简版冠心病教育问卷的汉化及信度与效度检验

Reliability and validity of Chinese version of coronary artery disease education questionnaire short version

目的汉化简版冠心病教育问卷(CADE-Q SV),并分析其在上海市冠心病患者中应用的信度与效度。方法采用改良Brislin回译模型对CADE-Q SV进行翻译和跨文化调适,并随机抽取上海交通大学医学院附属新华医院16例冠心病患者进行认知性访谈,最终形成中文版CADE-Q SV。由心血管内科医师、心血管内科护士、康复医学科康复治疗师和营养科营养师各2名组成专家小组,对问卷进行清晰度与内容效度检验。随机抽取上海交通大学医学院附属新华医院263例冠心病患者进行线上调查,其中47例患者间隔1周后重新填写问卷,对收集的2次调查数据进行重测信度与内部一致性信度检验;另216例患者的调查数据用于结构效度和区分效度检验。结果中文版CADE-Q SV指导语清晰度得分为(9.9±0.4)分,20个条目平均清晰度得分为(9.8±0.4)分。20个条目的条目水平内容效度指数(I-CVI)为0.88~1.00,平均量表水平内容效度指数(S-CVI/Ave)为0.98。20个条目的重测信度组内相关系数(ICC)为0.30~0.88,量表总得分重测信度ICC为0.82,内部一致性Cronbach’sα系数为0.77。验证性因子分析结果显示χ~2/df为1.66,近似误差均方根(RMSEA)为0.05,调整拟合优度指数(AGFI)为0.82。不同文化程度的受试者之间问卷得分的差异有统计学意义(P<0.01)。结论中文版CADE-Q SV在上海市冠心病患者中初步检验具有良好的信度与效度,可用于评估该人群冠心病知识掌握水平,进而帮助医务人员在临床心脏康复中制订个体化教育方案、评估教育效果。

Objective To translate the coronary artery disease education questionnaire short version(CADE-Q SV)into Chinese and to assess its reliability and validity in patients with coronary artery disease(CAD)in Shanghai.Methods CADE-Q SV was translated and culture-adapted by improved Brislin backward translation model.Sixteen CAD patients were randomly selected from Xinhua Hospital,Shanghai Jiao Tong University School of Medicine for cognitive interview,and the Chinese version of CADE-Q SV was finally formed.The clarity and content validity of the questionnaire were evaluated by an expert panel composing of 2 cardiovascular physicians,2 cardiovascular nurses,2 physiotherapists and 2 dieticians.A total of 263 CAD patients were randomly selected from Xinhua Hospital,Shanghai Jiao Tong University School of Medicine to finish the online questionnaire.Among them,47 patients finished the questionnaire again after 1-week interval,and the test-retest reliability and internal consistency reliability were tested.Data from the rest 216 patients were extracted for construct validity and discrimination validity analyses.Results The instruction clarity score of the Chinese version of CADE-Q SV was 9.9±0.4,and the average clarity score of the 20 items was 9.8±0.4;the item-content validity index(I-CVI)of the 20 items ranged from 0.88 to 1.00,and the scale-content validity index/average(S-CVI/Ave)was 0.98.The test-retestreliability intraclass correlation coefficient(ICC)for each item ranged from 0.30-0.88,for the total score of the scale was 0.82,and the Cronbach’sαcoefficient of internal consistency was 0.77.The result of confirmatory factor analysis showed thatχ2/df was 1.66,root mean square error of approximation(RMSEA)was 0.05,and adjusted goodness of fit index(AGFI)was 0.82.There were significant differences in the questionnaire scores among the participants with different education levels(P<0.01).Conclusion The Chinese version of CADE-Q SV showed promising reliability and validity in patients with CAD in Shanghai.It can be used to evaluate the level of CAD knowledge in this population,helping medical staff to develop personalized education programs and evaluate the effect of education in clinical cardiac rehabilitation.