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An Evaluation of Psychometric Properties of Needs Assessment Instruments in Patients with Coronary Artery Disease Undergoing Cardiac Rehabilitation Programs: A Systematic Review

Kourosh Zarea  -  Nursing Department, Nursing Care Research Centre in Chronic Disease, Ahvaz Jundishapur University of Medical Sciences, Iran, Islamic Republic of
Eesa Mohammadi  -  Department of Nursing, Faculty of Medical Sciences, Tarbiat Modares University, Iran, Islamic Republic of
Johanne Alteren  -  Faculty of Health Sciences and Social Care, Molde University College, Norway
*Neda Sayadi  -  Nursing Department, Nursing Care Research Centre in Chronic Disease, Ahvaz Jundishapur University of Medical Sciences, Iran, Islamic Republic of
Open Access Copyright (c) 2022 Nurse Media Journal of Nursing
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Abstract

Background: Coronary Artery Disease is the foremost reason of illnesses and death in the world. Assessment of the needs is a priority in these patients. However, there is a paucity of tools for the evaluation of needs, with the controversy surrounding their validity.

Purpose: This review aimed to evaluate the psychometric properties of tools used to assess needs of patients with CAD undergoing cardiac rehabilitation (CR) plans.

Methods: An online literature search combined with manual search was carried out on 11 databases to identify relevant articles. The terms used in the search were: cardiac rehabilitation AND coronary artery disease, cardiac rehabilitation AND acute coronary syndrome, and questionnaires OR need assessment OR tool OR scale. Articles from 1989 to 2021 were selected using some inclusion criteria and no validation studies were excluded. The quality of the questionnaires was evaluated by researchers using consensus-based standards for the selection of health status measurement instruments (COSMIN) list. Data analysis had been done by calculating overall methodological quality scores per study on a measurement property using COSMIN checklist. A methodological quality score per box was obtained by taking the lowest rating of any item in a box (‘worse score counts’).

Results: Of 653 articles, 15 papers were involved in the study. Six studies reported cross-cultural validity, nine studies for criterion validity, and none reported measurement error, hypothesis testing, and responsiveness. There is no vigorous and valid single scale for the measurement of needs in CAD patients Overall, the CADEQ questionnaire was good and a patient self-assessment tool for cardiac rehabilitation was poor based on psychometric properties.

Conclusions: The findings of this study disclosed that even though it has been more than 32 years, from 1989 to 2021, of the development in need assessment instruments; each instrument has as a minimum of one “poor” psychometric property according to the COSMIN checklist.  So, it is recommended for the next studies to design and develop instruments with better psychometric validities for clinical environment.

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Keywords: Cardiovascular rehabilitation; coronary artery disease; COSMIN checklist; instrument needs assessment

