Effects of perceived disease control and exercise self-efficacy on kinesiophobia in patients with heart failure: a longitudinal study / 中国实用护理杂志

ABSTRACT

Objective:To explore the status of kinesiophobia in patients with heart failure during discharge transition period, and analyze its changing trend and influencing factors.Methods:The189 patients with heart failure treated in Henan Provincial People′s Hospital from February 2020 to April 2021 were conveniently selected as the research objects. The general situation questionnaire, the Tampa Scale for Kinesiophobia Heart, the Self-efficacy for Exercise Scale and the Control Attitudes Scale-Revised were used to investigate the patients 2-3 days before leaving the hospital, 1 month and 4 months after discharge.Results:The score of patients′ kinesiophobia deteriorated slightly from 2-3 days before discharge (48.62 ± 11.26) to 1 month after discharge (49.03 ± 11.24), and decreased with the extension of the transition time to 4 months after discharge (47.86 ± 11.11). The overall trend of improvement was statistically significant ( F = 17.92, P<0.01). The score of perceived disease control also showed the same change pattern, 2-3 days before discharge (27.34 ± 7.40), 1 month after discharge (26.18 ± 7.39), 4 months after discharge (27.76 ± 7.38), the difference was statistically significant ( F = 38.41, P<0.01). The score of the exercise self-efficacy of 4 months after discharge (35.63 ± 11.51) was higher than (34.00 ± 11.88) of 2-3 days before discharge and (34.20 ± 11.69) of 1 month after discharge ( F = 12.33, P<0.01). The generalized estimation equation showed that exercise self-efficacy ( B = -0.255, P<0.01) and perceived disease control ( B = -0.439, P<0.01) were protective factors of kinesiophobia in patients with heart failure. Path analysis showed that perceived disease control could not only directly predict patients′ kinesiophobia ( β = -0.461, P<0.01), but also indirectly affect patients′ kinesiophobia by acting on exercise self-efficacy (mediating effect = -0.21, 95% CI -0.293 - -0.136). The mediating effect accounted for 31% of the total effect. Conclusions:The kinesiophobia, perceived disease control and exercise self-efficacy in patients with heart failure during discharge transition were dynamic. Perceived disease control could not only directly predict patients′ kinesiophobia, but also indirectly affect it by acting on exercise self-efficacy. Nursing staff can develop nursing interventions based on perceived disease control or exercise self-efficacy to reducethe level of kinesiophobia inheart failure patients.