Objective Australia has an ageing population, with an increasing number of older people needing to live in residential aged care facilities (RACFs). There are more Emergency department (ED) presentations by older people living in Australia, including those that are from RACF, and many die in hospital. The aim of this study was to perform a descriptive analysis of hospital deaths, comparing the characteristics of patients from Residential Aged Care Facilities (RACFs) to those from non-RACF accommodation.Methods This study examined data from the In-Hospital Death Database for a major metropolitan tertiary hospital. De-identified data from 2015 to 2022 were extracted and included in the analysis. Data for patients over the age of 16 were collected. Data were matched on age and sex between the two groups.Results Compared with non-RACF patients, patients from RACFs who died in hospital were more likely to have died from a respiratory illness, more likely to die in the ED, no more likely to have been a 28-day readmission, more likely to have been admitted under Geriatrics, less likely to have been a coroner's case, and had a shorter length of stay. A large proportion of deaths of RACF patients (15%) were in the ED. Approximately 40% of patients from RACFs who died in hospital had Advance Care Plans (ACPs) in place prior to hospitalisation.Conclusions The relatively large percentage of RACF patients that die in the ED is concerning and raises the question of whether their end-of-life care may have been more appropriately delivered within the RACF. The rate of ACP among RACF patients was low but comparable to other studies, and higher than among non-RACF patients.

This study aimed to report the incidence, common reasons, and associated risk factors for unplanned hospital presentations during chemotherapy treatment. A secondary analysis using data from a randomized controlled trial containing hospital data for the first three cycles of chemotherapy of adult oncology patients in two tertiary hospitals in Australia. Descriptive statistics were used to report hospital utilization patterns. Poisson regression explored risk factors for unplanned presentations. Analyses included data from 346 patients; 115 patients (33

BACKGROUND:Football (soccer) referees are crucial to contol of football matches. Exposure to emotional stressors may precipitate coronary events. AIMS:To characterise emotional stressors, including abuse faced by football (soccer) referees, which may lead to burnout and potential cardiac risk. METHODS:The survey was disseminated to referees from eight referee associations ranging from grassroots/amateur to professional competitions in Sydney, Australia. The questionnaire assessed the level and type of emotional stressors that football referees faced in the preceding 12 months and whether they had experienced verbal or physical abuse in the prior 12 months or at any time in their career. RESULTS:One hundred thirty-four participants undertook the survey, mean age 44.0 years, 117 (87.3%) male and 17 (12.7%) female, 83.6% Caucasian with 62.7% refereeing grassroots football, 23.9% semi-professional and 13.4% professional football. Most participants had experienced stress (69.8%), anxiety (58.3%), frustration (57.2%) and/or anger (42.9%) during at least one match in the previous 12 months. Younger referees and those refereeing at higher levels reported higher levels of psychological stressors than their colleagues, with age remaining a multivariable predictor. Most participants (93.6%) during their career had experienced verbal abuse while refereeing, while 15.2% reported physical abuse, with younger age being a positive predictor. One in five (21.5%) referees had considered quitting due to the stress they experienced. CONCLUSIONS:Findings show a significant emotional stress burden exists with Australian football referees. These findings can guide support and education for referees about stress management techniques and highlight the need to reduce stress and abuse that might contribute to referee burnout and cardiac risk.

