Translation and validation of the Chinese version of the Acute Coronary Syndrome Response Index (C-ACSRI)

Background: Patients' knowledge, attitudes, and beliefs toward acute coronary syndrome are important predictors of delay in seeking medical attention. Currently, there is no instrument in China to measure these factors. Without such an instrument, there is limited understanding of the knowledge, attitudes and beliefs of Chinese patients. The Acute Coronary Syndrome Response Index is a validated instrument to measure patients' knowledge, attitudes, and beliefs about the symptoms and responses to acute coronary syndrome. Objectives: The study aims to translate and validate a Chinese version of the Acute Coronary Syndrome Response Index and to assess the knowledge, attitudes, and beliefs of individuals in mainland China with a history of coronary heart disease. Design: Cross-sectional study. Setting: Two tertiary teaching general hospitals and community in Shandong province, Eastern China. Participants: Individuals with a history of coronary heart disease. Method: The Acute Coronary Syndrome Response Index was professionally translated and piloting was undertaken to ensure equivalence of meaning and cultural appropriateness. Two means were used for participant recruitment: (1) direct approach in hospital and (2) advertisement in a popular health magazine in Shandong province. Principal component analysis was performed to examine the construct validity, and internal consistency was assessed using Cronbach's alpha values. Results: 224 participants with coronary heart disease were recruited, including 158 in-patients and 66 individuals living in the community. Participants' mean age was 64.3 ± 13.8 years. The majority of participants (61.7%) were male. Cronbach's coefficient for total scores of the Chinese version of Acute Coronary Syndrome Response Index was 0.81, 0.79 for knowledge, 0.87 for attitudes, and 0.71 for the beliefs scale. Pearson's method of bivariate correlation test demonstrated convergent validity. Conclusion: The Chinese version of Acute Coronary Syndrome Response Index can be considered as a reliable and valid instrument. Further testing of the instrument which is needed to assess the acceptability and to ensure the utility of the instrument is warranted.