Validation of a Scale to Assess Patients’ Comprehension of Frequently Used Cardiology Terminology: The Cardiac TERM Scale in Brazilian Portuguese

Purpose The aim of this study was to psychometrically validate the translation of a questionnaire on patient understanding of cardiology terminology (TERM) to Brazilian Portuguese. Design After piloting the translation and cross-cultural adaptation, the 16-item TERM questionnaire was psychometrically tested. Methods Internal and test–retest reliability, as well as validity, were assessed in 322 cardiac patients. Findings Internal (&agr; = .88) and test–retest reliability (all weighted Kappa > 0.63) exceeded the minimum recommended standards. Criterion validity was supported by significant differences in mean scores by socioeconomic indicators (p < .01). Discriminant validity was supported in that cardiac rehabilitation participants had significantly higher TERM scores (p < .001). Participants did not correctly define any of the terms, and a floor effect was identified in all terms. Conclusions The Cardiac TERM Scale was demonstrated to have good reliability and validity. Clinical Relevance The scale can be used by healthcare professionals, such as nurses. Results can be used to inform patient education, which could in turn impact patient adherence to medical advice and hence outcomes.

[1]  A. Clark,et al.  Patient education in the management of coronary heart disease. , 2017, The Cochrane database of systematic reviews.

[2]  S. Grace,et al.  Effects of comprehensive cardiac rehabilitation on functional capacity and cardiovascular risk factors in Brazilians assisted by public health care: protocol for a randomized controlled trial , 2016, Brazilian journal of physical therapy.

[3]  S. Matsuoka,et al.  Health literacy is independently associated with self-care behavior in patients with heart failure. , 2016, Patient education and counseling.

[4]  L. Merriman,et al.  A randomised crossover trial of minimising medical terminology in secondary care correspondence in patients with chronic health conditions: impact on understanding and patient reported outcomes , 2016, Internal medicine journal.

[5]  Antoinette M. Fage‐Butler,et al.  Medical terminology in online patient–patient communication: evidence of high health literacy? , 2015, Health expectations : an international journal of public participation in health care and health policy.

[6]  S. Grace,et al.  Behavior determinants among cardiac rehabilitation patients receiving educational interventions: an application of the health action process approach. , 2015, Patient education and counseling.

[7]  S. Grace,et al.  Development and psychometric validation of the second version of the Coronary Artery Disease Education Questionnaire (CADE-Q II). , 2015, Patient education and counseling.

[8]  S. Grace,et al.  A systematic review of patient education in cardiac patients: do they increase knowledge and promote health behavior change? , 2014, Patient education and counseling.

[9]  P. Oh,et al.  Development and validation of an English version of the Coronary Artery Disease Education Questionnaire (CADE‐Q) , 2013, European journal of preventive cardiology.

[10]  J. Buckley,et al.  International Charter on Cardiovascular Prevention and Rehabilitation: a call for action. , 2013, Journal of cardiopulmonary rehabilitation and prevention.

[11]  D. Mozaffarian,et al.  Heart disease and stroke statistics--2012 update: a report from the American Heart Association. , 2012, Circulation.

[12]  F. Blackstock,et al.  Psychoeducational Rehabilitation for Health Behavior Change in Coronary Artery Disease: A SYSTEMATIC REVIEW OF CONTROLLED TRIALS , 2011, Journal of Cardiopulmonary Rehabilitation and Prevention.

[13]  Stacey L. Sheridan,et al.  Low Health Literacy and Health Outcomes: An Updated Systematic Review , 2011, Annals of Internal Medicine.

[14]  Robert C Hornik,et al.  Use of mass media campaigns to change health behaviour , 2010, The Lancet.

[15]  C. Terwee,et al.  The COSMIN checklist for assessing the methodological quality of studies on measurement properties of health status measurement instruments: an international Delphi study , 2010, Quality of Life Research.

[16]  D. Stewart,et al.  Degree and correlates of cardiac knowledge and awareness among cardiac inpatients. , 2009, Patient education and counseling.

[17]  Sunil Kripalani,et al.  Clinical research in low-literacy populations: using teach-back to assess comprehension of informed consent and privacy information. , 2008, IRB.

[18]  Xianggui Qu,et al.  Multivariate Data Analysis , 2007, Technometrics.

[19]  B. Fridlund,et al.  Knowing Your Risk Factors for Coronary Heart Disease Improves Adherence to Advice on Lifestyle Changes and Medication , 2006, The Journal of cardiovascular nursing.

[20]  Alastair Gray,et al.  Economic burden of cardiovascular diseases in the enlarged European Union. , 2006, European heart journal.

[21]  John D. Piette,et al.  Physician notification of their diabetes patients’ limited health literacy: A randomized, controlled trial , 2005, Journal of General Internal Medicine.

[22]  N. Suskin,et al.  The Ontario Cardiac Rehabilitation Pilot Project. , 2004, The Canadian journal of cardiology.

[23]  Mark V. Williams,et al.  Health literacy and knowledge of chronic disease. , 2003, Patient education and counseling.

[24]  Terry Davis,et al.  The role of health literacy in patient-physician communication. , 2002, Family medicine.

[25]  S. Yusuf,et al.  Emerging epidemic of cardiovascular disease in developing countries. , 1999, Circulation.

[26]  S. Yusuf,et al.  Emerging Epidemic of Cardiovascular Disease in Developing Countries , 1998 .

[27]  D W Baker,et al.  The relationship of patient reading ability to self-reported health and use of health services. , 1997, American journal of public health.

[28]  C. Bombardier,et al.  Cross-cultural adaptation of health-related quality of life measures: literature review and proposed guidelines. , 1993, Journal of clinical epidemiology.

[29]  Daniel L. McGee,et al.  Health Status Of Illiterate Adults: Relation Between Literacy And Health Status Among Persons With Low Literacy Skills , 1992, The Journal of the American Board of Family Medicine.

[30]  P. Mullen,et al.  A meta-analysis of controlled trials of cardiac patient education. , 1992, Patient education and counseling.

[31]  J. R. Landis,et al.  The measurement of observer agreement for categorical data. , 1977, Biometrics.

[32]  Suzanne Graham,et al.  Do patients understand? , 2008, The Permanente journal.

[33]  D. Schillinger,et al.  Physician notification of their diabetes patients’ limited health literacy: A randomized, controlled trial , 2007, Journal of General Internal Medicine.

[34]  C. Terwee,et al.  Quality criteria were proposed for measurement properties of health status questionnaires. , 2007, Journal of clinical epidemiology.

[35]  T. Thom,et al.  American Heart Association Statistics Committee and Stroke Statistics Subcommittee : Heart disease and stroke statistical-2006 update : A report from the American Heart Association Statistics Committee and Stroke statistics subcommittee , 2006 .

[36]  David A. Kindig,et al.  Health literacy : a prescription to end confusion , 2004 .

[37]  L. Weinehall.  The emerging epidemic of cardiovascular disease. , 2003, Scandinavian journal of public health. Supplement.