BackgroundMany parents today use digital or mobile health (mHealth) resources for parenting information and support. Thus, interventions or programs to support parenting delivered in this way are a rapidly growing area of innovation and research. Evidence indicates that face-to-face interventions that provide education and support for parents about infant sleep can have positive impacts on both infant sleep and maternal mood. However, there is limited research on the delivery of such interventions via digital or mHealth platforms. SleepWellBaby is an infant sleep mobile app for parents with infants and young children. The app provides parents with a 7-day program that may be repeated according to individual user demand, with information and interactive features aimed at supporting parents to understand infant sleep, and providing advice about strategies to support sleep in a responsive way. ObjectiveThe study objectives were (1) to determine engagement with, and acceptability of, an mHealth-delivered parenting program to support infant sleep and (2) to investigate the impact of the program on parental fatigue, emotional health, and parenting competence, confidence, and self-efficacy. MethodsA multimethod quasi-experimental pre-post study design was used. Participants were parents of infants aged under 6 months, recruited through online advertising. Participants completed baseline questionnaires, then 2 further follow-up questionnaires at 7 days and 30 days post baseline. These questionnaires captured participant demographics (baseline) and perceptions of the program (follow-up), in addition to measuring parental fatigue (Fatigue Severity Scale), parent sense of competence, confidence, and self-efficacy (Me as a Parent Scale), and symptoms of anxiety (Generalized Anxiety Disorder 7-item scale) and depression (Edinburgh Postnatal Depression Scale) at all time points. Open-ended text responses were also collected at the 2 follow-up surveys. Questionnaire data were linked with participants’ engagement with the program (Engagement Index), measured using app analytics. ResultsParticipants’ (baseline: n=700; 7-d follow-up: n=339; and 30-d follow-up: n=220) engagement with the program varied; however, the majority reported cessation of app use by 1 month. Most participants were broadly satisfied with the program, finding the app easy to use and understand, and reported they could trust the information on the app. Those participants who had higher engagement or found the program most helpful for their sleep and their infant’s sleep showed the greatest improvement in their fatigue. Qualitative feedback from participants noted that while many found the app a lifeline with helpful information and features, others noted unintended negative impacts, such as spending too much time on their phone. ConclusionsDelivery of an infant sleep program via mHealth is effective for and acceptable to many parents. While not preferred by all parents, mHealth is an accessible, low-cost, and high-reach mode of providing information and management strategies for parents experiencing early parenting difficulties.

BACKGROUND:Pelvic exenteration (PE) is a radical surgery for advanced pelvic malignancies that carries substantial psychosocial impacts. Assessing distress is critical for timely support. AIMS:To evaluate the responsiveness-to-change and convergent validity of the distress thermometer (DT), and to determine an optimal cutoff score for detecting clinically significant distress in a PE cohort. METHODS:Secondary analyses of cohort study data involving adult patients who underwent PE at a quaternary referral hospital. Responsiveness was evaluated by determining whether the DT differentiated cases of decreased emotional well-being and health-related quality of life from pre- to post-surgery, using the Functional Assessment of Cancer Therapy-General (FACT-G), FACT-Colorectal, and Emotional Well-Being (EWB) subscale as external criteria. Convergent validity was evaluated using the correlation between the DT and the EWB subscale scores. Cutoff scores were examined by reviewing the following indices, using an existing EWB cutoff as an external anchor: sensitivity, specificity, positive/negative predictive values, and clinical utility index (CUI). RESULTS:The analysis included 377 patients (mean age: 61 years, 56% male; 41% recurrent rectal cancer). The DT demonstrated responsiveness, with AUCs > 0.7 for detecting emotional and quality-of-life decline post-surgery. Convergent validity was demonstrated through a moderate correlation between the DT and the EWB subscale scores (rs = -0.56, p < 0.001). The optimal DT cutoff score was 4: Sensitivity; 87.0%, Specificity; 52.7%, CUI- value; 0.49 (ruling out cases: satisfactory utility), CUI+ value; 0.33 (case finding: poor utility). CONCLUSION:The DT is a valid and responsive tool for detecting psychological distress in PE patients. Its high sensitivity supports its use in routine screening.

INTRODUCTION:Emergency nursing involves rapid decision-making, undifferentiated patient presentations, and limited opportunity for follow-up, often leaving patient and family outcomes unknown. Although outcome ambiguity has been linked to occupational distress, its nature and impact remain poorly understood. Existing knowledge is largely inferred from broader research on burnout and secondary trauma, leaving a gap in understanding how 'not knowing' shapes the professional and personal lives of emergency nurses. OBJECTIVES:This study aimed to explore the frequency, scope, and impact of ambiguity relating to patient and/or significant others' clinical, personal, and social outcomes, and to identify strategies used by emergency nurses to mitigate its effects. METHODS:A 17-item online survey was analysed using descriptive and inferential statistics and reflexive thematic analysis of free-text responses. RESULTS:Almost all participants (99%) reported experiencing outcome ambiguity, most related to whether a patient survived or died. Negative impacts were reported on professional practice (74.8%) and personal life (84.9%). Three themes describing ambiguity salience were identified in free-text data: the impact of extreme events, the vulnerability of paediatric patients, and impacts on the clinician self. CONCLUSION:Outcome ambiguity is pervasive in emergency nursing and affects both professional practice and personal wellbeing. Rare but extreme cases carry disproportionate emotional weight, highlighting the inseparability of clinical, emotional, and ethical dimensions of emergency nursing. Addressing ambiguity is critical to supporting emergency nurses' wellbeing.

