Cross-cultural Adaptation And Validation Of Tampa Scale For Kinesiophobia Heart And Its Application In Patient With Coronary Heart Disease

Objective1.Introduce and translate the Tampa Scale for kinesiophobia Heart(TSK-Heart)according to the cultural background in China,and assess reliability and validity of the TSK-Heart to evaluate its applicability among patients with coronary heart disease(CHD)in China.2.Investigate the level of kinesiophobia in patients with CHD using the Chinese version of the TSK-Heart.And analyze its influencing factors to provide a basis for develop intervention programs to reduce the kinesiophobia in the future.Method1.After obtaining authorization from the TSK-Heart research team,the scale was translated by Brislin pre-translation-back translation method,and then was modified according to expert opinions and preliminary survey results to form a tentative Chinese version of the TSK-Heart.A total of 193 patients with CHD were selected to fill in the general information questionnaire and the tentative Chinese version of the TSK-Heart from 6 community health service centers in Changchun from November 2018 to April 2019 by convenient sampling method.Cronbach's ? was used to evaluate internal consistency reliability,Pearson correlation coefficient was used to assess test-retest reliability,item level content validity index(I-CVI)and scale level content validity index(S-CVI)were used to evaluate the content validity of the scale,and exploratory factor analysis was conducted to assess structure validity.Eventually,a Chinese version of the TSK-Heart will be formed.2.A total of 265 patients with CHD were selected to fill in the general information questionnaire,the Chinese version of TSK-Heart,9-item Patient Health Questionnaire,Generalized Anxiety Disorder,Exercise Self-Efficacy Scale and the Social Support Rating Scale from 6 community health service centers in Changchun from November 2018 to April 2019 by convenient sampling method.And the level of kinesiophobia in patients with CHD and its influencing factors were analyzed.Results1.The results of item analysis showed that item 5 and item 13 had poor identification and homogeneity.After deleting item 5 and item 13,the Chinese version of TSK-Heart contained 15 items,has a Cronbach's ? coefficient of 0.758 and a test-retest reliability coefficient of 0.89,which indicates good reliability.The Chinese version of TSK-Heart has good content validity with I-CVI range from 0.83 to 1,with a S-CVI of 0.90.Four factors were extracted by EFA for structural validity,which could explain 53.391% of the total variance.2.The total score of the TSK-Heart in patients with CHD range from 23 to 54,with an average score of 37.35±4.89.The scores of each dimension were: fear of injury(11.10±2.54),dysfunctional self(13.13±2.06),avoidance of exercise(7.75±1.32),and perceived danger for heart problem(5.37±0.95).3.The results of multiple stepwise regression analysis showed that depression,exercise self-efficacy,education and living status were independent influencing factors of fear of movement in patients with CHD.Conclusion1.The Chinese version of TSK-Heart has a good reliability and validity,which is suitable for CHD patients in China and provides a reliable measurement tool for the screening kinesiophobia in patients with CHD.2.The average score of kinesiophobia was high in patients with CHD,and most patients have kinesiophobia because of the uncomfortable symptoms or the recurrence of heart problems caused by exercise.3.Depression,exercise self-efficacy,education level and living status are important influencing factors of kinesiophobia in patients with CHD.Professionals should evaluate kinesiophobia in patients with CHD timely and develop effective intervention programs in the future.