Study of Factors Influencing Early Kinesiophobia in Older Patients after Coronary Artery Bypass Grafting in China

Yu Liu, Fenglin Ye, Jingjing Liu, Jiaming Yu, Limei Fan, Qin Yang
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Abstract

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.
中国老年冠状动脉旁路移植术后早期运动恐惧的影响因素研究
背景:运动恐惧在心脏病术后患者中非常普遍。及早发现冠状动脉旁路移植术(CABG)患者的运动恐惧,可以提高他们参加体育活动的能力。然而,关于影响老年患者在冠状动脉旁路移植术后早期运动恐惧的因素的研究还很有限。目的:研究冠状动脉旁路移植术后老年患者早期运动恐惧的影响因素,并探讨这些因素与社会支持和康复锻炼自我效能之间的相关性。研究方法采用方便抽样法,对 2022 年 10 月至 2023 年 9 月在蚌埠市某三级甲等医院心脏外科病房接受冠状动脉搭桥术的 117 例老年患者进行分析。调查采用一般信息问卷、中文版坦帕心脏运动恐惧症量表(TSK-SV Heart)、心脏运动自我效能感量表(CESEI)、社会支持评定量表(SSRS)和疼痛评估量表进行现场调查。采用了单因素分析、多因素回归分析和斯皮尔曼相关分析。结果显示在 117 名冠状动脉旁路移植术后早期的老年患者中,运动恐惧的发生率为 73.5%。单因素分析显示,受教育程度、医疗费用覆盖范围、居住地和疼痛评分与运动恐惧显著相关(P < 0.05)。多因素回归分析发现,年龄和月收入是影响心脏运动自我效能感的因素(P < 0.05)。年龄、教育程度、医疗费用覆盖范围和月收入影响患者的社会支持(P < 0.05)。斯皮尔曼相关分析显示,心脏锻炼自我效能感、社会支持和运动恐惧水平之间存在显著负相关(P < 0.001)。结论在冠状动脉旁路移植术后的老年患者中,早期运动恐惧的发生率相对较高。教育程度、医疗费用覆盖范围、居住地和术后疼痛是影响因素。心脏运动自我效能感和社会支持对患者的运动恐惧症有显著影响。因此,临床医护人员应优先考虑教育水平和月收入较低的冠状动脉旁路移植术后老年患者。根据这些影响因素及其相关性,可定制有效的循证临床干预措施,以促进患者积极参与康复锻炼,改善术后早期患者的预后。
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