Influencing factors of kinesiophobia in knee arthroplasty patients under the social cognitive theory: A structural equation model

IF 4.6 Q2 MATERIALS SCIENCE, BIOMATERIALS ACS Applied Bio Materials Pub Date : 2024-09-28 DOI:10.1016/j.gerinurse.2024.09.004

Yaqin Xu MSN, RN , Xia Chen BSN, RN , Xiaoqun Li BSN, RN , Fangdi Liu BSN, RN , Chunhua Deng BSN, RN , Ping Jia MSN, RN , Yang Yang Liu MS , Caixia Xie DSN, RN

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Abstract

Objective

To analyze the path relationships among influencing factors for kinesiophobia in knee arthroplasty patients through a structural equation model.

Background

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.

Design

A cross-sectional study was conducted and reported following the STROBE guideline.

Methods

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.

Results

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 (χ² = 35.656, RMSEA = 0.031, χ²/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) (Δχ² = 4.213, p = 0.648).

Conclusions

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.

Relevance to Clinical Practice

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.

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社会认知理论下膝关节置换术患者运动恐惧的影响因素：结构方程模型

目的：通过结构方程模型分析膝关节置换术患者运动恐惧影响因素之间的路径关系：通过结构方程模型分析膝关节置换术患者运动恐惧影响因素之间的路径关系：背景：运动恐惧的发生严重影响了膝关节置换术患者的康复过程。背景：膝关节置换术患者运动恐惧的发生严重影响了患者的康复进程，然而，仍有必要确定减少运动恐惧的因素：方法：在 2022 年 2 月至 2020 年 10 月期间，根据 STROBE 指南进行了一项横断面研究：在 2022 年 2 月至 2022 年 10 月期间，162 名全膝关节置换术（TKA）患者和 81 名单间室膝关节置换术（UKA）患者完成了一项调查。采用结构方程建模（SEM）方法分析了运动恐惧与影响因素（社会支持、疼痛恢复力和康复自我效能）之间的关系。此外，还进行了多组 SEM 分析，以检验该模型是否同样适合不同类型的膝关节置换术患者：结果：康复自我效能感（β = -0.535）和疼痛复原力（β = -0.293）对运动恐惧有直接负效应。疼痛复原力和康复自我效能感在社会支持和运动恐惧之间的中介效应（β = -0.183）也是显著的。SEM 模型达到了可接受的拟合程度（χ2 = 35.656，RMSEA = 0.031，χ2/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（Δχ2 = 4.213，P = 0.648）：结论：满意的社会支持可增强疼痛恢复能力和康复自我效能感，从而减少运动恐惧。未来直接针对运动恐怖症评估和管理的干预措施、可用的社会支持可能有助于减少运动恐怖症，而疼痛恢复能力和康复自我效能可能是管理运动恐怖症的关键因素：减少膝关节置换术患者的运动恐惧需要令人满意的社会支持、疼痛恢复能力和康复自我效能。因此，医疗机构可以通过考虑这些因素来减少运动恐惧。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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