Factors influencing kinesiophobia after thoracoscopic lung cancer surgery: A cross-sectional study based on structural equation modeling

The level and incidence of kinesiophobia in patients with lung cancer after thoracoscopic surgery are at a high level, which seriously affects the patient's exercise compliance and ultimately affects the recovery process. The study of kinesiophobia is still in its preliminary stage, and there are few studies on kinesiophobia in patients after lung cancer surgery. In addition, existing studies focus on the influencing factors of kinesiophobia and ignore the mechanism of kinesiophobia, resulting in a relatively single intervention. This study explores the relationship between variables through structural equation modeling, providing a basis for constructing diverse interventions. A total of 409 inpatients from 3 general hospitals in Wuxi City who underwent thoracoscopic surgery for lung cancer for 3 days from August 2023 to February 2024 were selected by convenience sampling method, and the general information questionnaire, Tampa Scale for Kinesiophobia, Pain Catastrophizing Scale, Exercise Self-Efficacy Scale for Lung Cancer Patients, the Conner-Davidson Resilience Scale, and Multidimensional Scale of Perceived Social Support were used for investigation. AMOS 26.0 is used to construct structural equations and analyze the path relationship between variables. The scores of the Tampa Scale for Kinesiophobia were (47.74 ± 10.28) points, the Pain Catastrophizing Scale was (34.6 ± 9.82) points, the Exercise Self-Efficacy Scale for Lung Cancer Patients was (70.54 ± 23.53) points, the Conner-Davidson Resilience Scale was (57.3 ± 23.74) points, and the Multidimensional Scale of Perceived Social Support was (43.94 ± 19.77). The structural equation model showed that the total effects of pain catastrophizing, exercise self-efficacy, resilience, and perceived social support on kinesiophobia were 0.474, -0.320, -0.325, and -0.582, respectively. The level of kinesiophobia in patients after thoracoscopic surgery for lung cancer is directly and/or indirectly affected by pain catastrophizing, exercise self-efficacy, resilience, and perceived social support. Healthcare professionals should pay attention to the interaction between these factors and adopt personalized interventions based on the interaction paths among factors to reduce the incidence of kinesiophobia in patients.