Barriers to cardiac rehabilitation in the Czech Republic.

The aim of this study is first to translate and cross-culturally adapt the "Cardiac Rehabilitation Barriers Scale" (CRBS) to Czech (CRBS-CZE), and then psychometrically validate the translation and check internal reliability. The main aim is to identify the barriers which prevent patients from entering the II. phase of cardiac rehabilitation (CR). We need to compare these barriers between enrollers and non-enrollers. The percentage of completers and non-completers must be determined, and finally we will compare the barriers affecting adherence and completition of ambulatory training program. Study will take place in the Internal Cardiology Clinic of University Hospital Brno - coronary unit, care center, standard department. The research group will be made up of coronary artery disease (CAD) patients meeting the criteria for the II. phase of CR. Main data collection method is filling the CRBS-CZE. Patients indicated to the II. phase of CR will be educated in training program and CRBS-CZE through which we find their interest in participation. Physiotherapist will have a conversation with each patient and obtains necessary data (sample characteristics). Then immediatelly (4-12 weeks before CR commencement) each participant will fill in the CRBS-CZE individually (total approximate duration 30 mins). The standard CR program involves 3 trainings a week for 2 months. The patients attending at least one training session will be considered enrollers. The rest of them will be qualified as non-enrollers. Subsequently we will evaluate the barriers, compare among the enrollers and non-enrollers, prospectively among completers and non-completers. Furthermore, we will express the adherence of training program and percentage of total completition. Sample characteristics Diagnoses Gender Age BMI Waist circumference Marital status Education Average salary Work status Commuting time to CR Genetic factors Hypertension Dyslipidemia Diabetes mellitus Level of physical activity Smoking tobacco Excessive alcohol consumption Stress Depression CRBS original (I did not attend a cardiac rehabilitation program, or if I did attend, I missed some sessions because:) CRBS_01… of distance CRBS_02… of cost CRBS_03… of transportation problems CRBS_04… of family responsibilities CRBS_05… I didn’t know about CR CRBS_06… I don’t need CR CRBS_07… I already exercise at home, or in my community CRBS_08… severe weather CRBS_09… I find exercise tiring or painful CRBS_10… travel CRBS_11… of time constraints CRBS_12… of work responsibilities CRBS_13… I don’t have the energy CRBS_14… other health problems prevent me from going CRBS_15… I am too old CRBS_16… my cardiologist or thoracic surgeon did not feel it was necessary CRBS_17… many people with heart problems don’t go, and they are fine CRBS_18… I can manage my heart problem on my own CRBS_19… I think I was referred, but the rehab program didn’t contact me CRBS_20… it took too long to start the outpatient program after referral CRBS_21… I prefer to take care of my health alone, not in a group Likert scale: 1-5 (1 – strongly agree, 5 – strongly disagree, not applicable)