| BackgroundAcute myocardial infarction（AMI）is one of the acute and critical diseases that pose a serious threat to the life and health of Chinese residents.Because patients still have the possibility of recurrence after receiving myocardial reperfusion therapy,patients have kinesiophobia easily.Early exercise training can improve the cardiac function status and disease prognosis of patients after myocardial reperfusion.Kinesiophobia not only reduces the exercise rehabilitation effect,but also increases the risk of recurrence.At present,the research on kinesiophobia of heart disease at home and abroad is in its infancy,and few related studies focus on patients with AMI after myocardial reperfusion.Therefore,exploring the influencing factors of kinesiophobia after myocardial reperfusion in patients with AMI is essential to formulate effective measures to help patients improve their rehabilitation outcomes.ObjectivesTo understand the status quo of kinesiophobia in patients with first AMI after myocardial reperfusion,and analyze its influencing factors;through qualitative research,to deeply understand the real feelings of patients with first AMI after myocardial reperfusion with high-level kinesiophobia,and to explore the reasons for the formation of high-level kinesiophobia in patients,in order to provide the reference for comprehensive nursing intervention strategies to reduce the level of kinesiophobia,increase the participation rate of exercise rehabilitation,and improve the prognosis of the disease in patients with first AMI after myocardial reperfusion.Methods1.Convenience sampling method was used to select 360 patients with first AMI after myocardial reperfusion who were hospitalized in three tertiary grade A hospitals in Xinxiang City,Henan Province from October 2020 to September 2021 as the research subjects.The general information questionnaire,Tampa scale for kinesiophobia heart,stanford acute stress reaction questionnaire,general self-efficacy scale and social support rating scale were used for questionnaire survey.Descriptive analysis,independent sample t test,one-way ANOVA test,Pearson correlation analysis and multiple linear regression analysis were performed using SPSS25.0software.2.Using the objective sampling method,14 patients with first AMI after myocardial reperfusion with high level of motor fear who were hospitalized in a tertiary grade A hospital in Xinxiang City,Henan Province were selected as the research objects,and a one-half structured interview was conducted to refine the theme.Results1.The total score of kinesiophobia in patients with first AMI after myocardial reperfusion was（47.57±9.27）points,of which 86.26% had a total score of more than37 points.The exercise avoidance dimension has the highest score among the four dimensions（13.32±4.22）points,the motor fear dimension is（12.02±2.67）points,the risk perception dimension is（11.77±2.03）points,and the dysfunction dimension is（10.46±2.39）points.2.The total score of acute stress disorder in patients with first AMI after myocardial reperfusion was（21.41±14.13）points.The total score of self-efficacy was（21.25±4.58）points,which was at a medium level.The total score of social support was（43.88±6.92）points,which was at a medium level.3.The results of univariate analysis showed: different gender,age,education level,place of residence,number of children,occupational status,per capita monthly income of the family,medical payment method,body mass index classification,cardiac function Killip grade,smoking history,drinking history,The number of comorbidities and myocardial reperfusion pattern were significantly different in kinesiophobia score（P<0.05）.4.The results of Pearson correlation analysis showed that acute stress disorder was positively correlated with kinesiophobia（P<0.01）,self-efficacy and social support was negatively correlated with kinesiophobia（P<0.01）.5.The results of multiple linear regression analysis showed that occupational status,myocardial reperfusion pattern,acute stress disorder and self-efficacy were the influencing factors of kinesiophobia in patients with first AMI after myocardial reperfusion（P<0.05）,which could explain 40.70% of the total variance.6.The causes of high level kinesiophobia in patients with first AMI after myocardial reperfusion can be summarized into two major themes: individual internal factors and external factors.Individual internal factors include five subthemes:insufficient awareness of exercise rehabilitation,avoidance of stress events,negative emotions,over-awareness of one’s own physical state,and low exercise self-efficacy.External factors include three subthemes: lack of family support,inaccurate medical information or guidance,and medical financial burden.Conclusions1.The kinesiophobia in patients with first AMI after myocardial reperfusion is at a high level.Occupational status,myocardial reperfusion mode,acute stress disorder,and self-efficacy are the influencing factors of kinesiophobia in patients with first AMI after myocardial reperfusion.2.Insufficient awareness of exercise rehabilitation,psychological and environmental causes contribute to high level of kinesiophobia in patients with first AMI after myocardial reperfusion. |
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