Analysis Of Influencing Factors Of Kinesiophobia In Patients After PCI And Construction Of Exercise Management Program

ObjectiveTo explore the influencing factors of Kinesiophpbia in patients after PCI,and construct exercise management program for Kinesiophpbia patients after PCI,in order to provide reference for medical staff to intervene in Kinesiophpbia in patients after PCI.MethodsThis study consists of three parts1.Quantitative study: the convenience sampling method was used to select the patients in the Department of Cardiology after PCI for inpatient treatment or outpatient reexamination in a tertiary Class A general hospital in Qingdao.The self-designed general data questionnaire,Tampa Scale for Kinesiophobia Heart,Questionnaire of Rehabilitation Exercises for Coronary Heart Disease Patients,Generalized Anxiety Disorder Questionnaire,Medical Coping Modes Questionnaire and Social Support Rating Scale were used for the survey.Descriptive analysis,two-independent t-test,one-way ANOVA,Pearson correlation analysis,and multiple linear regression analysis were performed using SPSS Statistics software(version 26.0).2.Qualitative research : 11 patients with Kinesiophobia score > 37 points were selected as interview subjects by objective sampling method.Face-to-face semi-structured interviews were conducted to refine the themes.3.Construction of exercise management program: According to the integration results of quantitative,qualitative research and literature review,the draft of exercise management program is constructed based on the theory of protection motivation,and the final program of exercise management is formed through expert meeting.Results1.The first part is the result of quantitative research.(1)A total of 246 patients after PCI were included in this study,including 59 females(24.0%)and 187 males(76.0%),ranging in age from 35 to 85 years.(2)The total score of Kinesiophobia after PCI was(43.02±4.78).The average score of motor fear,exercise avoidance,risk perception,and dysfunction were(2.75±0.41),(2.30±0.35),(2.65±0.32)and(2.47±0.44)respectively.(3)Result of the univariate analysis showed that there were significant difference in score of Kinesiophobia of patients after PCI with different gender,age,marital status,education level,occupation,medical insurance payment method and the number of hypertension/diabetes patients.(P < 0.05).(4)The results of correlation analysis showed that Kinesiophobia was negatively correlated with knowledge,belief and behavior of rehabilitation exercise,face coping mode and social support(P < 0.01).Kinesiophobia was positively correlated with anxiety,avoidance coping mode and yielding coping mode(P < 0.01).(5)The results of multiple linear regression analysis showed that education level,retirement or turnover,rehabilitation exercise knowledge and behavior,anxiety,avoidance and face coping mode enter into the regression equation,accounting for 41.7% of the total variation.2.Qualitative research results.The influencing factors of Kinesiophobia after PCI include three themes:environmental factors,individual factors and disease-related factors.Environmental factors include inadequate social support,cold weather and lack of sports facilities.The individual factors included the wrong cognition of disease or sports,low self-efficiency in sports,negative emotion and heavy self-perceived burden.Disease-related factors included comorbidities and disease experience.The demand analysis of exercise education for patients after PCI can be summarized into four themes: object of educator,the educated,educational content and educational form.3.Result of construction programIn this study,based on quantitative,qualitative research and literature review results,a preliminary program of Kinesiophobia and exercise management for patients after PCI was constructed,and 10 experts were invited to discuss the preliminary program.The authority coefficient of the expert group was 0.880,and a total of 8 suggestions were put forward.After the revision,the final draft was formed,including 7 intervention topics and35 intervention contents.Conclusions1.The level of Kinesiophobia in Chinese patients after PCI is at a high level,and education level,retirement or turnover,knowledge and practice of rehabilitation exercise,anxiety,avoidance and face coping mode are influencing factors of exercise fear.2.Lack of social support,weather and sports facilities,misperception of disease or sports,low self-efficacy in sports,negative emotion,heavy burden of self-perception,complications and disease experience can affect Kinesiophobia of patients after PCI.Patients’ educational needs can be incorporated into the construction plan according to the objects,personnel,contents and forms of education.3.Exercise fear management program for patients after PCI,including 7 intervention topics and 34 intervention contents,can provide reference for the majority of medical personnel to implement Kinesiophobia intervention measures.