<0.01). CONCLUSION: The Korean version of CRBS has demonstrated face, content and criterion validity, suggesting it may be useful for assessing barriers to CR utilization in Korea.