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  1. Ahyana, A., Kritpracha, C., Thaniwattananon, P. (2013). Cardiac rehabilitation enhancing programs in patients with myocardial infarction: A literature review. Nurse Media Journal of Nursing, 3(1), 541-556. https://doi.org/10.14710/nmjn.v3i1.4468
  2. Anderson, L., Thompson, D. R., Oldridge, N., Zwisler, A. D., Rees, K., Martin, N., & Taylor, R. S. (2016). Exercise-based cardiac rehabilitation for coronary heart disease. The Cochrane Database of Systematic Reviews, 2016(1). https://doi.org/10.1002/14651858
  3. Balady, G. J., Williams, M. A., Ades, P. A., Bittner, V., Comoss, P., Foody, J. M., Franklin, B., Sanderson, B., Southard, D., American Heart Association Exercise, Cardiac Rehabilitation, and Prevention Committee, the Council on Clinical Cardiology, American Heart Association Council on Cardiovascular Nursing, American Heart Association Council on Epidemiology and Prevention, American Heart Association Council on Nutrition, Physical Activity, and Metabolism, & American Association of Cardiovascular and Pulmonary Rehabilitation (2007). Core components of cardiac rehabilitation/secondary prevention programs: 2007 update: A scientific statement from the American Heart Association Exercise, Cardiac Rehabilitation, and Prevention Committee, the Council on Clinical Cardiology; the Councils on Cardiovascular Nursing, Epidemiology and Prevention, and Nutrition, Physical Activity, and Metabolism; and the American Association of Cardiovascular and Pulmonary Rehabilitation. Circulation, 115(20), 2675–2682. https://doi.org/10.1161/CIRCULATIONAHA.106.180945
  4. Chen, Z., Geng, J., Wang, M, Hu, L., De Melo Ghisi, G. L., & Yu, H. (2018). The Chinese version of the coronary artery disease education questionnaire-II (CADEQ-II): Translation and validation. Patient Preference and Adherence, 12, 1587-1596. https://doi.org/10.2147/PPA.S176639
  5. De Bacquer, D., Dallongeville, J., Kotseva, K., Cooney, M. T., Pajak, A., Deckers, J. W., Mayer, O., Vanuzzo, D., Lehto, S., Fras, Z., Ostor, E., Ambrosio, G. B., De Backer, G., Wood, D., Keil, U., Sans, S., Graham, I., & Pyorala, K. (2013). Residual risk of cardiovascular mortality in patients with coronary heart disease: The EUROASPIRE risk categories. International Journal Cardiology, 168(2), 910-914. https://doi.org/10.1016/j.ijcard.2012.10.051
  6. De Melo Ghisi, G. L., Oh, P., Thomas, S., & Benetti, M. (2013). Development and validation of an English version of the Coronary Artery Disease Education Questionnaire (CADE-Q). European Journal of Preventive Cardiology, 20(2), 291–300. https://doi.org/10.1177/2047487312437061
  7. De Melo Ghisi, G., Sandison, N., & Oh, P. (2016). Development, pilot testing and psychometric validation of a short version of the coronary artery disease education questionnaire: The CADE-Q SV. Patient Education and Counseling, 99(3), 443–447. https://doi.org/10.1016/j.pec.2015.11.002
  8. De Melo Ghisi, G., & Oh, P. (2021). Validation of the French-Canadian version of a short questionnaire to assess knowledge in cardiac patients (CADE-Q SV). The Canadian Journal of Nursing Research, 54(1), 51–58. https://doi.org/10.1177/0844562120986001
  9. De Melo Ghisi, G. L., Grace, S. L., Thomas, S., Evans, M. F., & Oh, P. (2013). Development and psychometric validation of a scale to assess information needs in cardiac rehabilitation: The INCR Tool. Patient Education and Counseling, 91(3), 337–343. https://doi.org/10.1016/j.pec.2013.01.007
  10. De Melo Ghisi, G. L., Durieux, A., Manfroi, W. C., Herdy, A. H., Carvalho, T. d., Andrade, A., & Benetti, M. (2010). Construction and validation of the CADE-Q for patient education in cardiac rehabilitation programs. Arquivos Brasileiros de Cardiologia, 94(6), 813–822. https://doi.org/10.1590/s0066-782x2010005000045
  11. De Melo Ghisi, G., Chaves, G., Loures, J. B., Bonfim, G. M., & Britto, R. (2018). Validation of the Brazilian-Portuguese version of a short questionnaire to assess knowledge in cardiovascular disease patients (CADE-Q SV). Arquivos Brasileiros de Cardiologia, 111(6), 841–849. https://doi.org/10.5935/abc.20180169
  12. De Melo Ghisi, G. L., Dos Santos, R. Z., Bonin, C. B., Roussenq, S., Grace, S. L., Oh, P., & Benetti, M. (2014). Validation of a Portuguese version of the Information Needs in Cardiac Rehabilitation (INCR) scale in Brazil. Heart & Lung: The Journal of Critical Care, 43(3), 192–197. https://doi.org/10.1016/j.hrtlng.2014.01.009
  13. Dibben, G., Faulkner, J., Oldridge, N., Rees, K., Thompson, D.R., Zwisler, A. D., & Taylor, R.S. (2021). Exercise-based cardiac rehabilitation for coronary heart disease. Cochrane Database of Systematic Review, 6(11), CD001800. https://doi.org/ 10.1002/14651858.CD001800.pub4
  14. Fawcett, J., & Desanto-Madeya, S. (2012). Contemporary nursing knowledge: Analysis and evaluation of nursing models and theories. FA Davis
  15. Fayyazi, S., Sayadi, N., & Gheybizadeh, M. (2012). Comparison of quality of life before and after open heart surgery. Zahedan Journal of Research in Medical Sciences, 14(9), 98-100
