Abstract：
BACKGROUND: There is a lack of research on the relationship between pain catastrophizing, kinesiophobia, and physical activity (PA) in people with haemophilia (PWH), and the underlying mechanisms connecting these variables remain unclear.
OBJECTIVE: The study\'s aim was to clarify the roles of kinesiophobia and self-efficacy in the relationship between pain catastrophizing and PA in PWH.
METHODS: This cross-sectional study included adult PWH at the Haemophilia Centre of a Tertiary hospital in Beijing, China. The following questionnaires were used to collect data: the general information, the International Physical Activity Short Questionnaire, the Pain Catastrophizing Scale, the Tampa Scale of Kinesiophobia Scale, and the Exercise Self-Efficacy Scale.
RESULTS: The study included a total of 187 PWH, including 154 having haemophilia A and 33 having haemophilia B. The median interquartile range of PA was 594 (198, 1554) MET-min/wk. There were significant differences in PA of patients based on age stage, treatment modality, highest pain score within the last seven days, and presence of haemophilic arthropathy (p < .05). It was showed that pain catastrophizing could directly predict PA (p < .001), accounting for 38.13% of the total effect. Pain catastrophizing also had indirect effects on PA through the mediating factors of kinesiophobia or self-efficacy, and through the chain-mediating effect of kinesiophobia and self-efficacy, accounting for 38.40%, 17.07%, and 6.40%, respectively.
CONCLUSIONS: The study discovered that PWH have limited PA due to pain catastrophizing. This not only directly affects their activity but also indirectly influences it through kinesiophobia and self-efficacy.
OBJECTIVE: The study\'s aim was to clarify the roles of kinesiophobia and self-efficacy in the relationship between pain catastrophizing and PA in PWH.
METHODS: This cross-sectional study included adult PWH at the Haemophilia Centre of a Tertiary hospital in Beijing, China. The following questionnaires were used to collect data: the general information, the International Physical Activity Short Questionnaire, the Pain Catastrophizing Scale, the Tampa Scale of Kinesiophobia Scale, and the Exercise Self-Efficacy Scale.
RESULTS: The study included a total of 187 PWH, including 154 having haemophilia A and 33 having haemophilia B. The median interquartile range of PA was 594 (198, 1554) MET-min/wk. There were significant differences in PA of patients based on age stage, treatment modality, highest pain score within the last seven days, and presence of haemophilic arthropathy (p < .05). It was showed that pain catastrophizing could directly predict PA (p < .001), accounting for 38.13% of the total effect. Pain catastrophizing also had indirect effects on PA through the mediating factors of kinesiophobia or self-efficacy, and through the chain-mediating effect of kinesiophobia and self-efficacy, accounting for 38.40%, 17.07%, and 6.40%, respectively.
CONCLUSIONS: The study discovered that PWH have limited PA due to pain catastrophizing. This not only directly affects their activity but also indirectly influences it through kinesiophobia and self-efficacy.
摘要：
背景：缺乏关于痛苦灾难化之间关系的研究，运动恐惧症,血友病（PWH）患者的体力活动（PA），连接这些变量的潜在机制仍不清楚。
目的：本研究的目的是阐明运动恐惧症和自我效能感在PWH疼痛灾难化和PA之间的关系中的作用。
方法：这项横断面研究包括北京某三甲医院血友病中心的成人PWH，中国。以下问卷用于收集数据：一般信息，国际体育活动简短问卷，疼痛灾难量表，运动恐惧症的坦帕量表，和运动自我效能量表。
结果：该研究共包括187个PWH，其中154例患有A型血友病，33例患有B型血友病。PA的中位数四分位数范围为594（198，1554）MET-min/wk。患者的PA根据年龄阶段有显著差异，治疗方式，过去七天内疼痛评分最高，和血友病性关节病的存在（p<0.05）。研究表明，疼痛灾难化可以直接预测PA(p<.001)，占总效应的38.13%。疼痛灾难化也通过运动恐惧症或自我效能感的中介因素对PA产生间接影响，通过运动恐惧症和自我效能感的连锁中介作用，占38.40%，17.07%,和6.40%，分别。
结论：研究发现，由于疼痛灾难化，PWH的PA有限。这不仅直接影响他们的活动，而且还通过运动恐惧症和自我效能感间接影响他们的活动。
目的：本研究的目的是阐明运动恐惧症和自我效能感在PWH疼痛灾难化和PA之间的关系中的作用。
方法：这项横断面研究包括北京某三甲医院血友病中心的成人PWH，中国。以下问卷用于收集数据：一般信息，国际体育活动简短问卷，疼痛灾难量表，运动恐惧症的坦帕量表，和运动自我效能量表。
结果：该研究共包括187个PWH，其中154例患有A型血友病，33例患有B型血友病。PA的中位数四分位数范围为594（198，1554）MET-min/wk。患者的PA根据年龄阶段有显著差异，治疗方式，过去七天内疼痛评分最高，和血友病性关节病的存在（p<0.05）。研究表明，疼痛灾难化可以直接预测PA(p<.001)，占总效应的38.13%。疼痛灾难化也通过运动恐惧症或自我效能感的中介因素对PA产生间接影响，通过运动恐惧症和自我效能感的连锁中介作用，占38.40%，17.07%,和6.40%，分别。
结论：研究发现，由于疼痛灾难化，PWH的PA有限。这不仅直接影响他们的活动，而且还通过运动恐惧症和自我效能感间接影响他们的活动。
