Mediating effect of kinesiophobia between self-efficacy and physical activity levels in post-CABG patients: protocol for a prospective, multicentre, cross-sectional study in China

Abstract

IntroductionPhysical activity (PA) can improve cardiac function, exercise capacity, and quality of life, in addition to reducing mortality by 20%–30% and preventing the recurrence of adverse cardiovascular events in patients following coronary artery bypass graft (CABG). However, PA levels are low in patients after CABG. This study intends to explore the mediating effect of kinesiophobia between self-efficacy and PA levels in patients following CABG.Methods and analysisThe proposed study constitutes a prospective, multicentre and cross-sectional study comprising 413 patients. Four teaching hospitals with good reputations in CABG will be included in the study. All of them are located in Beijing, China, and provide medical service to the whole country. This study will assess the following patient-reported outcome measures: demographic information, International Physical Activity Questionnaire-Long, Social Support Rating Scale, Cardiac Exercise Self-Efficacy Instrument, Multidimensional Fatigue Inventory, Hospital Anxiety and Depression Scale, and Tampa Scale for Kinesiophobia Heart.Ethics and disseminationThis study conforms to the principles of the Declaration of Helsinki and relevant ethical guidelines. Ethical approval has been obtained from the Ethics Committee of The Sixth Medical Centre of PLA General Hospital (approval number: HZKY-PJ-2022–2). All study participants will provide written informed consent. Findings from this study will be published in Chinese or English for widespread dissemination of the results.Trial registration numberChinese Clinical Trial Register, ChiCTR2100054098.

Physical activity changes and related factors in chronic heart failure patients during the postdischarge transition period: a longitudinal study

“…According to the above results, kinesiophobia leads to maladaptive avoidance behavior, causing adverse health consequences such as physical inactivity. A previous study also confirmed that kinesiophobia was an essential mediator of PA in patients with cardiovascular disease [37], which was similar to our study results. These findings suggested that both CHF-related symptoms and kinesiophobia need to be identified and addressed as early as possible to avoid later deterioration of postdischarge transition PA.…”

Fear of Movement in Patients with Coronary Heart Disease: A Comprehensive Review

“…On the contrary, patients with low self-efficacy are more likely to feel frustrated when faced with difficulties and may choose to avoid or give up. Wang Yaxin [30] found that the lower the self-efficacy of patients with first-episode acute myocardial infarction, the higher their level of fear of movement, which is consistent with the results of other domestic studies [32][33][34] . Foreign studies [35] also emphasize the need to adopt intervention strategies to enhance the self-efficacy of patients with coronary heart disease to improve compliance with cardiac rehabilitation exercises.…”

Physical Activity Changes and Related Factors in Chronic Heart Failure Patients During the Post-Discharge Transition Period: A Longitudinal Study

“…In this study, kinesiophobia mediated the relationship between CHF-related symptoms and PA, implying that the association between CHF-related symptoms and PA was partially through the patients' fear of PA. Previous study has con rmed that kinesiophobia is an important mediator of PA in patients with cardiovascular disease 24 . This nding veri ed the FA model.…”