CADE-Q SV is validated

Information about CADE-Q SV (short version) has been updated in this website, including citation, tool (English and Portuguese versions) and scoring.



Since CADE-Q and CADE-Q II take between 15 to 20 minutes to complete we are developing a short version of this knowledge questionnaire, to be used in clinical practice. It is important to mention that if your objective is to test your patients’ knowledge in order to design and develop educational curricula you should use CADE-Q or CADE-Q II. The SV version is a quick tool to test the knowledge of your patients, but since it is a true/false questionnaire it will not give you detailed information.

We will be posting more information about this questionnaire once the development and validation is finished.


We have developed the second version of the CADE-Q (called CADE-Q II).
Abstract and link for full-text available here.

Objectives: To develop and psychometrically-validate a revised version of the Coronary Artery Disease Education Questionnaire (CADE-Q)- a tool to assess patients’ knowledge about CAD in cardiac rehabilitation (CR).
Methods: After a needs assessment, a literature review and focus group with CR experts, the revised questionnaire was developed. It underwent pilot-testing in 30 patients, which lead to further refinement. The questionnaire was then psychometrically-tested in 307 CR patients. Internal consistency was assessed using Cronbach’s alpha, the dimensional structure through exploratory factor analysis, and criterion validity with regard to educational level.
Results: Cronbach’s alpha was 0.91. Criterion validity was supported by significant differences in mean scores by educational level (p<.001). Factor analysis revealed four factors, which were internally-consistent (0.65-0.77), and well-defined by items. The mean total score was 64.2±18.1/93. Patients with a history of heart failure, cardiomyopathy and percutaneous coronary intervention (p<0.05) had significantly higher knowledge scores compared with patients without such a history. Knowledge about exercise and their medical condition was significantly higher than risk factors, nutrition and psychosocial risk.
Conclusions: The CADE-QII has good reliability and validity.
Practical Implications: This tool may be useful to assess CR participants’ knowledge gaps, and to evaluate the efficacy of educational delivery in CR.

Systematic Review

Our research group recently published a systematic review on patient education of cardiac patients and the promotion of behaviour change.

The first objective of this systematic review was to investigate the impact of education on patients’ knowledge about health and disease. The second objective was to determine if educational interventions are related to health behaviour change in CAD patients, namely smoking, physical activity, dietary habits, response to cardiac symptoms, and medication adherence, as well as psychosocial well-being. Finally, the third objective was to describe the nature of the educational interventions offered, as per the Workgroup for Intervention Development and Evaluation Research (WIDER) reporting guideline.

Click here to see the abstract and get the full-text article.

CADE-Q II under construction

A new study is in progress to develop and psychometrically validate of the second version of the CADE-Q, called CADE-Q II. Although CADE-Q demonstrated good reliability and validity in both psychometrically versions (Portuguese and English), presents lack of detailed assessment of all core components of cardiac rehabilitation (CR), such as nutrition and psychosocial risk. This is a limitation particularly when information from this tool is used to develop an educational curiiculum for cardiac rehabilitation patients. Thus, the CADE-Q started its development in 2004 and an update is needed. The availability of a more comprehensive and updated CADE-Q is important to assess cardiac patients’ knowledge and to tailor the educational component of CR programs.

Results from the application of the new tool in 307 patients and psychometric analysis are expected to be published in mid-2014.


Cardiac Rehabilitation (CR), defined as “a combination of the correct and practical use of guidelines, appropriate consultation, supplies of drugs and ancillary services, and education”, helps heart patients not only to improve their functional capacity, quality of life and to reduce risk factors, but also to educate them and to create a sense of well-being and optimism about the future. Studies have shown that when all facets of CR programs are applied in a comprehensive and systematic fashion, including patient education, it has a significant impact on recovery, reduction of admissions to hospital, improvement of quality of life and the functional state of these patients.

Knowledge of health and disease has been reported as an important component related to successful management of coronary artery disease. Studies have shown that patient education can influence cardiac patients to make healthier choices in daily life, to better manage their disease, to avoid adverse outcomes, and educational programs have even been associated with regression of coronary disease.

Despite well-established benefits from patient education in the CR setting, there are few psychometrically-validated questionnaires published in the literature assessing cardiac patients’
knowledge applicable to CR programs or that could be integrated into the routine management of this population. In addition, most of the tools are structured in a ‘true/false/do not know’ way, which may not reflect a real understanding of the patient about their condition because this form of structuring focuses more on ‘how much you know’ rather than ‘what you know’.

Ghisi et all (2010) recently developed the Coronary Artery Disease Education Questionnaire (CADE-Q) which assesses patients‟ knowledge about their disease and related factors in a CR setting. The questionnaire was developed following an extensive review of the literature, with feedback from cardiologists and a CR multidisciplinary team. The CADE-Q, originally developed and validated in Brazilian Portuguese, was demonstrated to be a valid tool, with strong overall characteristics in terms of content, development and testing. The instrument has been validated in English and Portuguese from Portugal.