Key result
Exercise self-efficacy correlates with lower kinesiophobia post-aortic dissection, mediated by family support and adaptive coping.
Why the study?
Early postoperative kinesiophobia impairs exercise adherence and quality of life in aortic dissection survivors, but kinesiophobia subtypes and associative psychosocial pathways remain poorly characterized.
Cross-Sectional (n=309)
Yes
Effect estimate: β -0.149 (95% CI -0.237 to -0.081)
p-value: p=<0.001
Aortic dissection survivors exhibit high rates of early postoperative kinesiophobia, which is negatively associated with exercise self-efficacy, family support, and adaptive coping styles.
May inform psychosocial interventions targeting self-efficacy in aortic dissection survivors; leaves open causality and requires prospective trials.
Background Early postoperative kinesiophobia in aortic dissection survivors is associated with reduced exercise adherence, worsening physical and mental health, and diminished quality of life. This study aimed to identify kinesiophobia subtypes 1 month after surgery and to explore the associative pathways linking exercise self-efficacy, family support, coping styles, and kinesiophobia, thereby providing a theoretical basis for the future development of targeted interventions. Methods This cross-sectional study enrolled 309 aortic dissection survivors (September 2024–July 2025) from three university hospitals 1 month post-surgery. Data were collected using a general information questionnaire, the Tampa Scale for Kinesiophobia Heart, the Self-Efficacy for Exercise Scale, the Family Apgar Index, and the Medical Coping Modes Questionnaire. Latent profile analysis identified kinesiophobia subtypes, followed by testing a chain mediation model integrating exercise self-efficacy, family support, coping styles, and kinesiophobia. Results Of the 309 patients, 73.14% ( n = 226) reported kinesiophobia. These patients were categorized into three subtypes: Subtype A (25.2%), Subtype B (17.7%), and Subtype C (57.1%). Participants with older age, Stanford Type A dissection, no spouse, lower education, and high invasive surgery correlated with higher fear. Exercise self-efficacy demonstrated a direct negative association with kinesiophobia, accounting for 38% of the total effect (−0.149, 95% CI: −0.237 to −0.081). Family support and adaptive coping style mediated this relationship by 45% (−0.178, 95% CI: −0.250 to −0.123) and 12% (−0.049, 95% CI: −0.089 to −0.023), respectively, with a significant but modest chain mediation effect of 5% (−0.019, 95% CI: −0.044 to −0.007). Conclusion Aortic dissection survivors exhibit high kinesiophobia with marked phenotypic heterogeneity. The relationships between exercise self-efficacy, family support, coping styles, and kinesiophobia must be strictly interpreted as associative rather than causal. While these pathways underscore potential intervention targets, they remain strictly hypothesis-generating. These findings provide a roadmap for future trials to validate before clinical translation and inform risk-stratified screening by identifying high-risk phenotypes (Subtype C) and the dominant role of family support.
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Yang et al. (2026) conducted a cross-sectional in Postoperative aortic dissection (n=309). Exercise self-efficacy (exposure) was evaluated on Direct effect of exercise self-efficacy on kinesiophobia (β -0.149, 95% CI -0.237 to -0.081, p=<0.001). Exercise self-efficacy had a direct negative association with kinesiophobia (β = -0.149) in postoperative aortic dissection survivors, mediated by family support and adaptive coping styles.
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