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

Abstract 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 basi...

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Main Authors: Yaru Wang, Xiaofang Zou, Chen Xiong, Xiaoqiao Xie, Guilian He
Format: Article
Language:English
Published: BMC 2025-05-01
Series:BMC Pulmonary Medicine
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Online Access:https://doi.org/10.1186/s12890-025-03699-6
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Summary:Abstract 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).
ISSN:1471-2466