Investigation of the relationship between kinesophobia and pain coping status of patients with gonarthrosis and pain and mobility levels during the first post-operative

The aim of this study was to investigate the relationship between preoperative kinesiophobia and pain coping status of patients with gonarthrosis and their pain and physical mobility levels during the first postoperative mobilisation. This descriptive and correlational study was conducted with 202 patients hospitalised in the orthopaedics and traumatology clinic of a state hospital in the Western Black Sea Region with a diagnosis of gonarthrosis. Data were collected between 1 March 2023 and 31 January 2024 using the "Demographic Information Form", "Tampa Kinesiophobia Scale", "Pain Coping Inventory", "Visceral Analogue Scale (VAS)", "Observer Mobility Scale" and "Patient Mobility Scale" were used. Patients were interviewed face to face before surgery and immediately after the first postoperative mobilisation and data collection forms were filled out. The relationships between the dimensions determining the scale levels of the patients were tested by Pearson correlation and linear regression analyses. Independent groups t-test, ANOVA and Tukey LSD analyses were used to examine the differences in scale levels according to the descriptive characteristics of the patients. The patients had moderate level of kinesiophobia with a preoperative score of 45.800 ± 5.318 on the TAMPA Kinesiophobia Scale. The patients scored a total of 51,891 ± 6,888 points from the Pain Coping Inventory and accordingly, the rate of using pain coping behaviours was found to be at a high level. Preoperative pain intensity measured by VAS was at a high level with a mean of 7,630±1,951. During initial mobilisation, patients had a moderate level of mobility independence with a mean score of 12,120 ± 1,951 on the Observer Mobility Scale. With a mean score of 24,680 ± 5,379 on the Patient Mobility Scale, patients experienced high levels of pain and difficulty while moving. There was a statistically significant correlation between preoperative kinesiophobia and the use of pain coping behaviours and the severity of pain experienced (p<0.05). A statistically significant correlation was found between the mean scores of the Observer Mobility Scale and Patient Mobility Scale and the mean VAS scores during the first postoperative mobilisation (p<0.05). A statistically significant relationship was also found between the mean scores of the TAMPA Kinesiophobia Scale and the mean scores of the Patient Mobility Scale (p<0.05). According to the results, patients should be encouraged to move by explaining the importance of moving after surgery, be aware of the factors that may restrict patients' mobility, and nursing interventions should be made to manage these factors. Patients should be motivated or trained for active coping methods especially with pain. The relationships between the dimensions determining the scale levels of the patients were tested with Pearson correlation and linear regression analyses. In the examination of differences in scale levels according to the descriptive characteristics of the patients, independent groups t-test, one-way analysis of variance and Tukey LSD analyses were used. The patients' kinesiophobia was at a moderate level before surgery, with a score of 45.800 ± 5.318 on the TAMPA Kinesiophobia Scale. It was found that the patients received a total average score of 51.891 ± 6.888 from the Pain Coping Inventory on the morning of surgery and accordingly the rate of using pain-coping behaviors was at a high level. Preoperative pain intensity measured with VAS was high with an average of 7.630±1.951. During the first mobilization, the patients had a moderate level of mobility independence with an average score of 12.120 ± 1.951 on the Observer Mobility Scale. It was determined that the patients experienced high levels of pain and difficulty while moving with an average score of 24.680 ± 5.379 from the Patient Mobility Scale. A statistically significant relationship was found between the preoperative kinesiophobia in the patients and the use of pain coping behaviors and the experienced pain intensity (p<0.05). A statistically significant relationship was found between the Observer Mobility Scale and Patient Mobility Scale mean scores and the VAS mean scores during the first mobilization after the surgery (p<0.05). A statistically significant relationship was also found between the patients' TAMPA Kinesiophobia Scale mean scores and the Patient Mobility Scale mean scores (p<0.05). According to the results, patients should be encouraged to move by explaining the importance of movement after surgery. They should also be aware of factors that may limit their movement; nursing interventions should be made to manage these factors. Patients should be motivated or trained, especially for active methods of coping with pain. Keywords: Pain, gonarthrosis, mobility, nursing, kinesiophobia, mobilization