Development and Psychometric Validation of the Second Version of the Coronary Artery Disease Education Questionnaire (CADE-Q II)

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<.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.