AIM(S):To examine the association between caregiving context and the health and well-being of community-dwelling people with dementia (functional ability, physical function, depression, quality of life and health-related quality of life) and their informal carers (health-related quality of life) at the pre-rehabilitation stage and the potential mediating role of caregiving context variables. DESIGN:Cross-sectional study. METHODS:Secondary analysis of baseline data from a randomised controlled trial of 130 dementia care dyads-the Interdisciplinary Home-based Reablement Programme (2018-2022). Bivariate analyses were applied to identify key caregiving context variables-co-residence, sole carer status, additional caring responsibilities, client-carer relationship and subjective carer burden (carer burden hereafter)-associated with health outcomes. Subsequently, multivariable linear regression models were developed. To examine carer burden, two models were run for each outcome: one with caregiving context variables and covariates, and the other adding carer burden. The mediating effects of the identified caregiving context variable were examined using post hoc mediation analysis. RESULTS:Spouse/partner carer relationship was significantly associated with better client well-being, including lower depressive symptoms and higher quality of life scores compared to adult child and other relationships. Higher carer burden was strongly associated with lower functional ability, more depressive symptoms, lower quality of life for clients and lower health-related quality of life for both clients and carers. Including carer burden in regression models explained the greatest variance across most models. Carer burden fully mediated the association between additional caring responsibilities and client functional ability, and partially mediated the association between other carers and client depression. CONCLUSION:Carer burden needs to be carefully considered in supporting the health and well-being of dementia carer dyads. IMPLICATIONS:Addressing carer burden and tailoring support to carers are essential for optimising health impacts for dementia carer dyads. REPORTING METHOD:STROBE checklist. PATIENT OR PUBLIC CONTRIBUTION:None. TRIAL REGISTRATION:ClinicalTrials.gov identifier: ACTRN12618000600246.

Background:The emerging role of pharmacists in chronic kidney disease (CKD) care prompted the pharmacy-led screening and quality use of medicines in CKD trial (QUM-CKD), a pharmacy-led screening initiative to detect previously undiagnosed CKD and improve medication safety.Objective: To explore pharmacists' experiences and perspectives on the implementation of the QUM-CKD trial in Australian community pharmacies. Methods:A descriptive phenomenological qualitative approach was employed, involving in-depth, semi-structured telephone interviews with thirteen metropolitan and rural community pharmacists in the trial. Pharmacists were selected via purposive maximum variation sampling and were recruited mid-trial. Interviews were audio- recorded, transcribed verbatim, and thematically analysed using both deductive and inductive approaches in NVivo 14. Results:Most participating pharmacists reported having positive experiences with the trial's implementation. Facilitators of implementation included pharmacists' knowledge and beliefs, the availability of resources, support and training. The alignment with roles, values, and systems, along with perceived benefits of the service, the point-of-care testing service, a whole-team approach, and patient acceptance coupled with positive feedback, also facilitated implementation. Barriers included insufficient pharmacist staffing, time constraints, heavy workload, trial software and documentation issues, patients' lack of time, interest or unfavourable perceptions of the service, and interprofessional communication challenges between pharmacists and general practitioners (GPs). Pharmacists also suggested several potential improvements and expressed concerns about the sustainability of the service. Conclusions:Australian community pharmacists generally reported positive experiences in implementing the QUM-CKD trial. To ensure the service's success and sustainability, we recommend adequate pharmacy staffing, appropriate pharmacist remuneration, active stakeholder promotion and strong interprofessional collaboration. Pharmacists' suggestions for service improvement should also be considered.

INTRODUCTION:The COmprehensive Score for Financial Toxicity (COST) measure developed in the United States measures the financial impact resulting from cancer and its treatment. This paper reports on an Australian cross-cultural validation of the COST measure. METHODS:Participant eligibility criteria included individuals aged ≥ 18, undergoing or completed primary treatment for cancer. Immediate family members of patients were also eligible for Phase 1. Face and content validity were assessed through concurrent interviews and a brief survey (Phase 1). The subsequent revised version of COST was field-tested using a prospective sample of participants to examine item importance, internal consistency reliability, and construct validity (Phase 2). RESULTS:Phase 1: Pretesting included 20 patients and two family members (mean age 61, range: 20-87). 19 or more patients agreed or strongly agreed that the COST items were written in clear language, easy to understand, and relevant to their experiences. Content analysis of interviews led to the inclusion of two family-related items to improve content coverage (hereby referred to as Australian-COST), along with two additional stand-alone items to facilitate clinical actions. Phase 2: One hundred and twenty-two patients completed a field-test survey. Each Australian-COST item was rated as "extremely important" or "important" by most participants (62%-81%). Cronbach's alpha coefficients were > 0.9 for both the COST and the Australian-COST. Exploratory factor analysis revealed two factors, explaining 64% (COST) and 63% (Australian-COST) of the variance. Both measures discriminated between low and high household income groups (< $39,999/year, > $125,000/year), demonstrating known-groups validity (COST: mean 19.51 vs. 28.33, p = 0.002, Australian-COST: mean 23.51 vs. 33.29, p = 0.006). CONCLUSIONS:The COST is a valid and reliable measure for Australian cancer patients, and the results largely support the construct equivalence across the United States and Australia. The revised version contains new family-related items to enhance content coverage, which may be applicable in other countries where the financial impact of cancer on the family is of significant concern for patients.

