冠心病患者运动恐惧发生率及影响因素的Meta分析

doi:10.3761/j.issn.1672-9234.2024.05.016

摘要/Abstract

摘要：

目的对冠心病患者运动恐惧的发生率及影响因素进行Meta分析。方法检索PubMed、Cochrane Library、Web of Science、Embase、CINAHL、中国知网、中国生物医学文献数据库、万方及维普数据库中有关冠心病患者运动恐惧发生率和（或）影响因素的文献，检索时限为建库至2023年9月。2名研究者独立进行文献筛选、资料提取、方法学质量评价后，采用Stata 16.0软件进行Meta分析。结果共纳入27篇文献，包含6 051例患者。Meta分析结果显示，冠心病患者运动恐惧发生率为64%[95%CI（0.54，0.73）]。性别（OR=3.387）、自我效能得分（OR=0.697）、心功能分级（OR=2.381）、自我感受负担得分（OR=1.555）、疼痛评分（OR=1.352）、病程（OR=0.701）、是否合并心力衰竭（OR=2.065）、心理弹性程度（OR=0.513）、焦虑得分（OR=1.189）是冠心病患者运动恐惧的影响因素（P<0.05）。结论冠心病患者运动恐惧发生率较高，且其发生受社会人口学因素、疾病相关因素、心理因素的影响。医护人员应基于上述影响因素尽早识别运动恐惧高危人群，并通过制订、实施针对性的干预措施，减少冠心病患者运动恐惧的发生，减轻运动恐惧对冠心病患者造成的不利影响。

关键词: 冠心病, 运动恐惧, 影响因素, Meta分析

Abstract:

Objective To systematically review the incidence and influencing factors of kinesiophobia in patients with coronary disease. Methods The databases including PubMed，Cochrane Library，Web of Science，Embase，CINAHL，CNKI，CBM，WanFang Data and VIP were searched from the date of their inception to September 2023. Studies were retrieved including cross-sectional studies，cohort studies or case-control studies reporting associated factors of kinesiophobia in patients with coronary disease. After that，two researchers independently screened the literature and performed quality evaluation and data extraction. Stata 16.0 was used for Meta-analysis. Results A total of 27 articles were included，covering 6 051 respondents. The detection rate of kinesiophobia was 64%[95%CI（0.54， 0.73）]. Gender（OR=3.387），self-efficacy score（OR=0.697），cardiac function rating（OR=2.381），self-perceived burden score（OR=1.555），pain score（OR=1.352），duration of disease（OR=0.701），heart failure was combined（OR=2.065），psychological resilience（OR=0.513），and anxiety score（OR=1.189） were found to be the influencing factors of kinesiophobia in patients with coronary disease（P<0.05）. Conclusion The incidence of kinesiophobia in patients with coronary disease is high. Sociodemographic factors，disease-related factors，and psychological factors are the main factors of kinesiophobia in patients with coronary disease. Health care providers should identify high-risk individuals for kinesiophobia as early as possible based on these factors，develop and implement targeted interventions to reduce the occurrence of kinesiophobia in patients with coronary heart disease and mitigate its adverse effects on these individuals.

Key words: Coronary Disease, Kinesiophobia, Influencing factors, Meta-analysis

沈玉珊, 刘凤, 陈梦玲, 游俊杰, 刘波, 郑思琳. 冠心病患者运动恐惧发生率及影响因素的Meta分析[J]. 中华护理教育, 2024, 21(5): 606-612.

SHEN Yushan, LIU Feng, CHEN Mengling, YOU Junjie, LIU Bo, ZHENG Silin. Incidence and influencing factors of kinesiophobia in patients with coronary disease:a meta-analysis[J]. Chinese Journal of Nursing Education, 2024, 21(5): 606-612.

