关键词: 慢性疼痛, 恐动症, 横断面研究, 影响因素分析

Abstract: Background　Chronic pain has become one of the most sensitive and most concerned symptoms for patients. Pain can cause fear of functional rehabilitation and daily activities, which in turn affects the quality of life for patients. Objective　To investigate the prevalence of kinesiophobia in patients with chronic low back pain and to explore its influential factors. Methods　This study was a cross-sectional study. A questionnaire survey was conducted among patients with chronic low back pain aged over 18 years in spine surgery clinics and wards of Tianjin Medical University General Hospital and Tianjin Hospital from November 2017 to March 2018. The survey included social demography questionnaire, pain-related data survey, general self-efficacy scale （GSES）, Tampa Scale for Kinesiophobia （TSK） （≥38 scores for kinesiophobia）, social support rating scale （SSRS）, simple chronic pain acceptance questionnaire （CPAQ-8）, hospital anxiety and depression scale （HADS）． Multivariate Logistic regression analysis was performed to analyze factors influencing kinesiophobia. Results　A total of 255 valid questionnaires were collected. The TSK score of patients was （46.2±10.2） points. Among them, 118（46.3%） had more than 38 points and 137（53.7%） had less than 38 points. The GSES score was （2.3±0.5） points, the SSRS score was （30.1±5.8） points, the CPAQ-8 score was 21 （15，29） points, the anxiety score was 9.5 （8.0，11.0） points, and the depression score was 8.0 （6.0，12.0） points. There were significant differences in family monthly income, pain degree, GSES score, SSRS score, CPAQ-8 score, anxiety score and depression score between patients with TSK score <38 and those with TSK score ≥38 points （P<0.05）． The results of multivariate Logistic regression analysis showed that the per capita monthly income level 〔OR=0.371，95%CI（0.185，0.744）〕, average pain degree 〔OR=1.413，95%CI（1.059，1.885）〕, SSRS score〔OR=0.892，95%CI（0.823，0.968）〕, CPAQ-8 score〔OR=0.864，95%CI（0.804，0.928）〕, degree of anxiety 〔OR=1.177，95%CI（1.045，1.275）〕, and degree of depression 〔OR=1.168，95%CI（1.071，1.275）〕 were influential factors of kinesiophobia in patients with chronic low back pain （P<0.05）． Conclusion　The incidence of kinesiophobia in patients with chronic low back pain is high. The degree of kinesiophobia is mainly affected by factors such as monthly income level, social support level, average pain degree, anxiety and depression. Researchers suggest the degree of kinesiophobia should be assessed in the process of treatment and medical workers need to carry out targeted health education and interventions for guiding patients to reduce the degree of kinesiophobia and increase activity participation.

Key words: Chronic pain, Kinesiophobia, Cross-sectional studies, Root cause analysis