Association between health literacy and kinesiophobia in patients after percutaneous coronary intervention

Kinesiophobia is a common barrier in the postoperative rehabilitation process of cardiovascular disease patients. This study aimed to investigate the association between health literacy and kinesiophobia in patients after Percutaneous Coronary Intervention (PCI).

This cross-sectional study included 168 patients who had undergone PCI. Based on their scores on the Tampa Scale for Kinesiophobia-Heart (TSK-Heart), patients were divided into high and low kinesiophobia groups. Univariate analyses were performed to compare baseline characteristics between the two groups. Three multivariate logistic regression models were constructed to analyze the association between health literacy and kinesiophobia after adjusting for different covariates. Restricted cubic spline (RCS) models were used to explore the potential nonlinear relationship between health literacy and kinesiophobia. Receiver operating characteristic (ROC) curve analysis was conducted to evaluate the discriminative ability of health literacy in identifying high versus low kinesiophobia. Interaction and stratified analyses were also performed to assess the effect modification of other variables on this association.

Patients in the high kinesiophobia group had lower education levels, longer disease duration, poorer cardiac function, and higher rates of previous myocardial infarction and multiple stent implantations (p < 0.05). In all multivariate logistic regression models, patients with higher health literacy levels (HeLMSQ3 and HeLMSQ4) had significantly lower odds of high kinesiophobia (p < 0.05). RCS analysis showed a significant linear or near-linear negative association between health literacy and kinesiophobia. Interaction analysis indicated that education level and NYHA cardiac function classification significantly modified the association, with the protective effect of health literacy being more prominent in patients with higher education and better cardiac function.

The results of this study indicate that health literacy is negatively associated with kinesiophobia in patients after PCI, and a linear or near-linear relationship may exist between the two. This association is more pronounced in patients with higher education levels and better cardiac function.