| Objective:To investigate the level of postoperative patients with colorectal cancer,clarify the characteristics of the patients’ kinesiophobia under the cultural background of our country,explore the influence of general demographic factors and disease characteristics on the level of the patients’ kinesiophobia,and then determine the main influencing factors of postoperative patients with colorectal cancer,so as to provide reference for future clinical work to formulate intervention measures and avoid the occurrence of the patients’ kinesiophobia.Methods:This study is a mixed method study,which first carries out quantitative research and then qualitative research.Firstly,through the quantitative research process,the situation of postoperative patients with colorectal cancer was obtained.Then,through qualitative research,the related factors of postoperative patients with colorectal cancer were obtained through in-depth interviews with high-score cases with kinesiophobia.Quantitative research adopts cross-sectional research method,using questionnaires to investigate 199 patients,using the short form of phobia assessment,general self-efficacy scale,postoperative pain coping strategies,anxiety and depression scale for hospital use and pain digital scale as research tools.IBM SPSS Statistics22.0 was used to analyze the data,including descriptive analysis,one-way ANOVA,Pearson correlation analysis and multiple linear regression analysis.Qualitative research adopts phenomenological research method.Twelve postoperative patients with high scores of hypochondria and colorectal cancer are interviewed in depth.Claizzi’s seven-step analysis method is used to analyze the qualitative research data.Results:Quantitative results:①The postoperative patients with colorectal cancer scored 11-43 points,with an average of 27.61±7.28 points;②There were statistically significant differences in the scores of postoperative patients with colorectal cancer in different age,sex,education level,place of residence,marital status,operation mode and other complications(p<0.05).Specifically,the older the age,the higher the kinesiophobia score(F=7.220,p=0.001),and the kinesiophobia score of women is higher than that of men(t=2.524,p=0.012).The higher the education level,the lower the kinesiophobia score(F=33.08,p<0.001),and the phobia score of patients living in rural areas is higher than that of urban patients(F=28.28,p<0.001).Patients with spouses scored lower in kinesiophobia than those without spouses(F=5.260,P=0.002).The patients who underwent laparotomy had a higher kinesiophobia score than those who underwent laparoscopic surgery alone(F=77.90,p<0.001).Patients with complications scored higher in fear of movement than those without complications(F=35.147,p<0.001).③the results of correlation analysis between the score of kinesiophobia.and the Pearson of each scale in postoperative patients with colorectal cancer:it was related to the total score of postoperative coping strategies and the scores of distraction,bravery,neglect,disaster and reexplanation.It was negatively correlated with the total score of postoperative pain coping strategies(r=-0.739,p<0.01),distraction(r=-0.536,p<0.01),facing bravely(r=-0.718,p<0.01),neglect(r=-0.778,p<0.01),and reinterpretation(r=-0.800,p<0.01),and positively correlated with disaster(r=0.791,p<0.01).It was negatively correlated with general self-efficacy(r=0.856,p<0.01),positively correlated with anxiety(r=0.882,p<0.01),depression(r=0.836,p<0.01),and positively correlated with pain score(r=0.879,p<0.01).④the variables entering the equation in multivariate linear regression analysis were anxiety,general self-efficacy,depression,pain degree,postoperative pain coping strategy,education level and operation method,which could explain 92.1%of the variation of phobia.Anxiety,depression,pain degree and operation mode played a positive role in predicting agitation,while self-efficacy,postoperative pain coping strategies and education level played a negative role in the prediction of kinesiophobia.The influence of each variable on the level of kinesiophobia.from large to small is anxiety,depression,pain degree,general self-efficacy,postoperative pain coping strategy,education level,operation mode.Qualitative research results:The risk factors of kinesiophobia in postoperative patients with colorectal cancer include three themes and eight subthemes:theme one is the body’s coping style in the face of stressors,including avoidance behavior.lack of cognition,low self-efficacy and negative emotion;theme two is external factors,including anxiety from family members and uncertainty about activity-related safety conditions.Theme 3 is related to exogenous injury,including pain and dizziness and fatigue.Conclusion:①The level of postoperative kinesiophobia in patients with colorectal cancer is on the high side.②The level of postoperative kinesiophobia in patients with colorectal cancer is influenced by factors such as age,gender,education level,place of residence,marital status,operation mode and other complications.③The level of postoperative kinesiophobia in patients with colorectal cancer is negatively correlated with general self-efficacy and postoperative pain coping strategies.④The main predictors of anxiety,general self-efficacy,depression,pain degree,postoperative pain coping strategies,education level and operation mode are significantly positively correlated with anxiety,depression and pain numerical scores.Among them,anxiety,depression,pain degree and operation mode are positive predictors of anxiety,while general self-efficacy,postoperative pain coping strategies and education level are negative predictors of anxiety.⑤The protective factors of postoperative patients with colorectal cancer fear disorder include positive coping style,high education level,risk factors including operation avoidance behavior,excessive tension,low self-efficacy,anxiety and depression,anxiety from family members,uncertainty of activityrelated safety conditions,high degree of pain,dizziness and weakness,and operation methods related to open surgery. |
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