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

摘要： 背景　慢性疼痛已成为患者最敏感和最关注的主要问题之一，因疼痛而出现的恐动症会使患者对功能康复锻炼及日常活动产生恐惧心理，严重影响患者生活质量。目的　了解慢性腰痛患者的恐动症现状并探讨其影响因素。方法　本研究为横断面研究，于2017年11月—2018年3月选取天津医科大学总医院和天津医院的脊柱外科门诊及病房≥18岁的慢性腰痛患者进行问卷调查，包括社会人口学问卷、疼痛相关资料调查、一般自我效能感量表（GSES）、恐动症Tampa量表（TSK）（TSK评分≥38分为存在恐动症）、社会支持评定量表（SSRS）、简易慢性疼痛接受问卷（CPAQ-8）、医院焦虑抑郁量表（HADS），采用多因素Logistic回归分析慢性腰痛患者恐动症的影响因素。结果　共收集有效问卷255份，患者TSK评分为（46.2±10.2）分，其中≥38分118例（46.3%），<38分137例（53.7%）；GSES评分为（2.3±0.5）分，SSRS评分为（30.1±5.8）分，CPAQ-8评分为21（15，29）分，焦虑评分为9.5（8.0，11.0）分，抑郁评分为8.0（6.0，12.0）分。TSK评分<38分和TSK评分≥38分者家庭人均月收入、疼痛程度得分、GSES评分、SSRS评分、CPAQ-8评分、焦虑评分、抑郁评分比较，差异均有统计学意义（P<0.05）。多因素Logistic回归分析结果显示，家庭人均月收入〔OR=0.371，95%CI（0.185，0.744）〕、疼痛程度得分〔OR=1.413，95%CI（1.059，1.885）〕、SSRS评分〔OR=0.892，95%CI（0.823，0.968）〕、CPAQ-8评分〔OR=0.864，95%CI（0.804，0.928）〕、焦虑评分〔OR=1.177，95%CI（1.045，1.275）〕、抑郁评分〔OR=1.168，95%CI（1.071，1.275）〕是慢性腰痛患者恐动症的影响因素（P<0.05）。结论　慢性腰痛患者恐动症的发生率较高，恐动程度主要受家庭人均月收入水平、疼痛程度、社会支持水平、疼痛接受程度、焦虑和抑郁程度等因素的影响，建议治疗过程中评估并关注患者恐动程度，开展针对性的健康教育和干预措施，引导患者减轻恐动程度，积极参加活动。

关键词: 慢性疼痛, 恐动症, 横断面研究, 影响因素分析