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运用恐惧回避模型探究疾病认知对心源性栓塞性中风患者运动功能的影响:运动恐惧的中介作用。

Investigating the effect of illness perception on motor function in cardioembolic stroke patients using the fear-avoidance model: The mediating role of kinesiophobia.

作者信息

Ding Yunmei, Yue Shouwei, Li Jing, Wang Lu, Gu Jiayun, Cui Yan

机构信息

School of Nursing and Rehabilitation, Shandong University, Shandong, China.

Rehabilitation Center, Qilu Hospital, Shandong University, Shandong, China.

出版信息

Heart Lung. 2025 May-Jun;71:39-46. doi: 10.1016/j.hrtlng.2025.02.006. Epub 2025 Feb 22.

Abstract

BACKGROUND

Cardioembolic stroke is the most common cause of ischemic stroke, and patients frequently have motor dysfunction as well as psychological disorders. Both physical and psychological causes can have an impact on a patient's motor function.

OBJECTIVES

In this study, we used the fear-avoidance model to examine the impact of patients' illness perception and kinesiophobia (excessive fear of exercise) on their motor function.

METHODS

Between June 2021 and February 2022, we conducted a cross-sectional study of 319 participants diagnosed with cardioembolic stroke in the selected hospitals. Correlation analyses and mediation effects tests were used to analyze the relationship between patients' illness perception, kinesiophobia, and motor function.

RESULTS

The total motor function score of the patients was (21.39 ± 29.30), the total kinesiophobia score was (48.51 ± 8.33), and the total illness perception score was (53.37 ± 16.82). There was a negative correlation between illness perception and motor function (r = -0.734, P < 0.001), a negative correlation between kinesiophobia and motor function (r = -0.522, P < 0.001), and a positive correlation between illness perception and kinesiophobia (r = 0.508, P < 0.001); kinesiophobia played a mediating role between illness perception and motor function (β = -0.63, P < 0.001).

CONCLUSIONS

The findings revealed that individuals with cardioembolic strokes had poor motor function, as well as negative illness perception and kinesiophobia. Negative illness perception had a direct impact on patients' motor function as well as an indirect effect via kinesiophobia. The fear-avoidance model contributes to understanding the process of reduced motor function in cardioembolic stroke patients.

摘要

背景

心源性栓塞性卒中是缺血性卒中最常见的病因,患者常伴有运动功能障碍以及心理障碍。生理和心理因素均可对患者的运动功能产生影响。

目的

在本研究中,我们运用恐惧回避模型来探究患者的疾病认知和运动恐惧(对运动的过度恐惧)对其运动功能的影响。

方法

在2021年6月至2022年2月期间,我们对选定医院中319名被诊断为心源性栓塞性卒中的参与者进行了横断面研究。采用相关性分析和中介效应检验来分析患者的疾病认知、运动恐惧和运动功能之间的关系。

结果

患者的总运动功能评分为(21.39±29.30),总运动恐惧评分为(48.51±8.33),总疾病认知评分为(53.37±16.82)。疾病认知与运动功能呈负相关(r = -0.734,P < 0.001),运动恐惧与运动功能呈负相关(r = -0.522,P < 0.001),疾病认知与运动恐惧呈正相关(r = 0.508,P < 0.001);运动恐惧在疾病认知和运动功能之间起中介作用(β = -0.63,P < 0.001)。

结论

研究结果表明,心源性栓塞性卒中患者运动功能较差,且存在负面的疾病认知和运动恐惧。负面的疾病认知对患者的运动功能有直接影响,同时也通过运动恐惧产生间接影响。恐惧回避模型有助于理解心源性栓塞性卒中患者运动功能下降的过程。

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