• Puteri Sofia Nadira Megat Kamaruddin Department of Community Health, Faculty of Medicine, Universiti Kebangsaan Malaysia
  • Azmawati Mohammed Nawi Department of Community Health, Faculty of Medicine, Universiti Kebangsaan Malaysia
  • Mohamad Nurman Yaman Department of Medical Education, Faculty of Medicine, Universiti Kebangsaan Malaysia
  • Rajiv Chowdhury Robert Stempel College of Public Health and Social Work, Florida International University
  • Nazarudin Safian Department of Community Health, Faculty of Medicine, Universiti Kebangsaan Malaysia
  • Mohd Shawal Faizal Mohamad Cardiology, Medical Department, Universiti Kebangsaan Malaysia, Jalan Yaacob Latif, Bandar Tun Razak, Cheras 56000, Kuala Lumpur, Malaysia
  • Abdul Muizz Abd Malek Cardiology Department, Hospital Serdang, Kajang 43000, Selangor, Malaysia


Malay, eHealth Literacy, Health Consciousness, Patient Adherence, Perceived Severity to Chronic Disease


A multifaceted approach is needed to treat ischaemic heart disease (IHD) patients and improve their overall quality of life. This study aims to translate, cross-culturally adapt and validate questionnaires exploring the multifactorial health empowerment component among IHD patients. This process involved: 1) Adaptation of conceptualising applicable questionnaires; 2) Translation; 3) Cultural adaptation of forward and backward translations; and 4) Pre-tested validation by experts (n=5) and piloted among participants (n=30). Content validity revealed that I-CVI and S- CVI were both 0.98, indicating that the questionnaire items were understandable and relevant. An FKI of 0.87 supported experts’ agreements. Cronbach alpha values ranged from 0.696–0.977 for each construct. Further reinforced by Rasch analysis, an overall Cronbach alpha of 0.87 indicated adequate internal consistency. Data fitted the model, as evidenced by Infit values of mean square (MNSQ) near 1, and Z standard (ZSTD) values near 0. An item reliability of 0.97 indicated that the anticipated items were correctly measured, and an item separation of 5.78 suggests a high degree of separation with precise measurement. A Person separation of 2.38 revealed the capacity to distinguish the participants in the agreement of the questionnaires. Rating scales between -3.54 and 2.77 demonstrated a strong separation of scales. A raw variance explained by measures of 68.3%, unexplained variance in 1st contrast with Eigenvalue 9.98 and noise level of 13.2% demonstrated the instrument is operating as intended. The Perceived Severity to Chronic Disease, Health Consciousness, eHealth Literacy and Patient Adherence questionnaires were valid and reliable tools to be administered and explore the multifactorial component in empowering health among IHD patients.


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How to Cite

Megat Kamaruddin, P. S. N., Mohammed Nawi, A., Yaman, M. N., Chowdhury, R., Safian, N., Mohamad, M. S. F., & Abd Malek, A. M. (2023). TRANSLATION, CROSS-CULTURAL ADAPTATION, AND DEVELOPING MALAY QUESTIONNAIRES TO MEASURE HEALTH EMPOWERMENT FOR PATIENTS WITH ISCHAEMIC HEART DISEASE (IHD): A VALIDATION STUDY. Malaysian Journal of Public Health Medicine, 23(2), 112–123. Retrieved from