老年慢性心力衰竭患者运动恐惧的影响因素：结构方程模型。
Influencing factors of kinesiophobia in older patients with chronic heart failure: A structural equation model.
机构信息
Department of Cardiology, Affiliated Hospital of Yangzhou University, Yangzhou University, Yangzhou, Jiangsu, China.
School of Nursing, Yangzhou University, Yangzhou, Jiangsu, China.
出版信息
Clin Cardiol. 2023 Jul;46(7):729-736. doi: 10.1002/clc.24024. Epub 2023 Apr 28.
BACKGROUND
Our recent study has demonstrated that kinesiophobia is common in Chinese inpatients with chronic heart failure (CHF). Symptoms of heart failure (HF), coping mode, self-efficacy for exercise (SEE), and social support have been reported to be associated with kinesiophobia. However, little is known about the relationships between these four variables and kinesiophobia in older patients with CHF.
OBJECTIVE
To test a model of influencing factors of kinesiophobia in older CHF patients.
METHODS
A cross-sectional design was conducted from January 2021 to October 2021. The general information questionnaire, the Chinese version of the Tampa Scale for Kinesiophobia Heart (TSK-SV Heart-C), Symptom Status Questionnaire-Heart Failure, SEE, the Medical Coping Modes Questionnaire, and Social Support Rating Scale were used. Spearman correlation analysis and structural equation model (SEM) were performed for data analysis.
RESULTS
A total of 270 older patients with CHF were recruited. Symptom status of HF (r = 0.455, p < .01), avoidance coping mode (r = 0.393, p <.01), and yielding coping mode (r = 0.439, p < .01) were positively correlated with kinesiophobia, while SEE (r = -0.530, p < .01), facing coping mode (r = -0.479, p < .01), and social support (r = -0.464, p < .01) were negatively correlated with kinesiophobia. SEM analysis showed that social support could affect kinesiophobia through the mediating variables of symptom status of HF, avoidance coping mode, and exercise self-efficacy.
CONCLUSIONS
Symptoms of HF, coping mode, SEE, and social support may play role in kinesiophobia in older CHF patients. We should pay more attention to the synergies among these four variables in the improvement of kinesiophobia.
背景
我们最近的研究表明，简体中文慢性心力衰竭（CHF）住院患者中普遍存在运动恐惧症。心力衰竭（HF）症状、应对方式、运动自我效能感（SEE）和社会支持与运动恐惧症有关。然而，对于 CHF 老年患者这四个变量与运动恐惧症之间的关系知之甚少。
目的
测试影响 CHF 老年患者运动恐惧症的模型。
方法
采用横断面设计，于 2021 年 1 月至 2021 年 10 月进行。采用一般资料问卷、中文版塔帕运动恐惧症量表（TSK-SV Heart-C）、心力衰竭症状状况问卷、SEE、医学应对方式问卷和社会支持评定量表进行调查。采用 Spearman 相关分析和结构方程模型（SEM）进行数据分析。
结果
共纳入 270 例 CHF 老年患者。HF 症状状况（r=0.455，p<0.01）、回避应对方式（r=0.393，p<0.01）和屈服应对方式（r=0.439，p<0.01）与运动恐惧症呈正相关，而 SEE（r=-0.530，p<0.01）、面对应对方式（r=-0.479，p<0.01）和社会支持（r=-0.464，p<0.01）与运动恐惧症呈负相关。SEM 分析显示，社会支持可通过 HF 症状状况、回避应对方式和运动自我效能感等中介变量影响运动恐惧症。
结论
HF 症状、应对方式、SEE 和社会支持可能在 CHF 老年患者的运动恐惧症中发挥作用。在改善运动恐惧症时，我们应更加关注这四个变量之间的协同作用。
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