Trajectories of fear of movement and the predictive factors in patients with heart failure: a short-term longitudinal study

AIMS: The aim of this study was to identify potential trajectories of fear of movement and explore relevant predictors in patients with heart failure. METHODS AND RESULTS: This was a prospective longitudinal study. A total of 310 patients with heart failure were recruited from a university hospital. Fear of movement was assessed using the Tampa Scale for Kinesiophobia-Heart at baseline (T0), and 1 months (T1) and 4 months (T2) after discharge. Predictors, including heart failure symptoms, psychological distress, resilience, health literacy, family functioning, and subjective social status, were evaluated at T0. Latent growth mixed model and logistic regression analyses were used to explore the potential trajectories and predictors of fear of movement. The results showed that among 310 patients with heart failure, the prevalence of fear of movement at T0, T1, and T2 was 73.5%, 71.6%, and 49.0%, respectively. Two trajectories of fear of movement were identified: the 'reduced risk group' and the 'persistent high-risk group'. Patients with severe heart failure symptoms tended to be in the 'persistent high-risk group', whereas patients with high resilience and health literacy were more likely to be in the 'reduced risk group'. However, psychological distress, family functioning, and subjective social status were failed to be observed associations with fear of movement trajectories in patients with heart failure. CONCLUSION: This study emphasizes the need for early screening and dynamic follow-up of fear of movement in patients with heart failure. Furthermore, alleviating heart failure symptoms, improving resilience and health literacy should be considered when developing targeted interventions to relieve fear of movement.