Objective:To explore the alexithymia of patients with kinesiophobia after total knee arthroplasty (TKA) and analyze its influencing factors.Methods:Convenience sampling was used to select 221 patients with kinesiophobia after TKA admitted to the First Affiliated Hospital of Zhengzhou University in Henan Province between June and October 2024. A survey was conducted using the self-designed General Information Questionnaire, Tampa Scale of Kinesiophobia-11, Chinese version of Toronto Alexithymia Scale-20 (TAS-20), Social Support Rating Scale, and General Self-efficacy Scale. Multiple linear regression was used to analyze the factors influencing patients' alexithymia.Results:A total of 221 questionnaires were distributed, and 210 questionnaires were effectively collected, with an effective response rate of 95.02%. Chinese version of TAS-20 score of 210 patients with kinesiophobia after TKA were (60.70±8.16), and the incidence of alexithymia was 52.86% (111/210), mainly manifested as describing emotional feeling disorders and externally oriented thinking disorders. Multiple linear regression analysis showed that educational level, per capita monthly household income, personality types, score of kinesiophobia, self-efficacy, and social support were statistically significant factors influencing the alexithymia of patients with kinesiophobia after TKA ( P<0.05), explaining 83.50% of the total variance. Conclusions:Patients with kinesiophobia after TKA have a high level of alexithymia. Patients with low educational level, low per capita monthly household income, introverted personalities, high levels of kinesiophobia, low self-efficacy, and low levels of social support are prone to developing alexithymia. Healthcare professionals should pay attention to the alexithymia of patients with kinesiophobia after TKA. Effective measures should be formulated from the aspects of emotional education, disease cognition, social skill training, and social support to reduce the level of alexithymia in patients with kinesiophobia.

Objective:To explore the application effect of BOPPPS (Bridge-in, Objectives, Pre-assessment, Participatory learning, Post-assessment, and Summary) combined with scenario simulation in cultivating the humanistic care ability of undergraduate nursing interns.Methods:Undergraduate nursing students who were interning at the First Affiliated Hospital of Zhengzhou University were selected by convenience sampling. The 46 interns from June to December 2023 were set as the control group, and the 46 interns from June to December 2024 were set as the experimental group. The control group adopted the traditional lecture-based teaching method, while the experimental group adopted BOPPPS combined with scenario simulation. Theoretical and practical scores, humanistic care ability, empathy ability, and critical thinking ability of the two groups were compared.Results:After the intervention, the theoretical and practical scores, as well as humanistic care ability, empathy ability, and critical thinking ability scores of the experimental group were all higher than those of the control group, and the differences were statistically significant ( P<0.05) . Conclusions:BOPPPS combined with scenario simulation plays a positive role in improving theoretical and practical scores, humanistic care ability, empathy ability, and critical thinking ability of undergraduate nursing interns, and it is worthy of further promotion and application.

Objective:To explore latent profile categories of pain catastrophizing in total knee arthroplasty patients and analyze differences in kinesiophobia among different categories of patients.Methods:Convenience sampling was used to select 340 patients who underwent total knee arthroplasty at the First Affiliated Hospital of Zhengzhou University from January 2023 to June 2024. The Pain Catastrophizing Scale (PCS) and Tampa Scale for Kinesiophobia (TSK) were used to assess patients' pain catastrophizing and kinesiophobia on the third postoperative day. Latent profile analysis was employed to simulate and categorize PCS, and to compare the kinesiophobia among patients in different categories.Results:A total of 340 questionnaires were distributed, with 327 valid responses collected, resulting in a valid response rate of 96.18%. The postoperative PCS score for 327 patients was (34.76±7.59) , with 33.33% (109/327) achieving a PCS score ≥38. The mean scores for the three dimension (exaggeration, helplessness, and rumination) items were (2.91±0.93) , (2.33±0.84) , and (2.51±0.79) , respectively. The TSK score was (48.39±9.42) , with 50.46% (165/327) scoring above 37. Three latent categories of pain catastrophizing were identified, including "high exaggeration-helplessness-rumination group", accounting for 28.75% (94/327) ; "high exaggeration-moderate helplessness-rumination group", accounting for 39.45% (129/327) ; "moderate exaggeration-helplessness-high rumination group", accounting for 31.80% (104/327) . The TSK scores of the three groups of patients were (51.75±8.49) , (46.83±8.76) , and (49.29±9.04) , respectively, with statistically significant differences ( P<0.05) . Conclusions:Patients undergoing total knee arthroplasty exhibit distinct categorical characteristics in postoperative pain catastrophizing, with varying levels of kinesiophobia observed across different pain catastrophizing characteristics. Healthcare providers should conduct early assessments to identify patients' pain catastrophizing characteristics and deliver targeted interventions to improve pain catastrophizing and kinesiophobia, thereby promoting early postoperative recovery.

