Factors related to fear of movement after acute cardiac hospitalization
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RESEARCH ARTICLE
Factors related to fear of movement after acute cardiac hospitalization P. Keessen1,2*, C. H. M. Latour1, I. C. D. van Duijvenbode1, B. Visser1, A. Proosdij1, D. Reen1 and W. J. M. Scholte op Reimer1,3
Abstract Background: Fear of movement (kinesiophobia) after an acute cardiac hospitalization (ACH) is associated with reduced physical activity (PA) and non-adherence to cardiac rehabilitation (CR). Purpose: To investigate which factors are related to kinesiophobia after an ACH, and to investigate the support needs of patients in relation to PA and the uptake of CR. Methods: Patients were included 2–3 weeks after hospital discharge for ACH. The level of kinesiophobia was assessed with the Tampa Scale for Kinesiophobia (TSK-NL Heart). A score of > 28 points is defined as ‘high levels of kinesiophobia’ (HighKin) and ≤ 28 as ‘low levels of kinesiophobia’ (LowKin). Patients were invited to participate in a semi-structured interview with the fear avoidance model (FAM) as theoretical framework. Interviews continued until data-saturation was reached. All interviews were analyzed with an inductive content analysis. Results: Data-saturation was reached after 16 participants (median age 65) were included in this study after an ACH. HighKin were diagnosed in seven patients. HighKin were related to: (1) disrupted healthcare process, (2) negative beliefs and attitudes concerning PA. LowKin were related to: (1) understanding the necessity of PA, (2) experiencing social support. Patients formulated ‘tailored information and support from a health care provider’ as most important need after hospital discharge. Conclusion: This study adds to the knowledge of factors related to kinesiophobia and its influence on PA and the uptake of CR. These findings should be further validated in future studies and can be used to develop early interventions to prevent or treat kinesiophobia and stimulate the uptake of CR. Keywords: Cardiovascular disease, Acute cardiac hospitalization, Fear of movement, Cardiac rehabilitation, Physical activity, Exercise Background Anxiety after an acute cardiac hospitalization (ACH) is common. A recent study shows that 43% of patients suffer from anxiety at the time of ACH and 28% directly after ACH [1]. Accumulating evidence suggests that
*Correspondence: [email protected] 1 Centre of Expertise Urban Vitality, Faculty of Health, Amsterdam University of Applied Sciences, Tafelbergweg 51, 1105 BD Amsterdam, The Netherlands Full list of author information is available at the end of the article
anxiety is an important risk factor for fatal and non-fatal cardiac events [2–4]. Cardiac rehabilitation (CR) is the cornerstone of secondary prevention aimed at improving physical, psychological and social functioning [5]. CR consists of multifactorial interventions such as physical activity counseling, exercise training, diet/nutritional counseling, risk factor control, patient education, psychosocial management and vocational advice [5]. Exercise training is a key element of CR and is def
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