The effect of pain on fear of movement in the early period after open heart surgery according to the fear-avoidance model: the role of moderating factors

Postoperative pain and fear of movement are critical factors that can adversely affect recovery outcomes. The interplay among these factors can significantly influence mobilization and rehabilitation outcomes. This study aims to examine the correlation between pain and fear of mobility during the initial phase following open-heart surgery, taking into account the influence of moderating variables. This cross-sectional and correlational study, conducted within the framework of the Fear-Avoidance Model, involved 203 patients in a Cardiovascular Surgery Intensive Care Unit. Data were collected using a “Patient Information Form,” the “Numeric Rating Scale” and the “Tampa Scale of Kinesiophobia.” These data collection tools were administered to patients at specific time points (12, 24, and 36 hours). The data collection process lasted approximately 30 minutes for each patient. A weak, positive connection was identified between pain and fear of movement at 12 h post-surgery. A comparable correlation was discovered between pre-mobilization discomfort and mobility apprehension at the 24-hour mark. At 24 h post-mobilization, the association between pain and fear of movement shifted to a moderate, negative correlation after mobilization. All demographic and health-related variables, with the exception of body mass index (BMI), were determined to have no moderating influence on the link between pain and fear of mobility. At 24 h post-surgery, post-mobilization BMI influenced the correlation between pain and fear of mobility. In patients with a lower BMI, the fear of mobility diminished as pain intensified. The identical relationship was noted prior to mobilization at 36 h following surgery. This study demonstrates that the direction and strength of the correlation between pain and fear of movement vary across the early postoperative period, with body mass index functioning as a significant moderating variable. The significance of pain management and early mobilization in the postoperative phase is emphasized. Thus, personalized patient management planning by nurses and healthcare experts is essential for improving patient comfort and facilitating the recovery process. Not applicable. • Open heart surgery is a critical procedure, but postoperative recovery can be challenging, with pain and fear of movement being significant obstacles to early mobilization and recovery. • Existing literature mainly examines pain and movement fear independently, with limited research on their interaction and moderating factors, especially in cardiovascular surgery patients. • Mobilization is a key component of recovery protocols, but pain and movement fear are often barriers to early mobilization. • This study provides insight into the temporal changes in pain and movement fear after open heart surgery, highlighting how these factors interact and evolve during the recovery process. • It identifies body mass index as a significant moderating factor influencing the relationship between pain and movement fear, suggesting the need for individualized pain management strategies, especially for patients with lower BMI. • The findings highlight the potential role of early mobilization in modifying the relationship between pain and fear of movement, particularly in the early postoperative period. These results suggest that early targeted interventions may support better recovery outcomes.