OBJECTIVE: To perform a translation and cross-cultural adaptation of the Cardiac Rehabilitation Barriers Scale (CRBS) for use in Korea, followed by psychometric validation. The CRBS was developed to assess patients' perception of the degree to which patient, provider and health system-level barriers affect their cardiac rehabilitation (CR) participation. METHODS: The CRBS consists of 21 items (barriers to adherence) rated on a 5-point Likert scale. The first phase was to translate and cross-culturally adapt the CRBS to the Korean language. After back-translation, both versions were reviewed by a committee. The face validity was assessed in a sample of Korean patients (n=53) with history of acute myocardial infarction that did not participate in CR through semi-structured interviews. The second phase was to assess the construct and criterion validity of the Korean translation as well as internal reliability, through administration of the translated version in 104 patients, principle component analysis with varimax rotation and cross-referencing against CR use, respectively. RESULTS: The length, readability, and clarity of the questionnaire were rated well, demonstrating face validity. Analysis revealed a six-factor solution, demonstrating construct validity. Cronbach's alpha was greater than 0.65. Barriers rated highest included not knowing about CR and not being contacted by a program. The mean CRBS score was significantly higher among non-attendees (2.71±0.26) than CR attendees (2.51±0.18) (p<0.01). CONCLUSION: The Korean version of CRBS has demonstrated face, content and criterion validity, suggesting it may be useful for assessing barriers to CR utilization in Korea.
Comprehension ; Factor Analysis, Statistical ; Humans ; Korea ; Myocardial Infarction ; Psychometrics* ; Rehabilitation* ; Reproducibility of Results ; Translations

Objective: To translate and culturally adapt the Information Needs in Cardiac Rehabilitation (INCR) questionnaire into Korean and perform psychometric validation. Methods: The original English version of the INCR, in which patients are asked to rate the importance of 55 topics, was translated into Korean (INCR-K) and culturally adapted. The INCR-K was tested on 101 cardiac rehabilitation (CR) participants at Kangwon National University Hospital and Seoul National University Bundang Hospital in Korea. Structural validity was assessed using principal component analysis, and Cronbach’s alpha of the areas was computed. Criterion validity was assessed by comparing information needs according to CR duration and knowledge sufficiency according to receipt of education. Half of the participants were randomly selected for 1 month of re-testing to assess their responsiveness. Results: Following cognitive debriefing, the number of items was reduced to 41 and ratings were added to assess participants’ sufficient knowledge of each item. The INCR-K structure comprised eight areas, each with sufficient internal consistency (Cronbach’s alpha>0.7). Criterion validity was supported by significant differences in mean INCR-K scores based on CR duration and knowledge sufficiency ratings according to receipt of education (p<0.05). Information needs and knowledge sufficiency ratings increased after 1 month of CR, thus supporting responsiveness (p<0.05). Conclusion The INCR-K demonstrated adequate face, content, cross-cultural, structural, and criterion validities, internal consistency, and responsiveness. Information needs changed with CR, such that multiple assessments of information needs may be warranted as rehabilitation progresses to facilitate patient-centered education.

The second affiliation of the authors, Sora Baek and Hee-won Park, was not added in the article.