Background We investigated the effectiveness of an Interdisciplinary Home-bAsed Reablement Programme (I-HARP) on improving functional independence, health and well-being of people with dementia, family carer outcomes and costs.Method A multicentre pragmatic parallel-arm randomised controlled trial compared I-HARP to usual care in community-dwelling people with mild to moderate dementia and their family carers in Sydney, Australia (2018-2022). I-HARP is a 4-month, home-based, dementia rehabilitation model delivered by an interdisciplinary team. Assessments were conducted at baseline (time-1), 4-month (time-2) and 12-month (time-3) follow-up. The primary outcome measure was the client's functional independence using the Disability Assessment for Dementia (DAD) scale at time-2, based on intention-to-treat analyses.Result Of 130 recruited client-carer dyads, 116 dyads (58/group) completed the trial. The I-HARP group were not significantly better in most outcome measures than usual care at both time-2 and time-3; with the only statistically significant difference being a reduction in home environment hazards at time-2. Post hoc subgroup analysis of 66 clients with mild dementia found significantly better functional independence in the intervention group compared with those in usual care: difference 8.99 on DAD (95% CI 1.21, 16.79) at time-2 and difference 12.16 (95% CI 1.93, 22.38) at time-3. Economic evaluation suggests potentially lower resource use in I-HARP compared with usual care, but the cost-effectiveness is uncertain.Conclusion Primary outcomes were not met for a population of people with dementia, with severity ranging from mild to moderate and severe. The I-HARP model appeared to benefit functional independence of participants with mild dementia, with potential cost savings.Trial registration number ACTRN12618000600246.

BACKGROUND:Increased demand, wait times and length of stay have seen many emergency departments implement nurse-initiated protocols In New South Wales, Australia, 74 nurse-initiated protocols have been developed for implementation. The aim of this paper is to identify the barriers and enablers to nurses' use of these protocols to inform and maximise future implementation. METHODS:Data were collected via surveys informed by the theoretical domains' framework and the Practice Environment Scale of the Nursing Work Index (PES-NWI). Descriptive statistics summarised quantitative data and content analysis was performed on qualitative data. Results were integrated and classified as barriers or enablers to nurses' use of protocols. RESULTS:The nurses' response rate was 82 % (n = 76) and doctors 72 % (n = 34) Six categories were generated; one barrier (lack of resources), three enablers (patient and organisational benefits, nurses' motivation, nurses' desire to develop their practice) and two were both a barrier and enabler ( nurse confidence and the work environment). CONCLUSION:Emergency nurses are highly motivated to use nurse-initiated protocols to positively impact patient outcomes. However, a lack of resources, time, access to education and confidence are barriers to use that need to be addressed when designing implementation.

Background: Patients receiving chemotherapy for cancer treatment frequently experience side effects such as nausea, vomiting, and diarrhoea, which negatively impact their quality of life and survival outcomes. In this study, an education program was delivered to community nurses (CNs), who subsequently provided home-based side effect management support to patients receiving chemotherapy. Aim: This study aimed to evaluate the education program designed to enhance CNs' knowledge of and confidence in providing chemotherapy side effect management support. Methods: This mixed-method study used surveys and interviews. The evaluation of program content and its delivery was reported using descriptive statistics. The pre- and post-education confidence levels were compared using a paired sample t-test. Interviews explored CNs' perspectives on the program's adequacy and appropriateness in building their knowledge and confidence in providing chemotherapy side effect management support. Findings: Sixty-five CNs completed the surveys. Overall, 69% (n = 45) rated the education program as either 'excellent' or 'very good'. A statistically significant improvement was found in mean item confidence from pre- (3.24, SD 0.72) to post-education (4.11, SD 0.42, P < 0.001). Two focus groups and seven individual interviews were conducted, involving a total of 17 CNs. Qualitative content analysis revealed two themes: (i) CNs' opinions on the program content and its mode of delivery, and (ii) CNs' opinions on the adequacy of the education program in building their knowledge and confidence in chemotherapy side effect management. Conclusion: This study demonstrated the acceptability and feasibility of delivering an education program to enhance CNs' knowledge and confidence in supporting patients undergoing chemotherapy. (c) 2024 Australian College of Nursing Ltd. Published by Elsevier Ltd. This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/).