Objective:To construct an early rehabilitation management model for postoperative kinesiophobia patients after total knee arthroplasty (TKA) based on a topic-oriented quality control circle method, aiming to improve the quality of early rehabilitation management.Methods:Using a convenience sampling method, 120 TKA patients with kinesiophobia treated in the Department of Orthopedics at the First Affiliated Hospital of Zhengzhou University from January to April 2022 and September to December 2022 were selected. The patients from January to April 2022 were set as the control group, and those from September to December 2022 were set as the observation group, with 60 patients in each group. The control group received routine rehabilitation management after TKA surgery, while the observation group received the early rehabilitation management model based on the 10 steps of the topic-oriented quality control circle (topic selection, activity planning, clarification of the topic, goal setting, countermeasure formulation, pursuit of optimal strategies, etc.) in addition to the routine management. The differences between the two groups were compared in terms of kinesiophobia score, knee function score, pain score, early rehabilitation assessment rate, effective analgesia rate, and 24-hour ambulation rate.Results:After the intervention, the observation group showed significantly lower knee pain scores (2.89±0.66) and kinesiophobia scores (23.27±4.87) compared to the control group, with a significantly higher knee function score (74.47±7.40), all differences were statistically significant (all P<0.01). Additionally, the observation group had a significantly higher early rehabilitation assessment rate, effective analgesia rate, 24-hour ambulation rate, early rehabilitation compliance rate, earlier time for the first ambulation, shorter hospital stay, and reduced costs compared to the control group, with all differences showing statistical significance (all P<0.01) . Conclusions:The application of the topic-oriented quality control circle to construct and implement an early rehabilitation management model for postoperative kinesiophobia patients after TKA can effectively improve the quality of early rehabilitation management, reduce kinesiophobia levels, enhance knee joint function, and alleviate the economic burden.

Objective:To construct an early rehabilitation management model for postoperative kinesiophobia patients after total knee arthroplasty (TKA) based on a topic-oriented quality control circle method, aiming to improve the quality of early rehabilitation management.Methods:Using a convenience sampling method, 120 TKA patients with kinesiophobia treated in the Department of Orthopedics at the First Affiliated Hospital of Zhengzhou University from January to April 2022 and September to December 2022 were selected. The patients from January to April 2022 were set as the control group, and those from September to December 2022 were set as the observation group, with 60 patients in each group. The control group received routine rehabilitation management after TKA surgery, while the observation group received the early rehabilitation management model based on the 10 steps of the topic-oriented quality control circle (topic selection, activity planning, clarification of the topic, goal setting, countermeasure formulation, pursuit of optimal strategies, etc.) in addition to the routine management. The differences between the two groups were compared in terms of kinesiophobia score, knee function score, pain score, early rehabilitation assessment rate, effective analgesia rate, and 24-hour ambulation rate.Results:After the intervention, the observation group showed significantly lower knee pain scores (2.89±0.66) and kinesiophobia scores (23.27±4.87) compared to the control group, with a significantly higher knee function score (74.47±7.40), all differences were statistically significant (all P<0.01). Additionally, the observation group had a significantly higher early rehabilitation assessment rate, effective analgesia rate, 24-hour ambulation rate, early rehabilitation compliance rate, earlier time for the first ambulation, shorter hospital stay, and reduced costs compared to the control group, with all differences showing statistical significance (all P<0.01) . Conclusions:The application of the topic-oriented quality control circle to construct and implement an early rehabilitation management model for postoperative kinesiophobia patients after TKA can effectively improve the quality of early rehabilitation management, reduce kinesiophobia levels, enhance knee joint function, and alleviate the economic burden.

