Patients knowledge about coronary artery disease: comparison between cardiac rehabilitation programs in Brazil and Canada / Conhecimento de pacientes sobre a doença arterial coronariana : comparação entre programas de reabilitação cardíaca no Brasil e Canadá

AUTOR(ES)
DATA DE PUBLICAÇÃO

2009

RESUMO

This is a descriptive and exploratory research, with a quantitative analysis that aimed to compare knowledge about coronary artery disease in patients admitted in cardiac rehabilitation programs in Brazil and Canada, using the implementation of CADE-Q Questionnaire (Coronary Artery Disease Educational Questionnaire). The sample consisted of 300 coronary patients participating in a cardiac rehabilitation program in Brazil, mean age 63.72+10 years (min.= 36, max.= 86), 227 men and 300 coronary patients participating in a cardiac rehabilitation program in Canada, mean age 64.02+9.87 years (min= 40; max.=88), 236 men. All patients were selected by a random way and characterized in terms of age, gender, risk factors, comorbidities or associated diseases, duration in cardiac rehabilitation program, surgical procedures and socioeconomic status (occupation, family income and educational level) by a questionnaire to characterize the individuals. Knowledge was assessed using the CADE-Q, which was translated, culturally adapted and validated for the English Canadian, by applying in 200 Canadians coronary patients in cardiac rehabilitation. Both study instruments were applied in the presence of the researcher and with the consent of patients. The data were processed through descriptive statistics, psychometric tests to validate the instrument in English Canada (exploratory factor analysis, Cronbach s alpha and Intraclass Correlation Coefficient - ICC) and ANOVA, Post-hoc and Student t-test (to verify and to describe patients knowledge about their disease and related factors and to compare the results of Canadians and Brazilians). Regarding the validation of the instrument it was obtained two translations of the Brazilian Portuguese to the Canadian English and these versions were back-translated, both performed by qualified translators. The two versions were taken for analysis of a Canadian Committee of Experts, which culturally adapted 11 of 19 questions. The clarity index obtained was 8.57. A pilot study was performed in 50 alumni of the Canadian cardiac rehab and filling time observed was 11+5 minutes. For the validation of analytical procedures, the Cronbach s alpha was 0.809, the ICC was 0.846 and factor analysis revealed six factors, four of them directly related to the four areas of knowledge which CADE-Q is divided. Comparing knowledge of coronary patients in a rehabilitation program in Brazil and another in Canada it was observed that Canadians have a statistically better knowledge than the Brazilians. These significant differences occurred in the total knowledge (total scores), in the number of complete knowledge alternatives marked, in the specific knowledge of three areas of the questionnaire (Area 2, 3 and 4) and in 13 of 19 questions of the CADE-Q. Patients that are Canadian, young (under 65 years old), male, with associated comorbidities, who had any cardiac surgery, with occupations in the health area or superior level, with university or postgraduate educational level, with a family income of over C$50.000 per year or more than 15 minimum salaries per month appear to have a significantly knowledge about coronary artery disease. Therefore, there is a difference in knowledge of coronary patients in cardiac rehabilitation programs in Brazil and Canada and this difference is related to factors such as socioeconomic status.

ASSUNTO(S)

coronary artery disease patient education educação do paciente nível sócio-econômico socioeconomic level knowledge conhecimento educacao fisica doença arterial coronariana

ACESSO AO ARTIGO

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