Mediating effect of self-efficacy for exercise on social support and kinesiophobia in patients with rheumatoid arthritis
SUN Xuejing1, WANG Liqin2, GAO Zhaohong2, DI Zhiyue2
1. Graduate School, Heilongjiang University of Chinese Medicine, Harbin, Heilongjiang 150040, China; 2. The First Affiliated Hospital of Heilongjiang University of Chinese Medicine, Harbin, Heilongjiang 150040, China
Abstract：Objective To explore the mediating effect of self-efficacy for exercise on social support and kinesiophobia in patients with rheumatoid arthritis (RA), so as to provide insights into alleviating fear for exercise and formulating exercise intervention programs. Methods RA patients hospitalized in a tertiary hospital in Harbin City from June to December 2023 were selected, and the levels of kinesiophobia, self-efficacy for exercise and social support were investigated using the Tampa Scale of Kinesiophobia (Chinese version), the Self-Efficacy for Exercise and the Social Support Rating Scale, respectively. The mediating effect of self-efficacy for exercise on social support and kinesiophobia was examined using a structural equation model. Results A total of 216 people were investigated, including 45 males (20.83%) and 171 females (79.17%), with the median age of 54.00 (interquartile range, 13.75) years. There were 159 of patients living in the urban areas, accounting for 73.61%. There were 102 of patients with a disease course of 1 to 5 years, accounting for 47.22%. The median scores of kinesiophobia, self-efficacy for exercise and social support were 31.00 (interquartile range, 5.00), 5.00 (interquartile range, 2.00) and 39.50 (interquartile range, 17.00), respectively. Social support had a direct negative effect on kinesiophobia (effect value=-0.358, P<0.05) and a indirect negative effect on kinesiophobia through self-efficacy for exercise (effect value=-0.887, P<0.05), and the mediating effect contributed 93.86% to the total effect. Conclusion Social support can directly or indirectly influence kinesiophobia through self-efficacy for exercise among patients with RA.
孙学菁, 王丽芹, 高兆虹, 邸之悦. 类风湿关节炎患者运动自我效能在社会支持与运动恐惧间的中介效应分析[J]. 预防医学, 2024, 36(5): 378-382.
SUN Xuejing, WANG Liqin, GAO Zhaohong, DI Zhiyue. Mediating effect of self-efficacy for exercise on social support and kinesiophobia in patients with rheumatoid arthritis. Preventive Medicine, 2024, 36(5): 378-382.
[1] LI Z,WANG X Q.Clinical effect and biological mechanism of exercise for rheumatoid arthritis:a mini review[J/OL].Front Immunol,2023,13[2024-04-10].http://doi.org/10.3389/fimmu.2022.1089621. [2] SMOLEN J S,ALETAHA D,MCINNES I B.Rheumatoid arthritis[J].Lancet,2016,388(10055):2023-2038. [3] ENGLAND B R,SMITH B J,BAKER N A,et al.2022 American college of rheumatology guideline for exercise,rehabilitation,diet,and additional integrative interventions for rheumatoid arthritis[J].Arthritis Care Res(Hoboken),2023,75(8):1603-1615. [4] HISHIKAWA N,TOYAMA S,SHIMAHARA N,et al.A home-based low-intensity resistance exercise programme with supervision for secondary sarcopenia in a patient with established rheumatoid arthritis:a case report[J].Mod Rheumatol Case,2023,7(2):354-358. [5] 李慧君,贾雯鼎,刘云,等.老年冠心病患者自我效能现状及影响因素分析[J].齐鲁护理杂志,2024,30(1):50-52. [6] 赵燕乐,李转珍,李旭春,等.冠心病特异性生活质量评估工具西雅图心绞痛量表的应用研究进展[J].全科护理,2023,21(9):1191-1195. [7] 郑宇,陈静,先媛媛,等.社会支持在类风湿关节炎患者自我效能与自我管理行为间的中介效应[J].临床护理杂志,2023,22(6):6-10. [8] ACAR S,SAVCI S,KESKINOĞLU P,et al.Tampa Scale of Kinesiophobia for Heart Turkish Version Study:cross-cultural adaptation,exploratory factor analysis,and reliability[J].J Pain Res,2016,9:445-451. [9] BRUNETTI N D,GUERRA A,IEVA R,et al.Scared for the scar:fearsome impact of acute cardiovascular disease on perceived kinesiophobia(fear of movement)[J].Clin Cardiol,2017,40(7):480-484. [10] FURER V,RONDAAN C,HEIJSTEK M W,et al.2019 update of EULAR recommendations for vaccination in adult patients with autoimmune inflammatory rheumatic diseases[J].Ann Rheum Dis,2020,79(1):39-52. [11] 刘阳,林坚,李海龙,等.神经根型颈椎病患者颅颈屈曲训练联合颈椎牵引干预效果评价[J].预防医学,2023,35(2):104-107. [12] 林永鸿.来氟米特联合甲氨蝶呤治疗类风湿性关节炎的疗效及对关节功能分级的影响探讨[J].中国现代药物应用,2023,17(2):11-15. [13] 蔡立柏,刘延锦,徐秋露,等.恐动症评估简表中文版在全膝关节置换患者中应用的信效度研究[J].中华行为医学与脑科学杂志,2019,28(3):270-274. [14] LEE L L,PERNG S J,HO C C,et al.A preliminary reliability and validity study of the Chinese version of the Self-efficacy for Exercise Scale for older adults[J].Int J Nurs Stud,2009,46(2):230-238. [15] 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,1994,6(2):98-100. [16] 杨娟华,郎啟智,李丹,等.积极应对方式在医学生健康素养与生活方式间的中介效应分析[J].预防医学,2024,36(3):189-192,197. [17] 徐云辉,应丹丹,杨静.中青年脑卒中患者功能锻炼依从性研究[J].预防医学,2023,35(2):171-175. [18] 于甜栖,孙国珍,高敏,等.运动自我效能在慢性心力衰竭患者运动恐惧与运动康复依从性间的中介效应[J].现代预防医学,2022,49(22):4163-4168.
