{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,12]],"date-time":"2026-06-12T17:06:04Z","timestamp":1781283964005,"version":"3.54.1"},"reference-count":46,"publisher":"MDPI AG","issue":"22","license":[{"start":{"date-parts":[[2022,11,17]],"date-time":"2022-11-17T00:00:00Z","timestamp":1668643200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJERPH"],"abstract":"<jats:p>Background: Cardiopulmonary rehabilitation (CR) serves as a core component of the management strategy for patients with heart failure (HF). CR is administered by multidisciplinary healthcare providers, but their perceptions toward delivering CR to HF patients, and the factors and barriers that might influence referral, have not been studied. This study aims to assess physicians\u2019 perceptions toward delivering CR programs to HF patients and identify factors and barriers that might influence their referral decisions. Methods: Between 15 February and 5 June 2022, a cross-sectional online survey with ten multiple-choice items was distributed to all general and cardiac physicians in Saudi Arabia. The characteristics of the respondents were described using descriptive statistics. Percentages and frequencies were used to report categorical variables. The statistical significance of the difference between categorical variables was determined using the chi-square (2) test. Logistic regression was used to identify referral factors. Results: Overall, 513 physicians (general physicians (78%) and cardiac doctors (22%)) completed the online survey, of which 65.0% (n = 332) were male. Of the general physicians, 236 (59%) had referred patients with HF to CR. Sixty-six (58%) of the cardiac doctors had referred patients with HF to CR. A hospital-supervised program was the preferred mode of delivering CR programs among 315 (79%) general physicians, while 84 (74%) cardiac doctors preferred to deliver CR programs at home. Apart from the exercise component, information about HF disease was perceived by 321 (80%) general physicians as the essential component of a CR program, while symptom management was perceived by 108 (95%) cardiac doctors as the essential component of a CR program. The most common patient-related factor that strongly influenced referral decisions was \u201cfatigue related to disease\u201d (63.40%). The availability of CR centers (48%) was the most common barrier preventing the referral of patients to CR. Conclusions: CR is an effective management strategy for HF patients, but the lack of CR centers is a major barrier to the referral of patients. A hospital-supervised program is the preferred method of delivering CR from the general physicians\u2019 perspective, while cardiac doctors prefer home-based CR programs. Apart from the exercise component, information about HF disease and symptom management is essential components of CR programs from general physicians\u2019 and cardiac doctors\u2019 perspectives, respectively.<\/jats:p>","DOI":"10.3390\/ijerph192215208","type":"journal-article","created":{"date-parts":[[2022,11,18]],"date-time":"2022-11-18T03:31:10Z","timestamp":1668742270000},"page":"15208","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Physicians\u2019 Perceptions of and Barriers to Cardiopulmonary Rehabilitation for Heart Failure Patients in Saudi Arabia: A Cross-Sectional Study"],"prefix":"10.3390","volume":"19","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4270-9494","authenticated-orcid":false,"given":"Abdulelah M.","family":"Aldhahir","sequence":"first","affiliation":[{"name":"Respiratory Therapy Department, Faculty of Applied Medical Sciences, Jazan University, Jazan 82511, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8429-9382","authenticated-orcid":false,"given":"Munyra","family":"Alhotye","sequence":"additional","affiliation":[{"name":"Department of Respiratory Therapy, College of Applied Medical Sciences, King Saud Bin Abdulaziz University for Health Sciences, Riyadh 12211, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jaber S.","family":"Alqahtani","sequence":"additional","affiliation":[{"name":"Department of Respiratory Care, Prince Sultan Military College of Health Sciences, Dammam 32210, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6677-1110","authenticated-orcid":false,"given":"Saeed M.","family":"Alghamdi","sequence":"additional","affiliation":[{"name":"Respiratory Care Program, Clinical Technology Department, Faculty of Applied Medical Sciences, Umm Al-Qura University, Makkah 24211, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3922-0548","authenticated-orcid":false,"given":"Abdullah S.","family":"Alsulayyim","sequence":"additional","affiliation":[{"name":"Respiratory Therapy Department, Faculty of Applied Medical Sciences, Jazan University, Jazan 82511, Saudi Arabia"},{"name":"National Heart and Lung Institute, Imperial College London, London SW7 2BX, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2460-3901","authenticated-orcid":false,"given":"Abdullah A.","family":"Alqarni","sequence":"additional","affiliation":[{"name":"Department of Respiratory Therapy, Faculty of Medical Rehabilitation Sciences, King Abdulaziz University, Jeddah 22230, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1444-7132","authenticated-orcid":false,"given":"Eidan M.","family":"Alzahrani","sequence":"additional","affiliation":[{"name":"Department of Physiotherapy, Prince Sultan Military College of Health Sciences, Dammam 32210, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rayan A.","family":"Siraj","sequence":"additional","affiliation":[{"name":"Department of Respiratory Therapy, College of Applied Medical Sciences, King Faisal University, Al-Hasa 36291, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hassan","family":"Alwafi","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, Umm Al-Qura University, Mecca 36291, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2022,11,17]]},"reference":[{"key":"ref_1","first-page":"e876","article-title":"2022 AHA\/ACC\/HFSA Guideline for the Management of Heart Failure: Executive Summary: A Report of the American College of Cardiology\/American Heart Association Joint Committee on Clinical Practice Guidelines","volume":"145","author":"Heidenreich","year":"2022","journal-title":"Circulation"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"499","DOI":"10.1016\/j.hfc.2015.03.011","article-title":"Assessing the Quality and Comparative Effectiveness of Team-Based Care for Heart Failure: Who, What, Where, When, and How","volume":"11","author":"Cooper","year":"2015","journal-title":"Heart Fail. 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