慢性阻塞性肺疾病中老年患者运动恐惧的影响机制：一项横断面研究
Influencing mechanisms of kinesiophobia in middle-aged and elderly patients with chronic obstructive pulmonary disease: a cross-sectional study.
作者信息
Wang Yaru, Zou Xiaofang, Xiong Chen, Xie Xiaoqiao, He Guilian
机构信息
The Third School of Clinical Medicine, Guangzhou Medical University, School of Nursing, Guangzhou Medical University, 195 West Dongfeng Road, 510182, Guangzhou, China.
Department of Nursing, Guangdong Provincial Key Laboratory of Major Obstetric Diseases, Guangdong Provincial Clinical Research Center for Obstetrics and Gynecology, The Third Affiliated Hospital, Guangzhou Medical University, 63 Duobao Road, Liwan District, Guangzhou, 510150, China.
出版信息
BMC Pulm Med. 2025 May 13;25(1):233. doi: 10.1186/s12890-025-03699-6.
BACKGROUND
The aim of this study is to explore the mechanism of the role of kinesiophobia in patients with chronic obstructive pulmonary disease (COPD), to construct a structural equation model of the factors influencing kinesiophobia in patients with COPD, and to provide a theoretical basis for the development of targeted intervention strategies.
METHODS
The cross-sectional design was conducted from December 2023 to July 2024, and middle-aged and elderly patients with COPD from a tertiary hospital in Guangzhou, China, were selected using convenience sampling. A general demographic information questionnaire, Breathlessness Beliefs Questionnaire scale (BBQ), modified Medical Research Council Dyspnea Scale (mMRC), Fatigue Scale (FS-14), Hospital Anxiety and Depression Scale (HADS), Self-Efficacy for Exercise (SEE), and Social Support Rating Scale (SSRS) were used for data collection. Spearman correlation analysis and structural equation modeling (SEM) were used for data analysis.
RESULTS
A total of 278 COPD patients were included. Correlation analysis showed that dyspnoea (r = 0.689, p < 0.01), fatigue (r = 0.731, p < 0.01) and anxiety (r = 0.678, p < 0.01) were significantly positively correlated with kinesiophobia, whereas social support (r=-0.518, p < 0.01) and exercise self-efficacy (r=-0.740, p < 0.01) were significantly negatively correlated with kinesiophobia. SEM analyses revealed six significant pathways of action: dyspnoea, exercise self-efficacy was a direct predictor of kinesiophobia. Fatigue, and social support were indirect predictors of kinesiophobia. Anxiety was a direct and indirect predictor of kinesiophobia.
CONCLUSIONS
Dyspnoea, fatigue, anxiety, social support and exercise self-efficacy are important predictors of kinesiophobia in COPD patients. Clinical interventions should focus on the synergistic effects of these five types of variables to establish a multidimensional and comprehensive management programme.
TRIAL REGISTRATION
The protocol was reviewed by the Ethics Committee of the Third Affiliated Hospital of Guangzhou Medical University (Ethics Code: LCYJ-2023-055).
背景
本研究旨在探讨运动恐惧在慢性阻塞性肺疾病（COPD）患者中发挥作用的机制，构建影响COPD患者运动恐惧因素的结构方程模型，为制定针对性干预策略提供理论依据。
方法
采用横断面设计，于2023年12月至2024年7月进行，通过便利抽样选取中国广州某三级医院的中老年COPD患者。使用一般人口学信息问卷、呼吸困难信念问卷量表（BBQ）、改良医学研究委员会呼吸困难量表（mMRC）、疲劳量表（FS - 14）、医院焦虑抑郁量表（HADS）、运动自我效能感量表（SEE）和社会支持评定量表（SSRS）收集数据。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278例COPD患者。相关分析显示，呼吸困难（r = 0.689，p < 0.01）、疲劳（r = 0.731，p < 0.01）和焦虑（r = 0.678，p < 0.01）与运动恐惧呈显著正相关，而社会支持（r = -0.518，p < 0.01）和运动自我效能感（r = -0.740，p < 0.01）与运动恐惧呈显著负相关。结构方程模型分析揭示了六条显著的作用路径：呼吸困难、运动自我效能感是运动恐惧的直接预测因子。疲劳和社会支持是运动恐惧的间接预测因子。焦虑是运动恐惧的直接和间接预测因子。
结论
呼吸困难、疲劳、焦虑、社会支持和运动自我效能感是COPD患者运动恐惧的重要预测因子。临床干预应关注这五类变量的协同作用，建立多维综合管理方案。
试验注册
本研究方案经广州医科大学附属第三医院伦理委员会审核通过（伦理代码：LCYJ - 2023 - 055）。
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