Hongyun Li, Lan Li, Dan Wang, Xin Li, Jing Li, Guilan Chen
{"title":"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。","authors":"Hongyun Li, Lan Li, Dan Wang, Xin Li, Jing Li, Guilan Chen","doi":"10.1002/msc.70181","DOIUrl":null,"url":null,"abstract":"<p><strong>Objective: </strong>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.</p><p><strong>Design: </strong>Cross-sectional study.</p><p><strong>Methods: </strong>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.</p><p><strong>Results: </strong>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).</p><p><strong>Conclusion: </strong>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.</p>","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":"{\"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\":\"<p><strong>Objective: </strong>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.</p><p><strong>Design: </strong>Cross-sectional study.</p><p><strong>Methods: </strong>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.</p><p><strong>Results: </strong>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).</p><p><strong>Conclusion: </strong>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.</p>\",\"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}","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}
The Mediating Effect of Psychological Flexibility in the Relationship Between Two-Way Social Support and Rehabilitation Exercise Adherence in Patients With Total Knee Arthroplasty.
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 ( = 0.538-0.730, < 0.001). Mediation analysis demonstrated that two-way social support enhanced rehabilitation exercise compliance indirectly through increased psychological flexibility (effect size = 0.336, 95% [0.253-0.442], < 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% [0.181-0.432], < 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.
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.
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