KINESIOPHOBIA IN THE SURGICAL PATIENT

Kinesiophobia is an excessive and irrational fear of physical movement due to a sense of vulnerability that develops after surgery or a painful injury. Defined by Kori et al. (1990), this concept is considered a predictor of chronic pain. The mechanism of kinesiophobia development is explained by the “Fear-Avoidance Model” proposed by Lethem et al. (1982). In this model, pain-related fear, catastrophic thoughts, and avoidance behavior lead to chronic functional loss and reduced quality of life, whereas maintaining physical activity supports the healing process. Patients undergoing major surgery may fear re-injuring the surgical site while performing activities that contribute to recovery and may unintentionally restrict their physical activity. Physical inactivity due to kinesiophobia can lead to complications such as muscle weakness, deep vein thrombosis, delayed wound healing, joint stiffness, anxiety, and depression. Nurses play a crucial role in reducing kinesiophobia through interventions such as monitoring hemodynamic parameters, promoting early mobilization, facilitating active and passive exercises, encouraging deep breathing and coughing exercises, ensuring regular spirometer use, and supporting walking activities that aid recovery. Although the literature reports the development of kinesiophobia after total knee arthroplasty, spinal surgery, cardiac surgery, and breast surgery, intervention-based nursing studies remain limited. As continuous support providers from hospital admission onward, nurses play a critical role in assessing kinesiophobia levels, identifying contributing factors, implementing necessary interventions to help patients regain preoperative functions, and advancing research in this field. The aim of this review is to examine studies examining the levels of kinesiophobia in surgical patients and intervention studies regarding kinesiophobia.