  16. Ghisi, G. L., Grace, S. L., Thomas, S., Evans, M. F., & Oh, P. (2015). Development and psychometric validation of the second version of the Coronary Artery Disease Education Questionnaire (CADE-Q II). Patient Education and Counseling, 98(3), 378–383. https://doi.org/10.1016/j.pec.2014.11.019
  17. Marofi, Z., Bandari, R., Heravi-Karimooi, M., Rejeh, N., & Montazeri, A. (2020). Cultural adoption, and validation of the Persian version of the coronary artery disease education questionnaire (CADE-Q): A second-order confirmatory factor analysis. BMC Cardiovascular Disorder, 20, 345. https://doi.org/10.1186/s12872-020-01628-5
  18. Menezes Costa, L., Maher, C. G., McAuley, J. H., & Costa, L. O. (2009). Systematic review of cross-cultural adaptations of McGill pain questionnaire reveals a paucity of clinimetric testing. Journal of Clinical Epidemiology, 62(9), 934–943. https://doi.org/10.1016/j.jclinepi.2009.03.019
  19. Mohammadi, E., Zarea, K., Alteren, J., & Sayadi, N. (2019). Care needs in the Phase I of cardiac rehabilitation: A hybrid concept analysis. Nursing and Midwifery Studies, 8(1), 48-54. http://doi.org/10.4103/nms.nms_76_17
  20. Mokkink, L. B., Terwee, C. B., Knol, D. L., Stratford, P. W., Alonso, J., Patrick, D. L., Bouter, L. M., & de Vet, H. C. (2010). The COSMIN checklist for evaluating the methodological quality of studies on measurement properties: A clarification of its content. BMC Medical Research Methodology, 18(10), 22. https://doi.org/10.1186/1471-2288-10-22
  21. Mokkink, L. B., Terwee, C. B., Patrick, D. L., Alonso, J., Stratford, P. W., Knol, D. L., Bouter, L. M., & de Vet, H. C. (2010). The COSMIN study reached international consensus on taxonomy, terminology, and definitions of measurement properties for health-related patient-reported outcomes. Journal of Clinical Epidemiology, 63(7), 737–745. https://doi.org/10.1016/j.jclinepi.2010.02.006
  22. Naghdi, S., Ansari, N N., Raji, P., Shamili, A., Amini, M., & Hasson, S. (2016). Cross-cultural validation of the Persian version of the functional independence measure for patients with stroke. Disability and Rehabilitation, 38(3), 289–298. https://doi.org/10.3109/09638288.2015.1036173
  23. Perk, J., De Backer, G., Gohlke, H., Graham, I., Reiner, Z., Verschuren, M., Albus, C., Benlian, P., Boysen, G., Cifkova, R., Deaton, C., Ebrahim, S., Fisher, M., Germano, G., Hobbs, R., Hoes, A., Karadeniz, S., Mezzani, A., Prescott, E., … Zannad, F.(2012). European guidelines on cardiovascular disease prevention in clinical practice (version 2012). The fifth joint task force of the European society of cardiology and other societies on cardiovascular disease prevention in clinical practice (constituted by representatives of nine societies and by invited experts). European Heart Journal, 33(13), 1635-1701. https://doi.org/10.1093/eurheartj/ehs092
  24. Phelan, C., Finnell, M. D., & Mottla, K. A. (1989). A patient self-assessment tool for cardiac rehabilitation. Rehabilitation Nursing, 14(2), 81–87. https://doi.org/10.1002/j.2048-7940.1989.tb01425.x
  25. Santos, R., Ghisi, G., Bonin, C., Chaves, G., Haase, C. M., Britto, R. R., & Benetti, M. (2019). Validation of the Brazilian version of CADE-Q II to assess knowledge of coronary artery disease patients. Arquivos Brasileiros de Cardiologia, 112(1), 78–84. https://doi.org/10.5935/abc.20180244
  26. Sayadi, N., Alteren, J., Mohammadi, E., & Zarea, K. (2021). Development and psychometric properties evaluation of a care needs questionnaire in phase 1 cardiac rehabilitation for patients with coronary artery disease: CNCR-Q. Journal of Caring Cciences, 10(1), 29–36. https://doi.org/10.34172/jcs.2021.006
  27. Smith, J., Garton-Smith, J., Briffa, T., & Maiorana, A. (2015). The development of a new cardiac rehabilitation needs assessment tool (CRNAT) for individualised secondary prevention. Heart, Lung & Circulation, 24(5), 458–464. https://doi.org/10.1016/j.hlc.2015.01.001
  28. Terwee, C. B., Bot, S. D., de Boer, M. R., van der Windt, D. A., Knol, D. L., Dekker, J., Bouter, L. M., & de Vet, H. C. (2007). Quality criteria were proposed for measurement properties of health status questionnaires. Journal of Clininical Epidemiology, 60(1), 34-42. https://doi.org/10.1016/j.jclinepi.2006.03.012
  29. Terwee, C. B., Mokkink, L. B., Knol, D. L., Ostelo, R. W., Bouter, L. M., & de Vet, H. C. (2012). Rating the methodological quality in systematic reviews of studies on measurement properties: A scoring system for the COSMIN checklist. Quality of Life Research: An International Journal of Quality of Life Aspects of Treatment, Care and Rehabilitation, 21(4), 651–657. https://doi.org/10.1007/s11136-011-9960-1
  30. Van Engen-Verheul, M. M., Kemps, H. M., de Keizer, N. F., Hellemans, I. M., Goud, R., Kraaijenhagen, RA., & Peek, N. (2012). Revision of the Dutch clinical algorithm for assessing patient needs in cardiac rehabilitation based on identified implementation problems. European Journal of Preventive Cardiology, 19(3), 504-514
  31. Vasan, R.S., Benjamin, E. J. (2016). The future of cardiovascular epidemiology. Circulation, 133(25), 2626-2633. https://doi.org/10.1161/CIRCULATIONAHA.116.023528

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