Translation, Adaptation, and Validation of the Malay Version of the Cardiac Rehabilitation Barriers Scale

Abstract

Background The rate of cardiac rehabilitation attendance at the Sarawak Heart Centre was identified as very low, and the reason has not been investigated. A scale is needed to identify barriers to participation in cardiac rehabilitation among patients with heart disease in Sarawak, Malaysia. Purpose The purposes of this study were to translate, adapt, and evaluate the Malay-language version of the Cardiac Rehabilitation Barriers Scale (CRBS) and to measure the psychometric properties of the Malay-version CRBS to justify its use in Sarawak. Methods A forward and back-translation method was used. Content validity was assessed by three experts. Psychometric testing was conducted on a sample of 283 patients who were eligible to participate in cardiac rehabilitation. A construct validity test was performed using factor analysis. Cronbach's alpha was used to examine the internal consistency. The test–retest reliability was calculated using the intraclass correlation coefficient on 22 participants. Independent-samples t test and analysis of variance were conducted to assess the criterion validity. Mean scores for total barriers of the scale and each individual factor were compared among the different patient characteristics. Results The Malay-version CRBS showed an item level of content validity index of 1.00 for all of the items after improvements were made based on the experts' suggestions. The factor analysis, using principal component analysis with direct oblimin rotation, extracted four factors that differed from the original study. These four factors explained 52.50% of the cumulative percentage of variance. The Cronbach's alphas ranged from .74 to .81 for the obtained factors. Test–retest reliability was established using the intraclass correlation coefficient value of .78. Criterion validity was supported using the significant differences in the mean score for total barriers among educational level, driving distance, travel time to the hospital, and cardiac rehabilitation attendance. Conclusions/Implications for Practice This study found the Malay-version CRBS to be a valid and reliable instrument. It may be used with inpatients to identify barriers to participation in cardiac rehabilitation to promote rehabilitation attendance and improve patient care.

Translation, Cross-Cultural Adaptation, and Psychometric Validation of the Chinese/Mandarin Cardiac Rehabilitation Barriers Scale (CRBS-C/M)

“…Higher scores indicate greater barriers to CR. Criterion validity has been established in the English version and in many of the translated versions, demonstrated by significant differences in CRBS scores by CR use [ 19 – 21 ]. Reliability is also established [ 19 ].…”

Reliability of the Scale of Barriers for Cardiac Rehabilitation in the Colombian Population

“…However, the Brazilian version is the only one that has assessed its psychometric properties in patients with cardiovascular risk factors, coronary heart disease, heart failure, arrhythmias, peripheral arterial disease and chronic obstructive pulmonary disease. Additionally, the CRBS when compared to the last two, is the only one that evaluates factors influencing participation or adherence to CRP (13,(22)(23)(24)(25)(26).…”

“…Finally, the different studies have been evaluated in subjects with average ages between 54 to 67 years, not taking into account other group ages that can demand cardiac rehabilitation services (13,(22)(23)(24)(25)(26). On the other hand, the Colombian version showed less stability when it was self-reported (in the presence of an interviewer), which allows us to suggest that it should preferably to be administered through an interview.…”

Translation and validation of the cardiac rehabilitation barriers scale in the Czech Republic (CRBS-CZE)

“…This is also a reasonable sample size to establish the validity of the translation, as demonstrated in previous CRBS translations. [ 21 , 22 ]…”

“…Criterion validity has been established in the English version and many of the translations, demonstrated by significant differences in CRBS scores by CR use. [ 21 , 23 ]…”