Postoperative kinesiophobia in patients undergoing video-assisted thoracoscopic lung surgery: a longitudinal study

Min Zhang, Xiaoshuang Dan, Qianqian Chen, Z Li, YJ Li

Objective To investigate the current status of postoperative kinesiophobia in patients undergoing video-assisted thoracoscopic surgery (VATS) and to identify its influencing factors. Methods A longitudinal study was conducted among patients who underwent VATS lung surgery between January 2024 and August 2024. Data were collected using a general information questionnaire, the Tampa Scale for Kinesiophobia (TSK), the Visual Analogue Scale (VAS) for pain, the Postoperative Pain Self-Management Behavior Questionnaire (PPSMB), and the Self-Rating Scale of Sleep (SRSS). Results Of the 187 enrolled patients, 101 (54.01%) developed kinesiophobia on postoperative day 1, with a median TSK score of 41.00 (interquartile range: 38.00–42.00). During follow-up until discharge, 83 patients transitioned from kinesiophobia to non-kinesiophobia, whereas 18 patients remained persistently kinesiophobic. Univariate analysis indicated that postoperative pain intensity, pain self-management ability, operation duration, chest tube dwell time, length of hospital stay, and sleep quality significantly influenced the occurrence of kinesiophobia. Multivariate logistic regression analysis revealed that moderate to severe pain, postoperative pain self-management ability, and operation duration were independently associated with kinesiophobia. Receiver operating characteristic (ROC) curve analysis showed that pain intensity, pain self-management ability, operative duration, and their combined model yielded high specificity and sensitivity in predicting kinesiophobia. Conclusion The incidence of postoperative kinesiophobia is relatively high in patients undergoing VATS lung surgery. Healthcare providers should pay close attention to moderate-to-severe postoperative pain, patients' pain self-management behaviors, sleep status, operation duration, chest tube duration, and length of hospitalization. Given that prolonged kinesiophobia poses greater challenges to recovery, early identification, timely intervention, enhanced patient education, and guided rehabilitation training are crucial to reducing its occurrence and promoting postoperative recovery.