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 < 0.001) and income (p < 0.001). Median total score was 53 (14) points corresponding to 65.4% of the total possible score. Conclusion: The Portuguese version of the CADE-Q II showed sufficient reliability, consistency and validity, supporting its use in future studies.

摘要 背景：冠状动脉疾病教育问卷（Coronary Artery Disease Education Questionnaire, CADE-Q）是一款用于评估患者对冠状动脉疾病（coronary artery disease, CAD）认知水平的工具，最初于巴西开发并完成心理测量学验证。后续该问卷被翻译、跨文化调适并验证为英文版本。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相结合，例如此前版本未纳入的心理因素，而此类内容已在后续的调适版本中新增。据此，研究人员开发了英文版本的第二代CADE-Q，即CADE-Q II。
目的：将CADE-Q II翻译为巴西葡萄牙语，并完成跨文化调适与心理测量学验证。
方法：经心脏康复领域专家委员会翻译与审核后，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；以患者的教育水平与家庭收入为效标，评估效标效度。所有检验的显著性水平均设定为5%。
结果：经组内相关系数分析后，剔除4个条目。问卷整体内部一致性良好（α＞0.7）。问卷平均总分与受教育程度（p＜0.001）、家庭收入（p＜0.001）均存在显著关联。问卷总分中位数为53（14）分，对应满分的65.4%。
结论：CADE-Q II巴西葡萄牙语版本具备充足的信度、一致性与效度，可支持其在后续研究中的应用。