Validity and Reliability of the Cardiac Rehabilitation Barriers Scale in the Czech Republic (CRBS-CZE): Determination of Key Barriers in East-Central Europe

Winnige, Petr; Filakova, Katerina; Hnatiak, Jakub; Dosbaba, Filip; Bocek, Otakar; Pepera, Garyfallia; Papathanasiou, Jannis; Batalik, Ladislav; Grace, Sherry L.

doi:10.3390/ijerph182413113

Open AccessArticle

Validity and Reliability of the Cardiac Rehabilitation Barriers Scale in the Czech Republic (CRBS-CZE): Determination of Key Barriers in East-Central Europe

by

Petr Winnige

^1,2,

Katerina Filakova

²,

Jakub Hnatiak

^2,3,

Filip Dosbaba

²,

Otakar Bocek

⁴,

Garyfallia Pepera

⁵

,

Jannis Papathanasiou

^6,7

,

Ladislav Batalik

^1,2,*

and

Sherry L. Grace

⁸

¹

Department of Public Health, Faculty of Medicine, Masaryk University, 62500 Brno, Czech Republic

²

Department of Rehabilitation, University Hospital Brno, 62500 Brno, Czech Republic

³

Faculty of Medicine, Masaryk University, 62500 Brno, Czech Republic

⁴

Department of Internal Cardiology Medicine, University Hospital Brno, 62500 Brno, Czech Republic

⁵

Physiotherapy Department, Faculty of Health Sciences, University of Thessaly, 35100 Lamia, Greece

⁶

Department of Medical Imaging, Allergology & Physiotherapy, Faculty of Dental Medicine, Medical University of Plovdiv, 4002 Plovdiv, Bulgaria

⁷

Department of Kinesitherapy, Faculty of Public Health, Medical University of Sofia, 1431 Sofia, Bulgaria

⁸

Faculty of Health, York University & KITE-Toronto Rehabilitation Institute, University Health Network, University of Toronto, Toronto, ON M3J 1P3, Canada

^*

Author to whom correspondence should be addressed.

Int. J. Environ. Res. Public Health 2021, 18(24), 13113; https://doi.org/10.3390/ijerph182413113

Submission received: 8 November 2021 / Revised: 9 December 2021 / Accepted: 10 December 2021 / Published: 12 December 2021

(This article belongs to the Special Issue Cardiac Rehabilitation in the Time of COVID-19)

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Abstract

Cardiovascular rehabilitation (CR) is an effective secondary preventive model of care. However, the use of CR is insufficient, and the reasons for this are not well-characterized in East-Central Europe. This prospective observational study psychometrically validated the recently translated Cardiac Rehabilitation Barriers Scale for the Czech language (CRBS-CZE) and identified the main CR barriers. Consecutive cardiac in/out-patients were approached from January 2020 for 18 months, of whom 186 (89.9%) consented. In addition to sociodemographic characteristics, participants completed the 21-item CRBS-CZE (response options 1–5, with higher scores representing greater barriers), and their CR utilization was tracked. Forty-five (24.2%) participants enrolled in CR, of whom 42 completed the CRBS a second time thereafter. Factor analysis revealed four factors, consistent with other CRBS translations. Internal reliability was acceptable for all but one factor (Cronbach’s alpha range = 0.44–0.77). Mean total barrier scores were significantly higher in non-enrollers (p < 0.001), decreased from first and second administration in these enrollers (p < 0.001), and were lower in CR completers (p < 0.001), supporting criterion validity. There were also significant differences in barrier scores by education, geography, tobacco use, among other variables, further supporting validity. The biggest barriers to enrolment were distance, work responsibilities, lack of time, transportation problems, and comorbidities; and the greatest barriers to adherence were distance and travel. Several items were considered irrelevant at first and second administration. Other barriers included wearing a mask during the COVID-19 pandemic. The study demonstrated sufficient validity and reliability of CRBS-CZE, which supports its use in future research.

Keywords: barriers; utilization; cardiac rehabilitation; coronary artery disease; Czech Republic

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MDPI and ACS Style

Winnige, P.; Filakova, K.; Hnatiak, J.; Dosbaba, F.; Bocek, O.; Pepera, G.; Papathanasiou, J.; Batalik, L.; Grace, S.L. Validity and Reliability of the Cardiac Rehabilitation Barriers Scale in the Czech Republic (CRBS-CZE): Determination of Key Barriers in East-Central Europe. Int. J. Environ. Res. Public Health 2021, 18, 13113. https://doi.org/10.3390/ijerph182413113

AMA Style

Winnige P, Filakova K, Hnatiak J, Dosbaba F, Bocek O, Pepera G, Papathanasiou J, Batalik L, Grace SL. Validity and Reliability of the Cardiac Rehabilitation Barriers Scale in the Czech Republic (CRBS-CZE): Determination of Key Barriers in East-Central Europe. International Journal of Environmental Research and Public Health. 2021; 18(24):13113. https://doi.org/10.3390/ijerph182413113

Chicago/Turabian Style

Winnige, Petr, Katerina Filakova, Jakub Hnatiak, Filip Dosbaba, Otakar Bocek, Garyfallia Pepera, Jannis Papathanasiou, Ladislav Batalik, and Sherry L. Grace. 2021. "Validity and Reliability of the Cardiac Rehabilitation Barriers Scale in the Czech Republic (CRBS-CZE): Determination of Key Barriers in East-Central Europe" International Journal of Environmental Research and Public Health 18, no. 24: 13113. https://doi.org/10.3390/ijerph182413113

APA Style

Winnige, P., Filakova, K., Hnatiak, J., Dosbaba, F., Bocek, O., Pepera, G., Papathanasiou, J., Batalik, L., & Grace, S. L. (2021). Validity and Reliability of the Cardiac Rehabilitation Barriers Scale in the Czech Republic (CRBS-CZE): Determination of Key Barriers in East-Central Europe. International Journal of Environmental Research and Public Health, 18(24), 13113. https://doi.org/10.3390/ijerph182413113

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Validity and Reliability of the Cardiac Rehabilitation Barriers Scale in the Czech Republic (CRBS-CZE): Determination of Key Barriers in East-Central Europe

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