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ORIGINAL RESEARCH article

Front. Psychol.

Sec. Psychology of Aging

Volume 16 - 2025 | doi: 10.3389/fpsyg.2025.1622585

Postoperative Kinesiophobia in Elderly Patients with Femoral Neck Fractures: A Prospective Study of Psychological and Social Determinants

Provisionally accepted
Kankai  GuoKankai Guo1Ling  ZhouLing Zhou2Min  ZhangMin Zhang2Xiaofang  HuXiaofang Hu2Yan  HanYan Han2Jialu  HouJialu Hou2Jie  ChengJie Cheng2Xia  ShenXia Shen2Qiaoqian  WangQiaoqian Wang2Quanying  ZhangQuanying Zhang3*
  • 1Xinxiang Medical University, Xinxiang, China
  • 2Changzhi People’s Hospital, Changzhi, China
  • 3The First Affiliated Hospital of Xinxiang Medical University, Xinxiang, China

The final, formatted version of the article will be published soon.

Objectives: This study examined the psychosocial correlates of postoperative kinesiophobia in elderly patients with femoral neck fractures, with a focus on the roles of psychological resilience and social support in mitigating movement-related fear during rehabilitation. Methods: A prospective observational study included 200 patients (≥65 years) undergoing femoral neck fracture surgery (January 2022-August 2024). Kinesiophobia was assessed using the Tampa Scale for Kinesiophobia (TSK), with scores >36 defining the kinesiophobia group (n=120). Psychosocial factors were evaluated using the Social Support Rating Scale (SSRS), Connor-Davidson Resilience Scale (CD-RISC), General Self-Efficacy Scale (GSES), and Numeric Rating Scale (NRS) for pain. Functional independence was measured via the Functional Independence Measure (FIM). Group comparisons and logistic regression analyses identified risk factors, while Pearson correlation assessed relationships between psychosocial variables and TSK scores. Results: The kinesiophobia incidence was 60% (mean TSK=39.20±4.10). Key risk factors included low education (OR=1.122), multiple comorbidities (OR=1.312), low SSRS (OR=1.329), low CD-RISC (OR=1.310), severe pain (OR=1.324), and low FIM (OR=1.204) (all p<0.05). SSRS and CD-RISC scores showed significant negative correlations with TSK (r=-0.524 and -0.602, respectively). The kinesiophobia group had prolonged hospitalization (10.50±2.10 vs. 7.50±1.80 days) and higher complication rates (6.67% vs. 1.25%). Conclusions: Postoperative kinesiophobia is prevalent and strongly associated with psychosocial vulnerabilities. Interventions targeting resilience, social support, and pain management may improve rehabilitation outcomes in this high-risk population.

Keywords: Kinesiophobia, Femoral neck fracture, psychological resilience, social support, Geriatric rehabilitation

Received: 04 May 2025; Accepted: 25 Aug 2025.

Copyright: © 2025 Guo, Zhou, Zhang, Hu, Han, Hou, Cheng, Shen, Wang and Zhang. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

* Correspondence: Quanying Zhang, The First Affiliated Hospital of Xinxiang Medical University, Xinxiang, China

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