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参考文献 38

[1]	中国心血管健康与疾病报告编写组. 中国心血管健康与疾病报告2021概要[J]. 中国循环杂志, 2022, 37(6):553-578.
[2]	Premkumar S, Ramamoorthy L, Pillai AA. Impact of nurse-led cardiac rehabilitation on patient’s behavioral and physiological parameters after a coronary intervention:a pilot randomized controlled trial[J]. J Family Community Med, 2022, 29(1):17-23. doi: 10.4103/jfcm.jfcm_315_21 pmid: 35197724
[3]	Dibben GO, Faulkner J, Oldridge N, et al. Exercise-based cardiac rehabilitation for coronary heart disease:a meta-analysis[J]. Eur Heart J, 2023, 44(6):452-469. doi: 10.1093/eurheartj/ehac747 pmid: 36746187
[4]	Kori S. Kinesiophobia:a new view of chronic pain behaviour[J]. Pain Manag, 1990,3:35-43.
[5]	Bäck M, Cider Å, Herlitz J, et al. The impact on kinesiophobia (fear of movement) by clinical variables for patients with coronary artery disease[J]. Int J Cardiol, 2013, 167(2):391-397. doi: 10.1016/j.ijcard.2011.12.107 pmid: 22305808
[6]	Çakal B, Yıldırım M, Emren SV. Kinesiophobia,physical perfor-mance,and health-related quality of life in patients with coronary artery disease[J]. Postepy Kardiol Interwencyjnej, 2022, 18(3):246-254.
[7]	Bäck M, Cider Å, Herlitz J, et al. Kinesiophobia mediates the influences on attendance at exercise-based cardiac rehabilita-tion in patients with coronary artery disease[J]. Physiother Theory Pract, 2016, 32(8):571-580.
[8]	黄蓉, 丁梅, 黄华华, 等. 运动自我效能在冠心病患者运动恐惧和体育活动量间的中介作用[J]. 中华护理教育, 2022, 19(12):1119-1123.
[9]	曾宪涛, 刘慧, 陈曦, 等. Meta分析系列之四:观察性研究的质量评价工具[J]. 中国循证心血管医学杂志, 2012, 4(4):297-299.
[10]	张名铷, 郭莉. 急性心肌梗死PCI术后患者运动恐惧与自我效能现况及其相关性研究[J]. 妇幼护理, 2023, 3(21):5170-5172.
[11]	王璐瑶. 急性心肌梗死PCI术后患者运动恐惧现况及发生机制研究[D]. 江西: 南昌大学, 2023.
[12]	胡新静, 荚恒娅, 胡冰, 等. 经皮冠状动脉介入治疗术后患者恐动症的潜在剖面分析及影响因素研究[J]. 中国实用护理杂志, 2023, 39(11):806-814.
[13]	丁娟, 孔祥娣. 老年急性心肌梗死患者PCI术后运动恐惧调查及其影响因素研究[J]. 医药前沿, 2023, 13(27):118-120.
[14]	郑宇娟, 赵华, 王晓云, 等. 冠心病患者经皮冠状动脉介入治疗术后运动恐惧现状及影响因素分析[J]. 山西医药杂志, 2022, 51(6):611-614.
[15]	张丽君, 马宏文, 孙然然. 老年急性ST段抬高型心肌梗死患者经皮冠状动脉介入治疗术后运动恐惧现状及影响因素分析[J]. 天津护理, 2022, 30(4):422-426.
[16]	伍拾遗. 运动恐惧症对冠心病患者生存质量的相关性分析[D]. 通辽: 内蒙古民族大学, 2022.
[17]	王亚欣, 桑文凤, 贾冠华, 等. 首发急性心肌梗死患者运动恐惧现状及影响因素分析[J]. 中国护理管理, 2022, 22(1):63-69.
[18]	王若涵. 运动恐惧与疼痛灾难化对冠心病患者体力活动水平的影响[D]. 石河子: 石河子大学, 2022.
[19]	宋晓梅. 心绞痛患者恐动症影响因素的病例对照研究[D]. 唐山: 华北理工大学, 2022.
[20]	梁燕, 张亮, 付莹, 等. 冠心病PCI术后病人运动恐惧现状及其相关危险因素分析[J]. 全科护理, 2022, 20(30):4287-4289.
[21]	陈思杏, 陈务贤, 张玉秀, 等. 中青年冠心病经皮冠状动脉介入术后处于长期康复期患者的恐动症现状及其影响因素分析[J]. 广西医学, 2022, 44(4):454-457.
[22]	陈航言. 冠心病PCI术后患者运动恐惧与生活质量的相关性研究[D]. 南宁: 广西中医药大学, 2022.
