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Validation of a Scale to Assess Patients’ Comprehension of Frequently Used Cardiology Terminology

The Cardiac TERM Scale in Brazilian Portuguese

Ghisi, Gabriela Lima de Melo, PhD1; dos Santos, Rafaella Zulianello, PhD2; Britto, Raquel R., PhD3; Bonin, Christiani Decker Batista, MS2; Servio, Thaianne Cavalcante, MS3; Schmidt, Luiz Fernando, PT Student2; Benetti, Magnus, PhD2; Grace, Sherry L., PhD1,4

doi: 10.1097/rnj.0000000000000099

Purpose The aim of this study was to psychometrically validate the translation of a questionnaire on patient understanding of cardiology terminology (TERM) to Brazilian Portuguese.

Design After piloting the translation and cross-cultural adaptation, the 16-item TERM questionnaire was psychometrically tested.

Methods Internal and test–retest reliability, as well as validity, were assessed in 322 cardiac patients.

Findings Internal (α = .88) and test–retest reliability (all weighted Kappa > 0.63) exceeded the minimum recommended standards. Criterion validity was supported by significant differences in mean scores by socioeconomic indicators (p < .01). Discriminant validity was supported in that cardiac rehabilitation participants had significantly higher TERM scores (p < .001). Participants did not correctly define any of the terms, and a floor effect was identified in all terms.

Conclusions The Cardiac TERM Scale was demonstrated to have good reliability and validity.

Clinical Relevance The scale can be used by healthcare professionals, such as nurses. Results can be used to inform patient education, which could in turn impact patient adherence to medical advice and hence outcomes.

1Cardiac Rehabilitation and Prevention Program, Toronto Rehabilitation Institute, University Health Network, Toronto, Canada

2Health Sciences and Sports Center, State University of Santa Catarina, Florianopolis, Brazil

3Physical Therapy Department, Federal University of Minas Gerais, Belo Horizonte, Brazil

4School of Kinesiology and Health Science, York University, Toronto, Canada

Correspondence: Gabriela Lima de Melo Ghisi, University Health Network Toronto Rehabilitation Institute, Cardiovascular Prevention and Rehabilitation Program, 347 Rumsey Road, Toronto, Ontario M4G 1R7, Canada. E-mail: or/and

Supplemental digital content is available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal’s Web site (

Cite this article as: Ghisi, G. L., dos Santos, R. Z., Britto, R. R., Bonin, C. D., Servio, T. C., Schmidt, L. F., Benetti, M., & Grace, S. L. (2019). Validation of a scale to assess patients’ comprehension of frequently used cardiology terminology. Rehabilitation Nursing, 44(2), 87–95. doi: 10.1097/rnj.0000000000000099

© 2019 Association of Rehabilitation Nurses.
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