Validity and reliability of a questionnaire on
					knowledge of cardiovascular risk factors for use in Brazil

Saffi, Marco Aurélio Lumertz; Macedo Junior, Luis Joeci Jacques de; Trojahn, Melina Maria; Polanczyk, Carisi Anne; Rabelo-Silva, Eneida Rejane

doi:10.1590/S0080-623420130000500011

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Original Article • Rev. esc. enferm. USP 47 (05) • Oct 2013 • https://doi.org/10.1590/S0080-623420130000500011 copy

Validity and reliability of a questionnaire on knowledge of cardiovascular risk factors for use in Brazil^* * Taken from the dissertation “Validity and reliability of a questionnaire on knowledge of cardiovascular risk factors in patients with coronary artery disease“, Federal University of Rio Grande do Sul, 2010.

Validade e fidedignidade de um questionário de conhecimento de fatores de risco cardiovascular para uso no Brasil

Validez y confiabilidad del cuestionario de conocimiento de factores de riesgo cardiovascular para su uso en el Brasil

Authorship SCIMAGO INSTITUTIONS RANKINGS

Using a sample of patients with coronary artery disease, this methodological study aimed to conduct a cross-cultural adaptation and validation of a questionnaire on knowledge of cardiovascular risk factors (Q-FARCS), lifestyle changes, and treatment adherence for use in Brazil. The questionnaire has three scales: general knowledge of risk factors (RFs); specific knowledge of these RFs; and lifestyle changes achieved. Cross-cultural adaptation included translation, synthesis, back-translation, expert committee review, and pretesting. Face and content validity, reliability, and construct validity were measured. Cronbach’s alpha for the total sample (n = 240) was 0.75. Assessment of psychometric properties revealed adequate face and content validity, and the construct revealed seven components. It was concluded that the Brazilian version of Q-FARCS had adequate reliability and validity for the assessment of knowledge of cardiovascular RFs.

Coronary disease; Risk factors; Health education; Questionnaires; Validation studies

Universidade de São Paulo, Escola de Enfermagem Av. Dr. Enéas de Carvalho Aguiar, 419 , 05403-000 São Paulo - SP/ Brasil, Tel./Fax: (55 11) 3061-7553, - São Paulo - SP - Brazil
E-mail: reeusp@usp.br

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[1] Correspondence:Marco Aurélio Lumertz Saffi, Escola de Enfermagem da UFRGS, Rua São Manoel, 963 – Santa Cecília, CEP 90620-110 - Porto Alegre, RS, Brasil

Characteristicss	n=240
Age (years) *	65 ± 10
Gender (male)†	135 (56)
Years of formal education‡	5 (4–8)
Comorbidities and risk factors†
Hypertension	240 (100)
Dyslipidemia	230 (96)
Acute myocardial infarction	135 (56)
Smoking (former)	122 (51)
Diabetes mellitus	118 (49)
Percutaneous coronary intervention	117 (48)
Coronary artery bypass surgery	84 (35)
Family history	39 (16)
Smoking (current)	31 (13)
Obesity	30 (12)
Stroke	17 (7)

Patients (n=240)	Items	Valid Instruments	Cronbach’s alpha
Overall internal consistency
240	28	69	0.75
240	25*	153	0.81
240	24†	240	0.78
Score-specific internal consistency
Score 1 (9 items)	09	240	0.71
Score 2 (8 items)	08	240	0.62
Score 2 (7 items)	07‡	240	0.70
Score 3 (8 items)	08	153	0.73
Score 3 (7 items)	07§	240	0.77

