# Analysis of factors influencing postoperative kinesiophobia in patients with perianal diseases based on structural equation modeling

## TL;DR

This study identifies pain as the main factor causing fear of movement after perianal surgery, with implications for improving recovery through better pain management and psychological support.

## Contribution

The study introduces a structural equation model to quantify causal relationships between pain, psychological factors, and kinesiophobia in perianal surgery patients.

## Key findings

- Pain intensity had the strongest direct effect on kinesiophobia (total effect 0.401).
- Social support and self-efficacy significantly reduced kinesiophobia.
- Illness perception positively influenced kinesiophobia, similar to pain.

## Abstract

This study aims to investigate the prevalence of postoperative motion kinesiophobia among patients undergoing perianal surgery and its influencing factors. Utilizing structural equation modeling, we explore the causal pathways and magnitude of these factors to inform the development of targeted clinical interventions. Ultimately, this seeks to reduce postoperative motion kinesiophobia levels in perianal surgery patients and enhance their quality of life.

Employing convenience sampling, 441 patients undergoing perianal surgery were enrolled. A cross-sectional survey utilized a demographic questionnaire, the Tampa Scale of Kinesiophobia (TSK), the Postoperative Pain Coping Strategies Questionnaire, the Brief Illness Perception Questionnaire (B-IPQ), the General Self-Efficacy Scale (GSES), and the Social Support Scale: structural equation modeling analyzed postoperative anxiety factors and their causal pathways.

Survey findings from the 441 enrolled patients revealed: TSK scores: (41.57 ± 6.82); Postoperative pain coping strategies: (84.45 ± 9.14); GSES: (27.72 ± 3.96); B-IPQ (33.66 ± 11.35), the Social Support Scale score was (40.35 ± 7.41); and the pain rating was (4.63 ± 1.41). The structural equation model demonstrated good data fit: χ2/df = 1.888, GFI = 0.969, AGFI = 0.946, IFI = 0.927, TLI = 0.889, CFI = 0.925, RMSEA = 0.045. Pain exerted a positive influence on Kinesiophobia (β = 0.242, p < 0.001) and Illness Perception (β = 0.238, p < 0.001); self- efficacy negatively influenced Kinesiophobia (β = −0.236, p < 0.001), while social support negatively affected Kinesiophobia (β = −0.187, p < 0.001). The most significant effect on Kinesiophobia was exerted by pain intensity (total effect 0.401), producing a direct influence, followed by social support (total effect −0.318), self-efficacy (total effect −0.241), Illness Perception (total effect 0.238).

Pain exerts the most significant influence on postoperative kinesiophobia in patients with perianal diseases, and this effect can be indirectly mediated through social support, self-efficacy, and Illness Perception. Clinically, healthcare professionals should prioritize pain management for patients and implement effective interventions to enhance self-efficacy, foster accurate Illness Perception, thereby reducing kinesiophobia symptoms and promoting postoperative recovery.