The Mediating Effect of Psychological Flexibility in the Relationship Between Two-Way Social Support and Rehabilitation Exercise Adherence in Patients With Total Knee Arthroplasty.

IF 1.6 Q3 RHEUMATOLOGY

Musculoskeletal Care Pub Date : 2025-09-01 DOI:10.1002/msc.70181

Hongyun Li, Lan Li, Dan Wang, Xin Li, Jing Li, Guilan Chen

{"title":"The Mediating Effect of Psychological Flexibility in the Relationship Between Two-Way Social Support and Rehabilitation Exercise Adherence in Patients With Total Knee Arthroplasty.","authors":"Hongyun Li, Lan Li, Dan Wang, Xin Li, Jing Li, Guilan Chen","doi":"10.1002/msc.70181","DOIUrl":null,"url":null,"abstract":"Objective: This study aims to investigate the impact of two-way social support on rehabilitation exercise compliance among patients undergoing total knee arthroplasty and examine psychological flexibility's mediating role.Design: Cross-sectional study.Methods: A convenience sample of 266 total knee arthroplasty patients was recruited from the orthopaedic department of a tertiary hospital in Guiyang, Guizhou Province, between November 12, 2024, and March 20, 2025. Data were collected using standardised instruments, including a general demographic questionnaire, a brief two-way social support scale, a simplified multidimensional psychological flexibility inventory, and a rehabilitation exercise adherence scale. Amos 29.0 software was used to construct a structural equation model of the mediating effect of psychological flexibility between two-way social support and rehabilitation exercise compliance.Results: Pearson correlation analysis revealed significant positive associations among two-way social support, psychological flexibility, and rehabilitation exercise compliance ( <math> <semantics><mrow><mi>r</mi></mrow> <annotation>$r$</annotation></semantics> </math> = 0.538-0.730, <math> <semantics><mrow><mi>p</mi></mrow> <annotation>$p$</annotation></semantics> </math> < 0.001). Mediation analysis demonstrated that two-way social support enhanced rehabilitation exercise compliance indirectly through increased psychological flexibility (effect size = 0.336, 95% <math> <semantics><mrow><mi>C</mi> <mi>I</mi></mrow> <annotation>$\\mathrm{C}\\mathrm{I}$</annotation></semantics> </math> [0.253-0.442], <math> <semantics><mrow><mi>p</mi></mrow> <annotation>$p$</annotation></semantics> </math> < 0.05), accounting for 53.0% of the total effect. Additionally, a significant direct effect of two-way social support on rehabilitation exercise compliance was observed (effect size = 0.298, 95% <math> <semantics><mrow><mi>C</mi> <mi>I</mi></mrow> <annotation>$\\mathrm{C}\\mathrm{I}$</annotation></semantics> </math> [0.181-0.432], <math> <semantics><mrow><mi>p</mi></mrow> <annotation>$p$</annotation></semantics> </math> < 0.05).Conclusion: Two-way social support has a positive influence on rehabilitation exercise compliance in TKA patients, with psychological flexibility serving as a partial mediator. These findings suggest that healthcare professionals can improve patient compliance with rehabilitation protocols by fostering greater psychological flexibility.","PeriodicalId":46945,"journal":{"name":"Musculoskeletal Care","volume":"23 3","pages":"e70181"},"PeriodicalIF":1.6000,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Musculoskeletal Care","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1002/msc.70181","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"RHEUMATOLOGY","Score":null,"Total":0}

引用次数: 0

Abstract

Objective: This study aims to investigate the impact of two-way social support on rehabilitation exercise compliance among patients undergoing total knee arthroplasty and examine psychological flexibility's mediating role.

Design: Cross-sectional study.

Methods: A convenience sample of 266 total knee arthroplasty patients was recruited from the orthopaedic department of a tertiary hospital in Guiyang, Guizhou Province, between November 12, 2024, and March 20, 2025. Data were collected using standardised instruments, including a general demographic questionnaire, a brief two-way social support scale, a simplified multidimensional psychological flexibility inventory, and a rehabilitation exercise adherence scale. Amos 29.0 software was used to construct a structural equation model of the mediating effect of psychological flexibility between two-way social support and rehabilitation exercise compliance.

Results: Pearson correlation analysis revealed significant positive associations among two-way social support, psychological flexibility, and rehabilitation exercise compliance ( $r$ = 0.538-0.730, $p$ < 0.001). Mediation analysis demonstrated that two-way social support enhanced rehabilitation exercise compliance indirectly through increased psychological flexibility (effect size = 0.336, 95% $C I$ [0.253-0.442], $p$ < 0.05), accounting for 53.0% of the total effect. Additionally, a significant direct effect of two-way social support on rehabilitation exercise compliance was observed (effect size = 0.298, 95% $C I$ [0.181-0.432], $p$ < 0.05).

Conclusion: Two-way social support has a positive influence on rehabilitation exercise compliance in TKA patients, with psychological flexibility serving as a partial mediator. These findings suggest that healthcare professionals can improve patient compliance with rehabilitation protocols by fostering greater psychological flexibility.

查看原文本刊更多论文

心理柔韧性在全膝关节置换术患者双向社会支持与康复运动依从性关系中的中介作用。

目的：本研究旨在探讨双向社会支持对全膝关节置换术患者康复运动依从性的影响，并探讨心理灵活性的中介作用。设计：横断面研究。方法：于2024年11月12日至2025年3月20日在贵州省贵阳市某三级医院骨科招募266例全膝关节置换术患者作为方便样本。使用标准化工具收集数据，包括一般人口调查问卷、简短的双向社会支持量表、简化的多维心理灵活性量表和康复锻炼依从性量表。采用Amos 29.0软件构建心理灵活性在双向社会支持与康复训练依从性之间中介作用的结构方程模型。结果：Pearson相关分析显示，双向社会支持、心理灵活性与康复运动依从性之间存在显著正相关（r$ r$ = 0.538 ~ 0.730, p$ p$ C $\ mathm {C}\ mathm {I}$ [0.253 ~ 0.442], p$ p$ C $\ mathm {C}\ mathm {I}$ [0.181 ~ 0.432], p$ p$）。结论：双向社会支持对TKA患者康复运动依从性有正向影响，其中心理灵活性起部分中介作用。这些发现表明，医疗保健专业人员可以通过培养更大的心理灵活性来提高患者对康复方案的依从性。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

Musculoskeletal Care RHEUMATOLOGY-

CiteScore

2.30

自引率

7.70%

发文量

期刊介绍： Musculoskeletal Care is a peer-reviewed journal for all health professionals committed to the clinical delivery of high quality care for people with musculoskeletal conditions and providing knowledge to support decision making by professionals, patients and policy makers. This journal publishes papers on original research, applied research, review articles and clinical guidelines. Regular topics include patient education, psychological and social impact, patient experiences of health care, clinical up dates and the effectiveness of therapy.