Objective:To construct an early rehabilitation exercise program for patients with agoraphobia after total knee arthroplasty (TKA) to provide guidance for orthopedic rehabilitation nursing practice.Methods:The first draft of an early rehabilitation exercise program for patients with agoraphobia after TKA was developed through literature search, semi-structured interviews, and group discussions. From November to December 2023, 20 experts from nine provinces and centrally administered municipalities were selected for two rounds of expert consultation using the Delphi method to form the final draft of the early rehabilitation exercise program for patients with agoraphobia after TKA.Results:In two rounds of consultation, the questionnaire recovery rates were 91.30% (21/23) and 95.24% (20/21), with authority coefficients of 0.92 and 0.96, and Kendall's coordination coefficients of 0.28 and 0.34, respectively ( P<0.05). After the second round of consultation, the mean importance assignment scores for all levels of indicators ranged from 3.90 to 5.00, with coefficients of variation ranging from 0 to 0.20. The finalized early rehabilitation exercise program for patients with agoraphobia after TKA contained two parts, including the preface and the main text, and the main text consisted of five first-level items, 21 second-level items, and 35 third-level items. Conclusions:The content of the early rehabilitation exercise program for patients with agoraphobia after TKA is scientific, reasonable, comprehensive, practical and targeted, which can provide a basis for clinical medical and nursing personnel to guide the early rehabilitation exercise for patients with agoraphobia after TKA.

Objective:To explore the alexithymia of patients with kinesiophobia after total knee arthroplasty (TKA) and analyze its influencing factors.Methods:Convenience sampling was used to select 221 patients with kinesiophobia after TKA admitted to the First Affiliated Hospital of Zhengzhou University in Henan Province between June and October 2024. A survey was conducted using the self-designed General Information Questionnaire, Tampa Scale of Kinesiophobia-11, Chinese version of Toronto Alexithymia Scale-20 (TAS-20), Social Support Rating Scale, and General Self-efficacy Scale. Multiple linear regression was used to analyze the factors influencing patients' alexithymia.Results:A total of 221 questionnaires were distributed, and 210 questionnaires were effectively collected, with an effective response rate of 95.02%. Chinese version of TAS-20 score of 210 patients with kinesiophobia after TKA were (60.70±8.16), and the incidence of alexithymia was 52.86% (111/210), mainly manifested as describing emotional feeling disorders and externally oriented thinking disorders. Multiple linear regression analysis showed that educational level, per capita monthly household income, personality types, score of kinesiophobia, self-efficacy, and social support were statistically significant factors influencing the alexithymia of patients with kinesiophobia after TKA ( P<0.05), explaining 83.50% of the total variance. Conclusions:Patients with kinesiophobia after TKA have a high level of alexithymia. Patients with low educational level, low per capita monthly household income, introverted personalities, high levels of kinesiophobia, low self-efficacy, and low levels of social support are prone to developing alexithymia. Healthcare professionals should pay attention to the alexithymia of patients with kinesiophobia after TKA. Effective measures should be formulated from the aspects of emotional education, disease cognition, social skill training, and social support to reduce the level of alexithymia in patients with kinesiophobia.

