Analysis of factors influencing postoperative kinesiophobia in elderly total knee arthroplasty patients based on health ecology theory: A cross-sectional study

This study is based on the theory of health ecology. It conducts a multi-level, comprehensive analysis of the factors influencing kinesiophobia in patients undergoing total knee arthroplasty (TKA), providing a theoretical basis for clinical identification and intervention. We employed convenience sampling to select 500 total knee arthroplasty patients from the Affiliated Hospital of Zunyi Medical University as the study population, with 446 questionnaires returned. Using health ecology as the theoretical framework for classifying influencing factors, we examined personal characteristics, behavioral patterns, social networks, work and living environments, and policy levels. Data collection tools included a general information questionnaire, the Tampa scale for kinesiophobia, the 7-item generalized anxiety disorder scale, the patient health questionnaire-9, the social support scale, the numerical rating scale, and the Knee self-efficacy scale. We used univariate analysis and multivariate regression analysis to explore influencing factors and established a health ecology model for exercise phobia in TKA patients. The results showed that the incidence of exercise phobia in TKA patients was 21.75%. Multivariate linear regression analysis showed that self-rehabilitation efficacy, pain, positive attention from children and social support level were independent factors influencing exercise-related anxiety in patients undergoing TKA (P < .05). Healthcare providers should focus on the factors influencing kinesiophobia levels in TKA patients from a health ecology perspective, and intervene from multiple dimensions and levels to reduce kinesiophobia and promote knee function rehabilitation.