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Abstract
Background: Transplant recipients are chronically ill patients, who require lifelong follow-up to manage comorbidities
and prevent graft loss. This necessitates a system of care that is congruent with the Chronic Care
Model. The eleven-item self-report Patient Assessment of Chronic Illness Care (PACIC) scale assesses whether
chronic care is congruent with the Chronic Care Model, yet its validity for heart transplant patients has not been
tested.
Methods: We tested the validity of the English version of the PACIC, and compared the similarity of the internal
structure of the PACIC across English-speaking countries (USA, Canada, Australia and United Kingdom) and across
six languages (French, German, Dutch, Spanish, Italian and Portuguese). This was done using data from the crosssectional
international BRIGHT study that included 1378 heart transplant patients from eleven countries across 4
continents. To test the validity of the instrument, confirmatory factor analyses to check the expected
unidimensional internal structure, and relations to other variables, were performed.
Results: Main analyses confirmed the validity of the English PACIC version for heart transplant patients. Exploratory
analyses across English-speaking countries and languages also confirmed the single factorial dimension, except in
Italian and Spanish.
Conclusion: This scale could help healthcare providers monitor level of chronic illness management and improve
transplantation care.