BACKGROUND:Major knowledge and practice gaps exist in aged care home services to support independence of older people with dementia. This research evaluates an adaptation of a community-based rehabilitation model for care homes, namely Interdisciplinary Care Home-bAsed Reablement Program (I-CHARP), by examining whether (and, if so, how) I-CHARP produces its intended effects and how this programme can be practicably implemented, sustained and scaled up across care homes in Australia. METHODS:I-CHARP is a 4-month bio-behavioural-environmental rehabilitation model of care, integrated in care home services, supported through the deployment of an implementation strategy, the Research Enabled Aged Care Homes (REACH) network. It consists of (1) 8-12 full individual sessions and additional eight brief follow-ups per resident, tailored to the resident's needs, delivered primarily by a team of an occupational therapist, registered nurse and other allied health staff; (2) environmental modifications/assistive devices up to the value of $400 per resident; and (3) engagement of intervention care home staff, managers and regular visitors. An overarching evaluation approach is participatory action research using a cluster quasi-experimental design and mixed methods. It involves testing of the implementation strategy (REACH network and other approaches) while observing/gathering information on the intervention (I-CHARP) and related outcomes in three cycles. Participants include residents (aged ≥ 60 years with early stages of dementia) and care staff from 16 care homes. Care quality indicators, health care costs, field notes and semi-structured interviews/focus groups with intervention site staff, regular visitors and managers will provide further insights into I-CHARP processes and implementation issues. DISCUSSION:In the final phase of the project, an Agile Implementation Playbook will be developed for the delivery of reablement care that can be used in routine practice across care homes in Australia. The study findings will also inform future policy development and strategic directions for dementia care in care homes. TRIAL REGISTRATION:Australian New Zealand Clinical Trial Registry, ACTRN12623000885695 Registered 16 August 2023, https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=386088. PROTOCOL VERSION:1.0 dated 20 July 2023.

Background: Much has been written about the loss to follow-up in the transition between pediatric and adult Congenital Heart Disease (CHD) care centers.Much less is understood about the loss to follow-up (LTF) after a successful transition.This is critical too, as patients lost to specialised care are more likely to experience morbidity and premature mortality.Aims: To understand the prevalence and reasons for loss to follow-up (LTF) at a large Australian Adult Congenital Heart Disease (ACHD) centre.Methods: Patients with moderate or highly complex CHD and gaps in care of >3 years (defined as LTF) were identified from a comprehensive ACHD database.Structured telephone interviews examined current care and barriers to clinic attendance.Results: Overall, 407 (22%) of ACHD patients (n = 1842) were LTF.The mean age at LTF was 31 (SD 11.5) years and 54% were male; 311 (76%) were uncontactable.Compared to adults seen regularly, lost patients were younger, with a greater socio-economic disadvantage, and had less complex CHD (p < 0.05 for all).We interviewed 59 patients (14%).The top 3 responses for care absences were "feeling well" (61%), losing track of time (36%), and not needing follow-up care (25%).Conclusions: A large proportion of the ACHD population becomes lost to specialised cardiac care, even after a successful transition.This Australian study reports younger age, moderate complexity defects, and socio-economic disadvantage as predictive of loss to follow-up.This study highlights the need for novel approaches to patient-centered service delivery even beyond the age of transition and resources to maintain patient engagement within the ACHD service.

