上海护理2025，Vol.25Issue(6)：43-48,6.DOI:10.3969/j.issn.1009-8399.2025.06.008
运动恐惧和康复自我效能在全膝关节置换术后患者疼痛灾难化与锻炼依从性间的链式中介效应分析
Analysis of the Chain Mediating Effect of Kinesiophobia and Rehabilitation Self-efficacy Between Pain Catastrophizing and Exercise Compliance in Patients Undergoing Total Knee Arthroplasty
摘要
Abstract
Objective To analyze the chain mediating effect of kinesiophobia and rehabilitation self-efficacy between pain catastrophizing and exercise compliance in patients undergoing total knee arthroplasty(TKA),aiming to provide a reference for developing targeted clinical interventions.Methods From October 2023 to October 2024,a total of 232 patients who underwent TKA at Nanjing Drum Tower Hospital Group Suqian Hospital were selected by convenience sampling.They were investigated using the General Information Questionnaire,Tampa Scale of Kinesiophobia,Self-Efficacy for Rehabilitation Outcome Scale,Functional Exercise Compliance Scale for Orthopedic Patients and Pain Catastrophizing Scale.Multiple linear regression identified factors influencing exercise compliance.The Pearson correlation test analyzed the correlation between variables.A structural equation model was used to evaluate the chain mediating effect of kinesiophobia and rehabilitation self-efficacy between pain catastrophizing and exercise compliance.Results Age,sex,education level,TKA history,kinesiophobia,pain catastrophizing,and rehabilitation self-efficacy were factors influencing exercise compliance in post-TKA patients(all P<0.05).Pain catastrophizing and kinesiophobia scores negatively correlated with exercise compliance and rehabilitation self-efficacy scores;rehabilitation self-efficacy scores positively correlated with exercise compliance scores;pain catastrophizing scores positively correlated with kinesiophobia scores(all P<0.001).The total indirect effect of kinesiophobia and rehabilitation self-efficacy accounted for 49.29%of the total effect;the mediating effect of kinesiophobia and rehabilitation self-efficacy accounted for 61.06%and 19.71%of the total indirect effect,respectively;the chain mediating effect of kinesiophobia and rehabilitation self-efficacy accounted for 19.23%of the total indirect effect.Conclusion Exercise compliance needs to be improved in post-TKA patients.Pain catastrophizing indirectly influences exercise compliance through multiple mediating effects of kinesiophobia and rehabilitation self-efficacy.关键词
运动恐惧/康复自我效能/关节成形术,置换,膝/疼痛灾难化/锻炼依从性/链式中介效应Key words
Kinesiophobia/Rehabilitation self-efficacy/Arthroplasty,replacement,knee/Pain catastrophiz-ing/Exercise compliance/Chain mediating effect分类
临床医学引用本文复制引用
闵敏,吴凡凡,吴莎莎..运动恐惧和康复自我效能在全膝关节置换术后患者疼痛灾难化与锻炼依从性间的链式中介效应分析[J].上海护理,2025,25(6):43-48,6.基金项目
2019年度宿迁市指导性科技计划项目(Z2019174). （Z2019174）
