Xu Yaqin, Chen Xia, Li Xiaoqun, Liu Fangdi, Deng Chunhua, Jia Ping, Liu Yang Yang, Xie Caixia
Orthopedics Department, Qionglai Medical Center Hospital, 611530, PR China; Medical School, University of Electronic Science and Technology of China, Chengdu, Sichuan 610054, PR China.
Nursing Department, Qionglai Medical Center Hospital,611530, PR China.
Geriatr Nurs. 2024 Nov-Dec;60:270-280. doi: 10.1016/j.gerinurse.2024.09.004. Epub 2024 Sep 28.
To analyze the path relationships among influencing factors for kinesiophobia in knee arthroplasty patients through a structural equation model.
The occurrence of kinesiophobia significantly impacts the rehabilitation process of knee arthroplasty patients. However, there is still a need to determine factors that contribute to reducing kinesiophobia.
A cross-sectional study was conducted and reported following the STROBE guideline.
Between February 2022 to October 2022, 162 total knee arthroplasty (TKA) patients and 81 unicompartmental knee arthroplasty (UKA) patients completed a survey. A structural equation modeling (SEM) approach was utilized to analyze the relationships between kinesiophobia and influencing factors (social support, pain resilience, and rehabilitation self-efficacy). Furthermore, multi-group SEM analysis was conducted to examine whether the model equally fitted patients in different types of knee arthroplasty.
The direct negative effects of rehabilitation self-efficacy (β = -0.535) and pain resilience (β = -0.293) on kinesiophobia were observed. The mediating effect (β = -0.183) of pain resilience and rehabilitation self-efficacy between social support and kinesiophobia was also significant. The SEM model achieved an acceptable model fit (χ = 35.656, RMSEA = 0.031, χ/df = 1.230, GFI = 0.972, NFI = 0.982, IFI = 0.997, CFI = 0.996). In multicohort analysis, no significant differences were observed among knee arthroplasties (TKA, UKA) (Δχ = 4.213, p = 0.648).
Satisfactory social support enhances pain resilience and rehabilitation self-efficacy, so as to reduce kinesiophobia. Future interventions that directly target the assessment and management of kinesiophobia, available social support may help reduce kinesiophobia, and pain resilience and rehabilitation self-efficacy may be critical factors in managing kinesiophobia.
Reducing kinesiophobia in knee arthroplasty patients requires satisfactory social support, pain resilience, and rehabilitation self-efficacy. Therefore, healthcare organizations may implement initiatives to reduce kinesiophobia by taking these factors into account.
通过结构方程模型分析膝关节置换患者运动恐惧影响因素之间的路径关系。
运动恐惧的发生显著影响膝关节置换患者的康复进程。然而，仍需确定有助于减轻运动恐惧的因素。
采用横断面研究，并按照STROBE指南进行报告。
2022年2月至2022年10月期间，162例全膝关节置换（TKA）患者和81例单髁膝关节置换（UKA）患者完成了一项调查。采用结构方程建模（SEM）方法分析运动恐惧与影响因素（社会支持、疼痛耐受力和康复自我效能感）之间的关系。此外，进行多组SEM分析以检验该模型是否同样适用于不同类型膝关节置换的患者。
观察到康复自我效能感（β = -0.535）和疼痛耐受力（β = -0.293）对运动恐惧有直接的负面影响。疼痛耐受力和康复自我效能感在社会支持与运动恐惧之间的中介作用（β = -0.183）也很显著。SEM模型实现了可接受的模型拟合度（χ = 35.656，RMSEA = 0.031，χ/df = 1.230，GFI = 0.972，NFI = 0.982，IFI = 0.997，CFI = 0.996）。在多队列分析中，膝关节置换术（TKA、UKA）之间未观察到显著差异（Δχ = 4.213，p = 0.648）。
满意的社会支持可增强疼痛耐受力和康复自我效能感，从而减轻运动恐惧。未来针对运动恐惧评估和管理的干预措施中，现有的社会支持可能有助于减轻运动恐惧，而疼痛耐受力和康复自我效能感可能是管理运动恐惧的关键因素。
减轻膝关节置换患者的运动恐惧需要满意的社会支持、疼痛耐受力和康复自我效能感。因此医疗机构可通过考虑这些因素来实施减轻运动恐惧的举措。
