How does social support influence Kinesiophobia after AMI? A mechanism-based analysis of rehabilitation resource utilization and exercise self-efficacy (a cross-sectional study).

BACKGROUND

Kinesiophobia, defined as fear of movement, has emerged as a critical psychological barrier affecting health behaviors in patients undergoing rehabilitation following percutaneous coronary intervention (PCI) for acute myocardial infarction (AMI). Existing research on kinesiophobia has largely focused on non-cardiac chronic conditions, with social support's mechanism in alleviating cardiac-specific kinesiophobia underexplored.

OBJECTIVE

Drawing upon Social Cognitive Theory and the Health Belief Model, the present study proposes and tests a chain-mediated model linking social support to kinesiophobia through rehabilitation resource utilization and exercise self-efficacy.

METHODS

A cross-sectional survey was conducted among 200 post-PCI patients to examine the proposed pathways using mediation analysis with bootstrapping.

RESULTS

A total of 200 patients (mean age: 62.3 ± 8.5 years; 88.0% male; 97.0% married; 57.0% with one implanted stent) were included. Social support was significantly and negatively associated with kinesiophobia, with rehabilitation resource utilization and exercise self-efficacy acting as partial mediators through multiple indirect pathways. Although the full chain mediation pathway did not reach statistical significance, the overall pattern of results was consistent with a sequential process linking external support, resource access, and efficacy beliefs to fear-based avoidance.

CONCLUSION

The study provides both theoretical and practical implications for developing integrated rehabilitation interventions that leverage social support to reduce kinesiophobia and improve post-AMI recovery outcomes.