Study of Factors Influencing Early Kinesiophobia in Older Patients after Coronary Artery Bypass Grafting in China
DOI:
https://doi.org/10.59958/hsf.7377Keywords:
older patients, coronary artery bypass grafting, kinesiophobia, correlationAbstract
Background: Kinesiophobia is highly prevalent among postoperative cardiac patients. Early identification of kinesiophobia in patients who have undergone coronary artery bypass grafting (CABG) can improve their ability to participate in physical activities. However, there is limited research on the factors influencing kinesiophobia in older patients during the early stages after CABG. To investigate the factors influencing early kinesiophobia in older patients after coronary artery bypass grafting and to examine the correlation between these factors and social support and rehabilitation exercise self-efficacy. Methods: Using convenience sampling, 117 older patients who underwent coronary artery bypass grafting in the cardiac surgery ward of a tertiary grade A hospital in Bengbu City from October 2022 to September 2023 were analyzed. The survey was conducted on-site using a general information questionnaire, the Chinese version of the Tampa Scale for Kinesiophobia Heart (TSK-SV Heart), the Cardiac Exercise Self-Efficacy Instrument (CESEI), the Social Support Rating Scale (SSRS), and the pain assessment scale. Single-factor analysis, multifactor regression analysis, and Spearman's correlation analysis were employed. Results: Among the 117 older patients in the early postoperative phase following coronary artery bypass grafting, the incidence of kinesiophobia was 73.5%. Single-factor analysis revealed that education level, medical expense coverage, place of residence, and pain scores were significantly associated with kinesiophobia (p < 0.05). Multifactor regression analysis identified age and monthly income as factors influencing cardiac exercise self-efficacy (p < 0.05). Age, education level, medical expense coverage, and monthly income affected patient social support (p < 0.05). Spearman's correlation analysis revealed significant negative correlations among cardiac exercise self-efficacy, social support, and kinesiophobia level (p < 0.001). Conclusion: The incidence of early kinesiophobia is relatively high among older patients after coronary artery bypass grafting. Educational level, medical expense coverage, place of residence, and postoperative pain were influential factors. Both cardiac exercise self-efficacy and social support have a significant impact on kinesiophobia in patients. Therefore, clinical healthcare professionals should prioritize older patients undergoing postcoronary artery bypass grafting with lower educational levels and monthly incomes. Effective and evidence-based clinical interventions can be tailored based on these influencing factors and their correlations to promote active participation in rehabilitation exercises and improve patient outcomes in the early postoperative phase.
References
China Cardiovascular Health and Disease Report 2022 Overview. Chinese Circulation Journal. 2023; 38: 583–612.
Dirimeşe E, Korkmaz FD, Alcan AO. Quality of life and healthy life style before coronary artery bypass graft surgery. Balıkesir Health Sciences Journal. 2016; 5: 56–61.
Vanhees L, Rauch B, Piepoli M, van Buuren F, Takken T, Börjesson M, et al. Importance of characteristics and modalities of physical activity and exercise in the management of cardiovascular health in individuals with cardiovascular disease (Part III). European Journal of Preventive Cardiology. 2012; 19: 1333–1356.
Paquin A, Poirier P, Beaudoin J, Piché ME. Secondary prevention after CABG: do new agents change the paradigm? Current Opinion in Cardiology. 2020; 35: 664–672.
Van Bogaert W, Coppieters I, Kregel J, Nijs J, De Pauw R, Meeus M, et al. Influence of Baseline Kinesiophobia Levels on Treatment Outcome in People With Chronic Spinal Pain. Physical Therapy. 2021; 101: pzab076.
Ozyemisci-Taskiran O, Demirsoy N, Atan T, Yuksel S, Coskun O, Aytur YK, et al. Development and Validation of a Scale to Measure Fear of Activity in Patients With Coronary Artery Disease (Fact-CAD). Archives of Physical Medicine and Rehabilitation. 2020; 101: 479–486.
Domingues de Freitas C, Costa DA, Junior NC, Civile VT. Effects of the pilates method on kinesiophobia associated with chronic non-specific low back pain: Systematic review and meta-analysis. Journal of Bodywork and Movement Therapies. 2020; 24: 300–306.