Items	Item-total correlation	Cronbach’s alpha if item excluded
Score 1 (overall alpha = 0.71)
2. Do you think obesity influences the progress of coronary heart disease?	0.33	0.70
3. Do you think high lipid levels influence the progress of coronary heart disease?	0.50	0.67
4. Do you think high blood glucose levels/diabetes influence the progress of coronary heart disease?	0.40	0.68
5. Do you think exercise habits influence the progress of coronary heart disease?	0.44	0.67
6. Do you think stress influences the progress of coronary heart disease?	0.33	0.70
7. Do you think smoking habits influence the progress of coronary heart disease?	0.46	0.68
8. Do you think diet influences the progress of coronary heart disease?	0.43	0.68
9. Do you think hereditary influences the progress of coronary heart disease?	0.38	0.69
10. Do you think high blood pressure influences the progress of coronary heart disease?	0.33	0.70
Score 2 (overall alpha = 0.62)
11. Do you think obesity influences or has influenced the progress of your coronary heart disease?	0.50	0.53
12. Do you think high lipid levels influence or have influenced your coronary heart disease?	0.43	0.57
13. Do you think high blood glucose levels/diabetes influence or have influenced your coronary heart disease?	0.43	0.56
14. Do you think exercise habits influence or have influenced your coronary heart disease?	0.46	0.55
15. Do you think stress influences or has influenced your coronary heart disease?	0.10	0.64
16. Do you think smoking habits influence or have influenced your coronary heart disease?	0.03	0.69
17. Do you think diet influences or has influenced your coronary heart disease?	0.41	0.57
18. Do you think high blood pressure influences or has influenced your coronary heart disease?	0.33	0.59

Items	Item-total correlation	Cronbach’s alpha if item excluded
Score 3 (overall alpha = 0.73)
19. Have you lost weight with lifestyle changes after your coronary heart disease and/or after your coronary heart operation?	0.49	0.69
20. Have you reduced your lipid levels with lifestyle changes after your coronary heart disease and/or your coronary heart operation?	0.61	0.67
21. Have you reduced your blood glucose levels/diabetes with lifestyle changes after your coronary heart disease and/or your heart operation?	0.56	0.67
22. Have you increased your exercise habits after your coronary heart disease and/or your coronary heart operation?	0.30	0.73
23. Have you reduced your stress level with lifestyle changes after your coronary heart disease and/or your coronary heart operation?	0.20	0.75
24. Have you changed your smoking habits after your coronary heart disease and/or your heart operation?	0.36	0.71
25. Have you made any dietary changes after your coronary heart disease and/or your heart operation?	0.66	0.66
26. Have you reduced your blood pressure level with lifestyle changes after your coronary heart disease and/or your coronary heart operation?	0.34	0.71

Item	Component
		1	2	3	4	5	6	7
Q 11		0.815	0.082	0.088	0.069	-0.064	0.103	-0.058
Q 13		0.656	0.107	0.021	0.297	-0.146	-0.039	0.080
Q 12		0.632	0.156	0.232	-0.265	0.082	0.081	0.203
Q 17		0.572	0.128	0.020	0.072	0.067	0.029	0.203
Q 14		0.522	0.071	-0.163	0.372	0.142	0.280	0.126
Q 25		0.058	0.806	0.026	0.024	-0.018	0.154	0.111
Q 20		0.144	0.764	0.142	-0.049	-0.074	0.077	0.178
Q 21		0.390	0.565	-0.004	0.192	-0.189	0.122	0.117
Q 22		0.142	0.524	-0.129	0.209	0.117	-0.290	-0.003
Q 19		0.494	0.514	0.124	-0.103	0.107	-0.070	0.004
Q 8		0.146	-0.067	0.711	0.123	-0.011	0.256	0.022
Q 10		0.010	0.106	0.696	0.108	0.125	-0.098	0.327
Q 3		0.063	0.101	0.664	0.208	0.179	0.132	-0.287
Q 7		-0.042	-0.012	0.219	0.668	-0.017	0.295	0.265
Q 9		0.150	0.017	0.144	0.618	0.364	-0.085	-0.021
Q 4		0.195	0.116	0.321	0.596	-0.067	0.094	-0.310
Q 15		0.055	-0.087	0.067	0.076	0.850	-0.009	-0.045
Q 6		-0.079	-0.015	0.127	0.123	0.660	0.336	0.043
Q 23		-0.025	0.466	0.014	-0.088	0.474	0.000	0.004
Q 2		0.091	0.060	0.096	0.020	0.050	0.807	-0.081
Q 5		0.156	0.081	0.159	0.263	0.251	0.541	0.151
Q 26		0.137	0.295	-0.041	0.139	-0.119	0.039	0.676
Q 18		0.393	0.088	0.121	-0.114	0.111	-0.008	0.673