Kinesiophobia mediates the influences on attendance at exercise-based cardiac rehabilitation in patients with coronary artery disease
Kinesiophobia mediates the influences on attendance at exercise-based cardiac rehabilitation in patients with coronary artery disease
复制标题
DOI：
10.1080/09593985.2016.1229828
复制
发表时间：
2016-11-01
影响因子：
2
通讯作者：
Jansson, Bengt
中科院分区：
文献类型：
--
作者：
Back, Maria;Cider, Asa;Jansson, Bengt
目的：确定参加运动心脏康复(CR)的预测因素，并检验运动恐惧症对冠心病患者参加运动心脏康复(CR)的影响的假设。患者：瑞典Sahlgrenska大学医院共招募了332名确诊为冠心病的患者(75名女性，平均年龄65岁+/-9.1岁)。方法：对患者进行客观测量、自评心理测量和体力活动水平测试。通过运动恐惧症的直接和间接影响的路径模型被用来预测参与CR。对有意义的预测因子进行了探索性选择。结果：目前冠状动脉搭桥术的发生率(p<；0.001)和ST段抬高心肌梗死的诊断(p=0.004)增加了CR患者的就诊率，而运动恐惧症(p=0.001)减少了就诊率。作为中介变量，运动恐惧症受到四个预测因子的影响，并发现了以下间接效应。一般健康和肌肉耐力增加了去CR就诊的可能性，而自我评估的焦虑和当前心力衰竭的发生率则起到了相反的作用。结论：这项研究表明运动恐惧症对CR的就诊率有影响并起到中介作用。这一结果还需要结合临床实践进一步研究。
Purpose: To identify predictors of attendance at exercise-based cardiac rehabilitation (CR) and to test the hypothesis that kinesiophobia mediates the influence on attendance at CR in patients with coronary artery disease (CAD). Patients: In total, 332 patients (75 women; mean age 65 +/- 9.1 years) with a diagnosis of CAD were recruited at Sahlgrenska University Hospital, Sweden. Methods: The patients were tested in terms of objective measurements, self-rated psychological measurements, and level of physical activity. A path model with direct and indirect effects via kinesiophobia was used to predict participation in CR. An exploratory selection of significant predictors was made. Results: A current incidence of coronary bypass grafting (p < 0.001) and a diagnosis of ST-elevation myocardial infarction (p = 0.004) increased the probability of attendance at CR, while kinesiophobia (p = 0.001) reduced attendance. As a mediator, kinesiophobia was influenced by four predictors and the following indirect effects were found. General health and muscle endurance increased the probability of attendance at CR, while self-rated anxiety and current incidence of heart failure had the opposite effect. Conclusions: This study suggests that kinesiophobia has an influence on and a mediating role in attendance at CR. The results need to be further investigated in relation to clinical practice.