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Background <p>The aim of this study is to explore the mechanism of the role of kinesiophobia in patients with chronic obstructive pulmonary disease (COPD), to construct a structural equation model of the factors influencing kinesiophobia in patients with COPD, and to provide a theoretical basis for the development of targeted intervention strategies.</p> Methods <p>The cross-sectional design was conducted from December 2023 to July 2024, and middle-aged and elderly patients with COPD from a tertiary hospital in Guangzhou, China, were selected using convenience sampling. A general demographic information questionnaire, Breathlessness Beliefs Questionnaire scale (BBQ), modified Medical Research Council Dyspnea Scale (mMRC), Fatigue Scale (FS-14), Hospital Anxiety and Depression Scale (HADS), Self-Efficacy for Exercise (SEE), and Social Support Rating Scale (SSRS) were used for data collection. Spearman correlation analysis and structural equation modeling (SEM) were used for data analysis.</p> Results <p>A total of 278 COPD patients were included. Correlation analysis showed that dyspnoea (<i>r</i> = 0.689, <i>p</i> &lt; 0.01), fatigue (<i>r</i> = 0.731, <i>p</i> &lt; 0.01) and anxiety (<i>r</i> = 0.678, <i>p</i> &lt; 0.01) were significantly positively correlated with kinesiophobia, whereas social support (<i>r</i>=-0.518, <i>p</i> &lt; 0.01) and exercise self-efficacy (<i>r</i>=-0.740, <i>p</i> &lt; 0.01) were significantly negatively correlated with kinesiophobia. SEM analyses revealed six significant pathways of action: dyspnoea, exercise self-efficacy was a direct predictor of kinesiophobia. Fatigue, and social support were indirect predictors of kinesiophobia. Anxiety was a direct and indirect predictor of kinesiophobia.</p> Conclusions <p>Dyspnoea, fatigue, anxiety, social support and exercise self-efficacy are important predictors of kinesiophobia in COPD patients. Clinical interventions should focus on the synergistic effects of these five types of variables to establish a multidimensional and comprehensive management programme.</p> Trial registration <p>The protocol was reviewed by the Ethics Committee of the Third Affiliated Hospital of Guangzhou Medical University (Ethics Code: LCYJ-2023-055).</p>

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Influencing mechanisms of kinesiophobia in middle-aged and elderly patients with chronic obstructive pulmonary disease: a cross-sectional study

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  • 出版模式：

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  • 发表日期：

    2025年5月13日

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  • Yaru Wang,
  • Xiaofang Zou,
  • Chen Xiong,
  • Xiaoqiao Xie,
  • Guilian He

摘要

Background

The aim of this study is to explore the mechanism of the role of kinesiophobia in patients with chronic obstructive pulmonary disease (COPD), to construct a structural equation model of the factors influencing kinesiophobia in patients with COPD, and to provide a theoretical basis for the development of targeted intervention strategies.

Methods

The cross-sectional design was conducted from December 2023 to July 2024, and middle-aged and elderly patients with COPD from a tertiary hospital in Guangzhou, China, were selected using convenience sampling. A general demographic information questionnaire, Breathlessness Beliefs Questionnaire scale (BBQ), modified Medical Research Council Dyspnea Scale (mMRC), Fatigue Scale (FS-14), Hospital Anxiety and Depression Scale (HADS), Self-Efficacy for Exercise (SEE), and Social Support Rating Scale (SSRS) were used for data collection. Spearman correlation analysis and structural equation modeling (SEM) were used for data analysis.

Results

A total of 278 COPD patients were included. Correlation analysis showed that dyspnoea (r = 0.689, p < 0.01), fatigue (r = 0.731, p < 0.01) and anxiety (r = 0.678, p < 0.01) were significantly positively correlated with kinesiophobia, whereas social support (r=-0.518, p < 0.01) and exercise self-efficacy (r=-0.740, p < 0.01) were significantly negatively correlated with kinesiophobia. SEM analyses revealed six significant pathways of action: dyspnoea, exercise self-efficacy was a direct predictor of kinesiophobia. Fatigue, and social support were indirect predictors of kinesiophobia. Anxiety was a direct and indirect predictor of kinesiophobia.

Conclusions

Dyspnoea, fatigue, anxiety, social support and exercise self-efficacy are important predictors of kinesiophobia in COPD patients. Clinical interventions should focus on the synergistic effects of these five types of variables to establish a multidimensional and comprehensive management programme.

Trial registration

The protocol was reviewed by the Ethics Committee of the Third Affiliated Hospital of Guangzhou Medical University (Ethics Code: LCYJ-2023-055).