Xu Rui, Miao Junfang, Miao Junxia, Wang Weizhao, Dong Mengmeng, Zhang Ying, Li Fangli
School of Nursing, Gansu University of Chinese Medicine, Lanzhou, Gansu, China
Nursing Department, The First People's Hospital of Baiyin, Baiyin, Gansu, China.
BMJ Open. 2025 May 14;15(5):e090796. doi: 10.1136/bmjopen-2024-090796.
The primary aim of this study is to investigate the factors contributing to the development of kinesiophobia in patients following coronary artery stent implantation, integrating perspectives from both patients and healthcare professionals. The main hypothesis is that understanding and methods for effectively overcoming the fear of exercise and improving the effectiveness of cardiac rehabilitation require further exploration from both patient and professional viewpoints.
This qualitative study used a semi-structured interview approach to gather data from participants.
The study was conducted at a hospital in Gansu province, China, focusing on the level of care provided to cardiac rehabilitation patients.
A total of 11 cardiac rehabilitation patients identified as having kinesiophobia (Tampa Scale for kinesiophobia Heart, TSK-SV Heart >37) through screening and nine healthcare professionals participated in the study. The selection criteria included patients undergoing cardiac rehabilitation and professionals involved in their care.
The study identified a core theme, 'Navigating Fear and Uncertainty', encompassing five themes that elucidate how various factors contribute to the prevalent phenomenon of kinesiophobia among patients. These were further delineated into 11 subthemes: (1) physiological factors (fatigue, negative illness experiences), (2) psychological factors (hypervigilance, psychogenic anxiety and depression), (3) capacity factors (reduced physical abilities, lack of rehabilitation knowledge and skills), (4) motivational factors (low exercise self-efficacy, rehabilitation cognitive errors) and (5) support systems (primary caregivers, healthcare professionals and medical support). The results provide a qualitative understanding rather than quantitative measures, hence no CIs or statistical significance levels are provided.
The kinesiophobia observed in patients following coronary artery stent implantation stems from the combined influence of multiple factors, warranting early assessment and intervention by healthcare professionals. The study suggests that healthcare institutions should address the practical concerns faced by cardiac rehabilitation patients and enhance familial, medical and societal support systems to increase patient engagement and compliance with exercise rehabilitation. Further research is needed to develop and validate interventions based on these findings.
本研究的主要目的是综合患者和医护人员的观点，调查冠状动脉支架植入术后患者运动恐惧形成的影响因素。主要假设是，从患者和专业人员的角度来看，有效克服运动恐惧和提高心脏康复效果的理解及方法仍需进一步探索。
本定性研究采用半结构化访谈方法收集参与者的数据。
该研究在中国甘肃省的一家医院进行，重点关注为心脏康复患者提供的护理水平。
通过筛查，共有11名被确定患有运动恐惧（坦帕运动恐惧量表心脏版，TSK-SV Heart>37）的心脏康复患者和9名医护人员参与了研究。选择标准包括接受心脏康复的患者和参与其护理的专业人员。
该研究确定了一个核心主题，即“应对恐惧与不确定性”，其中包含五个主题，阐明了各种因素如何导致患者中普遍存在的运动恐惧现象。这些主题进一步细分为11个子主题：（1）生理因素（疲劳、负面疾病经历），（2）心理因素（过度警惕、心因性焦虑和抑郁），（3）能力因素（身体能力下降、缺乏康复知识和技能），（4）动机因素（运动自我效能低、康复认知错误）和（5）支持系统（主要照顾者、医护人员和医疗支持）。结果提供的是定性理解而非定量测量，因此未提供置信区间或统计显著性水平。
冠状动脉支架植入术后患者中观察到的运动恐惧源于多种因素的综合影响，需要医护人员进行早期评估和干预。该研究表明，医疗机构应解决心脏康复患者面临的实际问题，并加强家庭、医疗和社会支持系统，以提高患者对运动康复的参与度和依从性。需要进一步研究以基于这些发现开发和验证干预措施。
