Transcultural adaptation and psychometric properties of the Persian version of the Coronary Artery Disease Empowerment Scale (CADES) 

Abstract Background: Individuals with coronary artery disease are exposed to multiple problems and recurrent disease due to the chronic and progressive nature of the disease. They need to assess their own abilities and use them in their own healthcare to learn how to manage their disease and health independently. Objective: This study was conducted in order to determine the validity and reliability of the Persian version of "Coronary Artery Disease Empowerment Scale (CADES)" in Iran. Method: This is a cognitive study in which the Coronary Artery Disease Empowerment Scale (CADES) was translated into Persian using forward-backward translation method. After cultural validation, the steps of content assessment, response reaction, and internal structure evaluation were performed, which included evaluating the completeness of the structure in terms of items, the relationship between construct and observation of the tool, and the opinions and thoughts of experts and respondents, as well as the reliability and confirmation of the factorial structure. For confirmatory factor analysis, the research sample increased to 344 patients with heart disease, while 190 individuals were used for exploratory factor analysis (EFA). Participants were selected using convenient sampling method for this stage. Cronbach's alpha coefficient was used to assess internal consistency, and test-retest method was used to evaluate the reliability of the tool. SPSS version 26 and Lisrel version 8 were used for data analysis in this study. Results: The EFA and CFA results confirmed the tool with three factors and 25 items. The main indicators of the model in factor analysis were all above 0.9, indicating a good fit of the model. The Pearson correlation coefficient between the items and subscales with the main scale showed a direct and significant relationship. Additionally, the Cronbach's alpha coefficient (0.813) and retest (0.763) confirmed the reliability of the Persian version of CADES. Conclusion: Overall, the study results showed that the Persian version of CADES has acceptable and practical characteristics for assessing the empowerment of coronary artery disease patients and can serve as a valid tool that reflects the empowerment of CAD patients.