Psychometric Properties and Cross-cultural Adaptation of the Turkish Version of Physcian Attitudes Toward Cardiac Rehabilitation and Referral Scale-Revised (PACRR-R)

Research has reported that the reasons for low implementation of CR are multifactorial at the health system, physician and patient levels. It has also been found that patients are more likely to initiate CR if physicians strongly and positively promote the importance of CR participation. Unfortunately, there are insufficient and ineffective data on CR, referral to CR and both clinical and cost-effectiveness outcomes of CR in Turkey. In this context, it is important to examine more objectively from the perspective of physicians who play a key role in referring patients to CR. However, in our country, there is no relatively objective measurement tool to evaluate physicians' attitudes towards CR. Therefore, this study aims to adapt the original "Physician Attitudes towards Cardiac Rehabilitation and Referral Scale-Revised (PACRR-R)" into Turkish and to examine its psychometric properties.

Study Overview

• Status: Completed
• Conditions: Physician's Role
• Intervention / Treatment: Other: Physcian Attitudes toward Cardiac Rehabilitation and Referral Scale-Revised (PACRR-R)

• Study Type: Observational
• Enrollment (Actual): 89

Contacts and Locations

Study Locations

• Turkey (Türkiye)
  • Karaman, Turkey (Türkiye)
    • Karamanoğlu Mehmetbey University

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult; Older Adult
• Accepts Healthy Volunteers: No

• Sampling Method: Non-Probability Sample

Study Population

The population of the study is physicians. The sample was physicians who volunteered to participate in the study, to whom the study could be announced/notified, and who provided active service in patient diagnosis and treatment. In the literature, it is stated that the number of individuals to be included in the study in order to achieve meaningful and valid results in the scale development process is at least 5 times the number of items in the scale and ideally 10 times. In our study, the number of individuals to be included in the study to test the validity of the scale was planned to be at least 100 individuals (PACRR-R consists of 20 items). In order to examine the test-retest reliability of the scale, it was planned to reapply the scale to at least 25% of the individuals in the sample.

Description

Inclusion Criteria:

• To be a physician,
• Providing active service in patient diagnosis and treatment

Exclusion Criteria:

• Not providing active service in patient diagnosis and treatment despite being a physician (administrative position, etc.).

Study Plan

How is the study designed?

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Physician Attitudes toward Cardiac Rehabilitation and Referral (PACRR)-Revised Scale Score	The Physician Attitudes toward Cardiac Rehabilitation and Referral (PACRR)-Revised Scale comprises 20 items to assess physicians' attitudes and beliefs about CR and referral. Response options were 1 = strongly disagree, 2 = agree, 3 = neutral, 4 = agree, and 5 = strongly agree. Five (5) items are reverse-scored to mitigate acquiescence bias (denoted with *), such that higher scores reflect more positive attitudes toward CR and referral. A mean score is computed for the total (where at least 80% of items were completed; i.e., 15/19) scale and subscales. A final open-ended item asks physicians to list the most important factors that influence their decision to refer a patient to CR.	10-15 minutes

Collaborators and Investigators

• Sponsor: Karamanoğlu Mehmetbey University

Study record dates

Study Major Dates

• Study Start (Actual): May 13, 2024
• Primary Completion (Actual): May 30, 2025
• Study Completion (Actual): January 15, 2026

Study Registration Dates

• First Submitted: April 4, 2024
• First Submitted That Met QC Criteria: April 4, 2024
• First Posted (Actual): April 10, 2024

Study Record Updates

• Last Update Posted (Actual): February 20, 2026
• Last Update Submitted That Met QC Criteria: February 18, 2026
• Last Verified: February 1, 2026

More Information

Terms related to this study

• Other Study ID Numbers: KARYÖN-DR

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: UNDECIDED

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No