A self administered tool for the evaluation of the efficacy of health educational interventions in cardiac patients.
BACKGROUND
Since most cardiac rehabilitation and formal secondary prevention programmes for atherosclerotic cardiovascular disease include multidisciplinary interventions aimed at risk factors reduction and healthy lifestyle promotion, the use of specific outcome measurement instruments for the assessment of patients' knowledge before and after educational programmes should be included in usual clinical practice. For this reason we developed a new self-administered questionnaire (MaugerI CaRdiac preventiOn Questionnaire: MICRO-Q) addressed to the evaluation of information regarding secondary prevention in patients with coronary heart disease.


METHODS
The development of the questionnaire consisted of different phases aimed to define the content, the number of items and the choice of possible responses. The final version of questionnaire consists of 26 items, 18 true statements and 8 false ones, with responses true, false, or don't know. MICRO-Q provides three separate scores: correct (number of items answered correctly), misconceptions (number of items wrongly answered), uncertainty (number of items answered 'don't know'), and covers knowledge of risk factors and lifestyle, diet, pre-admission avoidable delay, and cardiac disease. MICRO-Q was administered to 250 coronary patients (206 males, 44 females), mean age 61 +/- 10 years, in different geographical areas of Italy. The questionnaire's reliability was evaluated and descriptive analyses were performed.


RESULTS
Spearman's Rho coefficient correlation (test-retest) for correct responses was 0.72, and the alpha value of the reliability analysis 0.68. Frequency analysis of each item was performed in detail. For the total score, the mean value was 18.90 (3.25) for the correct scale, 2.97 (1.66) for the misconceptions scale and 3.97 (3.56) for the uncertainty scale. Subgroups analysis of total scores showed no difference for gender and age, but patients with higher education had significantly higher scores on the correct scale (p < or = 0.0001), while patients with a lower level of education showed a higher score for misconceptions (p < or = 0.01).


CONCLUSIONS
MICRO-Q is a simple, self-administered, efficient outcome measurement tool for the assessment of the efficacy of educational interventions in cardiac rehabilitation and secondary cardiovascular prevention. Patients' level of education and some erroneous beliefs are important keys to be taken into account in planning tailored educational interventions. In patients with coronary artery disease the MICRO-Q could be an useful and reliable clinical and quality-of-care outcome indicator for cardiac rehabilitation professionals.
Sommaruga
Marinella
M
Psychology Unit, IRCCS, Fondazione Salvatore Maugeri, Servizio di Psicologia, Via Roncaccio 16, 21049 Tradate, Varese, Italia. msommaruga@fsm.it
Vidotto
Giulio
G
Bertolotti
Giorgio
G
Pedretti
Roberto F E
RF
Tramarin
Roberto
R
D000368:Aged; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000517:prevention & control / Q000534:rehabilitation; D010353:Patient Education as Topic / Q000379:methods*; D015397:Program Evaluation; D011795:Surveys and Questionnaires