[23]	郑栋莲, 陈燕辉, 刘娜, 等. 中老年冠状动脉旁路移植患者术后早期运动恐惧现状及影响因素分析[J]. 护理与康复, 2022, 21(3):7-11.
[24]	刘婷阳, 邓桂元, 赖娟. 冠心病支架植入术后患者运动恐惧调查及影响因素分析[J]. 齐鲁护理杂志, 2020, 26(8):109-112.
[25]	孙苗苗. 中青年冠心病患者恐动症、自我感受负担及生活质量的相关性研究[D]. 延安: 延安大学, 2019.
[26]	崔贵璞, 雷梦杰. 冠心病患者运动恐惧相关影响因素的研究[J]. 天津护理, 2019, 27(3):293-298.
[27]	Shen Y, Yan TT, Peng Q, et al. Kinesiophobia in patients with angina pectoris of coronary artery disease:a cross-sectional survey[J]. Heart Lung, 2023,57:7-11.
[28]	Yakut Ozdemir H, Ozalevli S, Felekoglu E, et al. Kinesiophobia and associated factors in patients with myocardial infarction[J]. Percept Mot Skills, 2023, 130(6):2564-2581.
[29]	Zhang SA, Wang ZY, Lin XY, et al. Kinesiophobia and self-management behaviour related to physical activity in Chinese patients with coronary heart disease:the mediating role of self-efficacy[J]. Nurs Open, 2023, 10(1):105-114.
[30]	Baykal Şahin H, Kalaycıolu E, Şahin M, et al. The effect of cardiac rehabilitation on kinesiophobia in patients with coronary artery disease[J]. Turk J Phys Med Rehabil, 2021, 67(2):203-210.
[31]	Knapik A, Dᶏbek J, Gallert-Kopyto W, et al. Psychometric features of the Polish version of TSK heart in elderly patients with coronary artery disease[J]. Medicina, 2020, 56(9):467.
[32]	Dᶏbek J, Knapik A, Gallert-Kopyto W, et al. Fear of movement(kinesiophobia)-an underestimated problem in Polish patients at various stages of coronary artery disease[J]. Ann Agric Environ Med, 2020, 27(1):56-60.
[33]	Knapik A, Dᶏbek J, Brzk A. Kinesiophobia as a problem in adherence to physical activity recommendations in elderly Polish patients with coronary artery disease[J]. Patient Prefer Adherence, 2019, 13:2129-2135.
[34]	Brunetti ND, 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. doi: 10.1002/clc.22682 pmid: 28272813
[35]	Kluszczyńska M, Mynarska A, Mikulakova W, et al. Influence of frailty syndrome on kinesiophobia according to the gender of patients after coronary artery bypass surgery[J]. Healthcare, 2021, 9(6):730.
[36]	Luque-Suarez A, Martinez-Calderon J, Falla D. Role of kinesio-phobia on pain,disability and quality of life in people suffering from chronic musculoskeletal pain:a systematic review[J]. Br J Sports Med, 2019, 53(9):554-559.
[37]	罗小甜. 心脏手术后患者恐动症现状及影响因素分析[D]. 苏州: 苏州大学, 2022.
[38]	Bäck M, Lundberg M, Cider Å, et al. Relevance of kinesiopho-bia in relation to changes over time among patients after an acute coronary artery disease event[J]. J Cardiopulm Rehabil Prev, 2018, 38(4):224-230.