Objective:To explore the application effect of BOPPPS (Bridge-in, Objectives, Pre-assessment, Participatory learning, Post-assessment, and Summary) combined with scenario simulation in cultivating the humanistic care ability of undergraduate nursing interns.Methods:Undergraduate nursing students who were interning at the First Affiliated Hospital of Zhengzhou University were selected by convenience sampling. The 46 interns from June to December 2023 were set as the control group, and the 46 interns from June to December 2024 were set as the experimental group. The control group adopted the traditional lecture-based teaching method, while the experimental group adopted BOPPPS combined with scenario simulation. Theoretical and practical scores, humanistic care ability, empathy ability, and critical thinking ability of the two groups were compared.Results:After the intervention, the theoretical and practical scores, as well as humanistic care ability, empathy ability, and critical thinking ability scores of the experimental group were all higher than those of the control group, and the differences were statistically significant ( P<0.05) . Conclusions:BOPPPS combined with scenario simulation plays a positive role in improving theoretical and practical scores, humanistic care ability, empathy ability, and critical thinking ability of undergraduate nursing interns, and it is worthy of further promotion and application.

Objective:To explore latent profile categories of pain catastrophizing in total knee arthroplasty patients and analyze differences in kinesiophobia among different categories of patients.Methods:Convenience sampling was used to select 340 patients who underwent total knee arthroplasty at the First Affiliated Hospital of Zhengzhou University from January 2023 to June 2024. The Pain Catastrophizing Scale (PCS) and Tampa Scale for Kinesiophobia (TSK) were used to assess patients' pain catastrophizing and kinesiophobia on the third postoperative day. Latent profile analysis was employed to simulate and categorize PCS, and to compare the kinesiophobia among patients in different categories.Results:A total of 340 questionnaires were distributed, with 327 valid responses collected, resulting in a valid response rate of 96.18%. The postoperative PCS score for 327 patients was (34.76±7.59) , with 33.33% (109/327) achieving a PCS score ≥38. The mean scores for the three dimension (exaggeration, helplessness, and rumination) items were (2.91±0.93) , (2.33±0.84) , and (2.51±0.79) , respectively. The TSK score was (48.39±9.42) , with 50.46% (165/327) scoring above 37. Three latent categories of pain catastrophizing were identified, including "high exaggeration-helplessness-rumination group", accounting for 28.75% (94/327) ; "high exaggeration-moderate helplessness-rumination group", accounting for 39.45% (129/327) ; "moderate exaggeration-helplessness-high rumination group", accounting for 31.80% (104/327) . The TSK scores of the three groups of patients were (51.75±8.49) , (46.83±8.76) , and (49.29±9.04) , respectively, with statistically significant differences ( P<0.05) . Conclusions:Patients undergoing total knee arthroplasty exhibit distinct categorical characteristics in postoperative pain catastrophizing, with varying levels of kinesiophobia observed across different pain catastrophizing characteristics. Healthcare providers should conduct early assessments to identify patients' pain catastrophizing characteristics and deliver targeted interventions to improve pain catastrophizing and kinesiophobia, thereby promoting early postoperative recovery.

Objective:To construct an early rehabilitation exercise program for patients with agoraphobia after total knee arthroplasty (TKA) to provide guidance for orthopedic rehabilitation nursing practice.Methods:The first draft of an early rehabilitation exercise program for patients with agoraphobia after TKA was developed through literature search, semi-structured interviews, and group discussions. From November to December 2023, 20 experts from nine provinces and centrally administered municipalities were selected for two rounds of expert consultation using the Delphi method to form the final draft of the early rehabilitation exercise program for patients with agoraphobia after TKA.Results:In two rounds of consultation, the questionnaire recovery rates were 91.30% (21/23) and 95.24% (20/21), with authority coefficients of 0.92 and 0.96, and Kendall's coordination coefficients of 0.28 and 0.34, respectively ( P<0.05). After the second round of consultation, the mean importance assignment scores for all levels of indicators ranged from 3.90 to 5.00, with coefficients of variation ranging from 0 to 0.20. The finalized early rehabilitation exercise program for patients with agoraphobia after TKA contained two parts, including the preface and the main text, and the main text consisted of five first-level items, 21 second-level items, and 35 third-level items. Conclusions:The content of the early rehabilitation exercise program for patients with agoraphobia after TKA is scientific, reasonable, comprehensive, practical and targeted, which can provide a basis for clinical medical and nursing personnel to guide the early rehabilitation exercise for patients with agoraphobia after TKA.