Objective To analyze the status quo and risk factors of early kinesiophobia in patients with ST-segment elevation myocardial infarction (STEMI) after percutaneous coronary intervention (PCI). Methods The clinical data of 150 patients with STEMI who received PCI in Nanjing First Hospital from January 2022 to January 2025 were retrospectively analyzed. Tampa Scale for Kinesiophobia (TSK) was used to evaluate the status quo of early kinesiophobia. According to the score, the patients were divided into kinesiophobia group (>37 points, n=63) and non-kinesiophobia group (≤37 points, n=87). The differences in age, education level, presence or absence of chronic disease, preoperative left ventricular ejection fraction level, marital status, smoking history, body mass index (BMI), complexity of coronary artery disease (SYNTAX score) and target vessel type were compared between the two groups. The General Self-Efficacy Scale (GSES), Social Support Rating Scale (SSRS) and Generalized Anxiety Disorder Scale (GAD)-2, and actively seeking rehabilitation guidance, disease awareness were counted in both groups, and univariate and multivariate logistic regression analyses were adopted. Pearson correlation coefficient was used to assess the correlation between Tampa score and GSES, SSRS and GAD-2 scores. Results The incidence rate of early kinesiophobia in STEMI patients after PCI was 42.00%. The proportions of patients with age≥60 years old, concurrent diabetes mellitus, preoperative LVEF level<40%, SYNTAX score≥33 points, GSES score≤20 points, SSRS score ≤30 points and GAD-2 score≥3 points in kinesiophobia group were higher than those in non-kinesiophobia group. After adjusting for gender, education level, concurrent hypertension, concurrent hyperlipidemia, marital status, smoking history, BMI, active inquiry about rehabilitation plan, and active confiding of psychological activities, multivariate analysis showed that age, concurrent diabetes mellitus, low LVEF level, high SYNTAX score, low GSES score, low SSRS score and high GAD-2 score were independent risk factors of early kinesiophobia in STEMI patients after PCI. Pearson correlation analysis showed that TSK score was positively correlated with GAD-2 score, and negatively correlated with GSES score and SSRS score. Conclusion The occurrence of early kinesiophobia after STEMI is closely related to the age, concurrent diabetes mellitus, preoperative LVEF level, SYNTAX score, anxiety, self-efficacy and social support. It is necessary to pay attention to the identification and intervention of high-risk patients, and relieve the anxiety of patients by enhancing the self-efficacy and social support level, so as to improve the postoperative rehabilitation effect.
Key words
ST segment elevation myocardial infarction /
percutaneous coronary intervention /
kinesiophobia /
self-efficacy /
social support /
anxiety
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References
[1] 刘冉, 王宗方, 杨洋, 等. 冠状动脉内注射重组人尿激酶原治疗急性ST段抬高型心肌梗死的疗效[J]. 西北药学杂志, 2023, 38(4): 174-178.
[2] 马龙飞, 韩新宇, 陈昌, 等. STEMI患者外周血单个核细胞中MAPK通路与炎症反应及PCI后无复流的关系[J]. 分子诊断与治疗杂志, 2024, 16(3): 526-529.
[3] ZHAO H, MIAO R, LIN F, et al.Drug-Coated Balloon in Primary Percutaneous Coronary Intervention[J]. J Interv Cardiol, 2023, 2023: 5210808.
[4] TAN P, XIE X, GUO M, et al.Effects of rehabilitation management on lifestyle and quality of life of patients with coronary heart disease after percutaneous coronary intervention based on behavior change theory[J]. Minerva Surg, 2023, 78(3): 261-266.
[5] WOOD L, BEJARANO G, CSIERNIK B, et sal. Pain catastrophising and kinesiophobia mediate pain and physical function improvements with Pilates exercise in chronic low back pain: a mediation analysis of a randomised controlled trial[J]. J Physiother, 2023, 69(3): 168-174.
[6] DUPUIS F, CHERIF A, BATCHO C, et al.The Tampa Scale of Kinesiophobia: A Systematic Review of Its Psychometric Properties in People With Musculoskeletal Pain[J]. Clin J Pain, 2023, 39(5): 236-247.
[7] 任鹏娜, 张月, 丁琳, 等. 运动恐惧在急性心肌梗死经皮冠状动脉介入治疗术后患者自我效能与运动依从性间的中介效应[J]. 解放军护理杂志, 2022, 39(1): 21-24.
[8] HELLERYD E, RAWSHANI A, RAWSHANI A, et al.Association between exercise load, resting heart rate, and maximum heart rate and risk of future ST-segment elevation myocardial infarction (STEMI)[J]. Open Heart, 2023, 10(2): e002307.
[9] SHAJRAWI A, KHALIL H, AL-SUTRY M, et al.Exercise Self-efficacy, Perceived Benefits, and Barriers to Exercise Among Patients Following Acute Myocardial Infarction[J]. J Cardiovasc Nurs, 2021, 36(4): E11-E19.
[10] 江苏省医学会心血管病学分会, 江苏省医师协会心血管内科医师分会, 江苏省医师协会心脏重症专业委员会, 等. 急性ST段抬高型心肌梗死溶栓治疗专家共识[J]. 中国介入心脏病学杂志, 2024, 32(7): 364-382.
[11] 喻茂文, 覃左丽, 汤洪波, 等. 基于RAAS与Syntax评分构建冠心病合并高血压患者PCI治疗近期预后的Nomogram预测模型[J]. 国际检验医学杂志, 2025, 46(6): 719-727.
[12] 胡文. 简体中文版TSK和FABQ量表的文化调适及其在退行性腰腿痛中的应用研究[D]. 上海: 第二军医大学, 2012.
[13] 王才康, 胡中锋, 刘勇. 一般自我效能感量表的信度和效度研究[J]. 应用心理学, 2001, 7(1): 37-40.
[14] 肖水源. 《社会支持评定量表》的理论基础与研究应用[J]. 临床精神医学杂志, 1994, (2): 98-100.
[15] 谢婷, 袁源, 雍桂珍, 等 GAD-2评估功能性消化不良患者伴焦虑状态的应用研究[J]. 胃肠病学和肝病学杂志, 2021, 30(6): 643-647.
[16] 张亚楠, 李利侠, 李红影, 等. 非ST段抬高心肌梗死PCI治疗后患者疾病感知对遵医行为的影响[J]. 湖南师范大学学报 (医学版), 2022, 19(1): 275-278.
[17] 许亚平, 吴静, 唐晓磊. 白细胞/平均血小板体积比值 (WMR), 纤维蛋白原/白蛋白比值 (FAR) 在预测急性ST段抬高型心肌梗死预后临床价值[J]. 湖南师范大学学报: 医学版, 2022, 19(1): 5.
[18] LI Q, YAN L, XING W, et al.The effect of fear-avoidance intervention on kinesiophobia and self-efficacy in patients after percutaneous coronary intervention: study protocol for a clinical randomized controlled trial[J]. Trials, 2024, 25(1): 517.
[19] ZHU Y, WANG Z, SU T, et al.Kinesophobia and its related factors in patients after percutaneous coronary intervention: A cross-sectional study[J]. J Clin Nurs, 2024, 33(12): 4692-4707.
[20] 张程, 王霄一, 杨文娟, 等. 双向社会支持在老年维持性血液透析患者中的应用研究[J]. 中华护理杂志, 2025, 60(07): 813-819.
[21] 张田岳, 李爱丽, 朱碧云, 等. 二元应对在脑卒中后运动障碍患者配偶领悟社会支持和家庭关系间的中介效应[J]. 中华行为医学与脑科学杂志, 2025, 34(02): 158-163.
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