Prevalence of Kinesiophobia and Associated Factors Among Patients After Percutaneous Coronary Intervention: A Multicenter Cross‐Sectional Study
Chunyuan Wang, Xiaoqin Hou, Pian Zhang, Caiyang Liu, Yi Yang, Zhenhua Zhao, Weijun Jiang, Guanfu Su, Xiaofang Jiang, Lijuan Lin, Libing Ning, Lixia Lin, Lechang Zhan, Jie ZhanABSTRACT
Aim
To investigate the prevalence and associated factors of kinesiophobia after percutaneous coronary intervention (PCI).
Design
A multicenter cross‐sectional study.
Methods
We collected data of post‐PCI patients who were recruited via convenience sampling from cardiology departments of eight tertiary hospitals between 1 November 2022 and 31 December 2023. Kinesiophobia was assessed by the Tampa Scale for Kinesiophobia Heart (TSK‐SV Heart). Exercise self‐efficacy, depression, anxiety, stress, and social support were evaluated by validated instruments. Participants' demographic and objective socioeconomic factors were also collected. Binary logistic regression analysis was conducted to identify the associated factors of kinesiophobia.
Results
Of 1145 recruited patients, 970 (84.72%) provided complete data and were included in the final analysis, of which 780 (80.41%) exhibited kinesiophobia. Factors significantly associated with kinesiophobia in the binary logistic regression analysis included: single status (vs. married: OR = 0.42, 95% CI: 0.22–0.79, p = 0.008), retired (vs. freelancers: OR = 1.89, 95% CI: 1.22–2.93, p = 0.004), had beyond 3 children (vs. 1 child: OR = 0.68, 95% CI: 0.46–0.99, p = 0.045), generally familiar with illness (vs. not familiar: OR = 2.00, 95% CI: 1.37–2.93, p < 0.001), comorbid hypertension (vs. no hypertension: OR = 1.49, 95% CI: 1.05–2.13, p = 0.028), participated in cardiac rehabilitation (vs. did not participate: OR = 1.52, 95% CI: 1.06–2.19, p = 0.023), moderate physical activity (vs. low: OR = 0.64, 95% CI: 0.42–0.97, p = 0.034), and high physical activity (vs. low: OR = 0.40, 95% CI: 0.25–0.65, p < 0.001) were significantly associated with kinesiophobia occurrence ( p < 0.05). For each one‐point increase in stress, anxiety, and objective support, the odds of kinesiophobia increased by 9% (OR = 1.09, 95% CI: 1.02–1.15, p = 0.008), 21% (OR = 1.21, 95% CI: 1.12–1.29, p < 0.001), and 9% (OR = 1.09, 95% CI: 1.01–1.19, p = 0.027), respectively. For each one‐point increase in depression and SEE‐C score, the odds of kinesiophobia decreased by 11% (OR = 0.89, 95% CI: 0.84–0.96, p = 0.001) and 1% (OR = 0.99, 95% CI: 0.98–0.99, p < 0.001), respectively.
Conclusion
Kinesiophobia is highly prevalent among post‐PCI patients. Identified associated factors include marital status, occupational status, number of children, illness familiarity, hypertension comorbidity, cardiac rehabilitation participation, physical activity level, levels of psychological distress, objective support, and exercise self‐efficacy. These findings highlight potential targets for intervention.
Implications for the Profession and Patient Care
Nurses should integrate routine kinesiophobia screening using the TSK‐SV Heart scale into post‐PCI assessment protocols. Risk‐stratified screening should prioritize married or retired patients, those with fewer than three children, individuals with hypertension, and those with low baseline physical activity. For patients with low exercise self‐efficacy, nurses can use motivational interviewing; for those with elevated anxiety or stress, collaborative cognitive‐behavioural therapy is recommended. These nursing actions can reduce kinesiophobia and improve cardiac rehabilitation adherence.
Impact
What problem did the study address?
Kinesiophobia is a common but under‐recognized barrier to cardiac rehabilitation in post‐PCI patients, yet its prevalence and modifiable factors in Chinese populations remain poorly understood.
What were the main findings?
The prevalence of kinesiophobia was 80.41%. Independent associated factors included marital status, retirement, number of children, illness familiarity, hypertension, cardiac rehabilitation participation, physical activity level, anxiety, stress, depression, objective support, and exercise self‐efficacy.
Where and on whom will the research have an impact?
The findings directly inform cardiac nursing practice in China and similar settings, enabling nurses to identify high‐risk patients and implement targeted psychosocial interventions.
Reporting Method
This study adhered to the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) guideline for cross‐sectional observational studies.
Patient or Public Contribution
No patient or public contributed to the design, conduct, analysis, or interpretation of this study.
Trial Registration
This observational study was registered in the Chinese Clinical Trial Registry (No. ChiCTR2300070396;