Piao JJ, Gu Y, Ling Y, Chi L, Chen Y, Wang R. Mediating effect of kinesiophobia between self-efficacy and physical activity levels in post-CABG patients: protocol for a prospective, multicentre, cross-sectional study in China. BMJ Open. 2022; 12: e062013.
Bäck M, Jansson B, Cider A, Herlitz J, Lundberg M. Validation of a questionnaire to detect kinesiophobia (fear of movement) in patients with coronary artery disease. Journal of Rehabilitation Medicine. 2012; 44: 363–369.
SY X. Theoretical basis and application of social support rating scale. The Journal of Clinical Psychiatry. 1994; 3: 98–100.
Hickey ML, Owen SV, Froman RD. Instrument development: cardiac diet and exercise self-efficacy. Nursing research. 1992; 41: 347–351
Sun YX, Zhao CY, Zhu Y, Yang ZY, Tang BX, Chen J, et al. Chinese Translation and Reliability and Validity Testing of the Cardiac Rehabilitation Exercise Self-Efficacy Instrument. Chinese Journal of Modern Nursing. 2021; 27: 4441–4446. (In Chinese)
Liu JW, Liu ML, Qi Y. Risk factors analysis of coronary heart disease patients’ fear of disease progression based on symptom management theory. Nursing Research. 2022; 36: 1771–1778. (In Chinese)
Qin JW, Xiong JJ, Pan X, Gong KZ. Analysis of the Status and Influencing Factors of Kinesiophobia in Elderly Patients with Chronic Heart Failure. Chinese Journal of Nursing. 2022; 57: 408–414. (In Chinese)
Knapik A, Dąbek J, Brzęk A. Kinesiophobia as a Problem in Adherence to Physical Activity Recommendations in Elderly Polish Patients with Coronary Artery Disease. Patient Preference and Adherence. 2019; 13: 2129–2135.
Kluszczyńska M, Młynarska A, Mikulakova W. Influence of Frailty Syndrome on Kinesiophobia According to the Gender of Patients after Coronary Artery Bypass Surgery. Healthcare. 2021; 9: 730.
Zhang R, Lao L, Ren K, Berman BM. Mechanisms of acupuncture-electroacupuncture on persistent pain. Anesthesiology. 2014; 120: 482–503.
Gheorghe A, Griffiths U, Murphy A, Legido-Quigley H, Lamptey P, Perel P. The economic burden of cardiovascular disease and hypertension in low- and middle-income countries: a systematic review. BMC Public Health. 2018; 18: 975.
Marques-Sule E, Söderlund A, Almenar L, Espí-López GV, López-Vilella R, Bäck M. Influence on kinesiophobia by disability, physical, and behavioural variables after a heart transplantation. European Journal of Cardiovascular Nursing. 2022; 21: 537–543.
Urell C, Zetterberg L, Hellström K, Anens E. Factors explaining physical activity level in Parkinson's disease: A gender focus. Physiotherapy Theory and Practice. 2021; 37: 507–516.
Qin J, Xiong J, Chen C, Wang X, Gao Y, Zhou Y, et al. Influencing factors of kinesiophobia in older patients with chronic heart failure: A structural equation model. Clinical Cardiology. 2023; 46: 729–736.
Inui Y, Tanaka Y, Ogawa T, Hayashida K, Morioka S. Relationship between exercise motivation and social support in a support facility for persons with disabilities in Japan. Annals of Medicine. 2022; 54: 820–829.
Karataş T, Bostanoğlu H. Perceived social support and psychosocial adjustment in patients with coronary heart disease. International Journal of Nursing Practice. 2017; 23.
Aronov D, Bubnova M, Iosseliani D, Orekhov A. Clinical Efficacy of а Medical Centre- and Home-based Cardiac Rehabilitation Program for Patients with Coronary Heart Disease After Coronary Bypass Graft Surgery. Archives of Medical Research. 2019; 50: 122–132.
Slovinec D'Angelo ME, Pelletier LG, Reid RD, Huta V. The roles of self-efficacy and motivation in the prediction of short- and long-term adherence to exercise among patients with coronary heart disease. Health Psychology. 2014; 33: 1344–1353.
