The latent class and influencing factors of kinesiophobia in patients after cardiac surgery with cardiopulmonary bypass: A prospective longitudinal study.

BACKGROUND: Kinesiophobia is common in patients after cardiac surgery with cardiopulmonary bypass (CPB), affecting their recovery and well-being. This study aimed to explore kinesiophobia trajectories and their influencing factors to inform personalized interventions.

METHODS: A prospective longitudinal study was conducted in a tertiary hospital in southern China, enrolling 301 patients who underwent cardiac surgery with CPB between January and July 2023 via continuous sampling method. Assessments were conducted at ICU transfer, discharge, and 1 and 3 months after discharge, using the Tampa Scale for Kinesiophobia, Hospital Anxiety and Depression Scale (HADS), Social Support for Exercise Scale (SSES), and Fatigue Severity Scale (FSS), among others. Latent class growth modeling (LCGM) identified kinesiophobia trajectories, and multiple logistic regression analyzed influencing factors. The study adhered to STROBE guidelines.

RESULTS: Three distinct kinesiophobia trajectories were identified: high-level rapid decline (Class 1, 25 %), persistent low-level (Class 2, 64 %), and high-level slow decline (Class 3, 10 %). Pain, fatigue, abnormal BMI, employment status, and low-to-moderate perfusion were significant risk factors for membership in the higher kinesiophobia classes (Class 1 and Class 3).

CONCLUSIONS: Patients undergoing cardiac surgery with CPB can be classified into three types of kinesiophobia within 3 months post-discharge. In clinical practice, early identification and tailored interventions based on the distinct characteristics of different kinesiophobia categories can help improve patients' recovery and postoperative quality of life.