Background. Chemotherapy can cause a range of side effects including nausea, vomiting, diarrhea, and infection, which can have a significant impact on an individual’s quality of life. Survival outcomes can be impacted when side effects are poorly managed, leading to failure to complete the defined dose of treatment. Objective. This study presents clinicians’ experiences with a shared care model involving home-based community nurse (CN) support to improve side-effect management of individuals receiving chemotherapy as an outpatient. Methods. A qualitative study was conducted with CNs, cancer nurses, medical oncologists, and a general practitioner involved in the CN intervention delivered as part of a randomized controlled trial (RCT) aimed at reducing unplanned presentations to hospital of cancer patients receiving outpatient chemotherapy. Semistructured individual and focus group interviews were conducted. Key themes were identified using thematic analysis. Findings. Twenty-three healthcare professionals were interviewed. Three themes were identified: (1) being able to enhance patient-centered care and clinical practice during chemotherapy; (2) importance of effective communication and collaborative relationships between different care settings; and (3) ways to adapt the intervention for implementation in routine clinical practice. Participants reported that it was feasible for CNs to care for this patient group, and their home visits enabled preemptive symptom management. Suggestions to improve and modify the intervention to implement this care model within existing clinical care included a flexible approach, such as a blended delivery with face-to-face visits and telephone calls; a risk- or needs-based approach to prioritize patient groups more likely to benefit from the intervention; and sharing of electronic medical records for more effective collaboration and communication. Conclusions. A CN-delivered shared care model provided a feasible approach to the provision of individualized support for outpatients receiving chemotherapy. This study suggests ways to adapt this care model into existing clinical workflow and structures. This trial is registered with ACTRN12614001113640.

This study evaluated the usability and effectiveness of an artificial intelligence application for wound assessment and management from a clinician-and-patient perspective. A quasi-experimental design was conducted in four settings in an Australian health service. Data were collected from patients in the standard (n=166,243 wounds) and intervention (n=124,184 wounds) group, at baseline and post-intervention. Clinicians completed a survey (n=10) and focus group (n=13) and patients were interviewed (n=4). Wound documentation were analysed descriptively, bivariate statistics determined between-group differences, and interviews were thematically analysed. Compared with the standard group, wound documentation in the intervention group improved significantly (<2 items documented 24% vs 70%, P < .001). During the intervention, 101/132 wounds improved (mean wound size reduction=53.99%). Positive evaluations included instantaneous objective wound assessment, shared wound plans increased patient adherence and enhanced efficiency in providing virtual care. Application use facilitated remote patient monitoring and reduced patient travel time while maintaining optimal wound care.

The aim of this randomised controlled trial (RCT) was to explore whether a community nursing intervention for outpatients receiving systemic therapy reduced unplanned hospital presentations and improved physical and psychosocial health outcomes over the first three cycles of treatment compared to a control group receiving standard care. The number of and reasons for unplanned presentations were obtained for 170 intervention and 176 control group adult patients with solid tumours starting outpatient chemotherapy. Poisson regression was used to compare the number of presentations between the intervention and control groups. Patients self-completed the Hospital Anxiety and Depression Scale, the Cancer Behavior Inventory and the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire core 30 (EORTC QLQ-C30) at the start of the first four cycles. Linear regression techniques were used to compare quality of life outcomes. The reduction in unplanned presentations in the intervention group relative to the control group was 12

BACKGROUND:Disease-related knowledge deficits are common in Chinese immigrants living in Western countries, putting them at risk of disease progression and mortality, particularly those with a coronary heart disease (CHD) diagnosis. However, no measurement instrument is available to assess CHD-related knowledge in this population.OBJECTIVES:The aim of this study was to culturally adapt and examine the psychometric properties of the short version of Coronary Artery Disease Education Questionnaire (CADE-Q SV) (simplified Chinese version) in Chinese immigrants with CHD.METHODS:Mandarin-speaking people recruited from medical centers and cardiology clinics across metropolitan Sydney completed the 20-item CADE-Q SV (5 domains; potential scores: 0-20). Internal consistency was assessed using Cronbach α . A subgroup (n = 40) repeated the survey 2 weeks later for test-retest reliability by intraclass correlation coefficient. Factor structure (confirmatory factor analysis) and discriminant (known-groups) validation using education and English proficiency (univariate general linear model) were also undertaken.RESULTS:Participants (n = 202) had a mean (SD) age of 66.08 (10.93) years, 45.1% were male, and the mean (SD) total CADE-Q SV score was 13.07 (4.57). Reliability and consistency were good (intraclass correlation coefficient > 0.70; Cronbach α coefficients > 0.70, for total and per domain, respectively). The 5-domain structure was validated by confirmatory factor analysis. The scale demonstrated discriminant validity, with low education ( P < .001) and low English proficiency ( P = .017) associated with lower knowledge scores.CONCLUSION:The CADE-Q SV (simplified Chinese version) can be used as a valid and reliable instrument, either paper based or digital, to evaluate the CHD-related knowledge of Chinese immigrants. This scale can be adapted to other migrant populations in the future.