Objective: To explore the mediating effect of exercise self-efficacy between physical activity-related self-management behaviors and exercise fear in maintenance hemodialysis(MHD) patients. Methods: From June 2022 to December 2023, a total of 380 patients at the end stage of renal disease, who were receiving regular hemodialysis treatments at our hospital's dialysis unit, were chosen as the subjects for this study. The assessments were conducted using the exercise self-management behavior assessment scale(ES-SMBPA), the tampa scale for kinesiophobia(TSK), and the multidimensional exercise self-efficacy scale(MSES). Pearson correlation analysis was used to examine the relationship between exercise self-efficacy, exercise fear, and self-management behavior related to physical activity(SMBPA). Process 3.4 was utilized to test the mediating effect of exercise self-efficacy between exercise fear and SMBPA in maintenance hemodialysis patients. Results: The survey successfully collected 352 valid questionnaires, with a response rate of 92.63%. The ES-SMBPA score was(22.01±4.39), which was at a low level. TSK score was(31.35±5.93), which was at a high level. The MSES score was(69.85±9.03), which was in a low level. Pearson correlation showed that TSK was negatively correlated with MSES(P<0.05), and ES-SMBPA was positively correlated with MSES(P<0.05). The mediation analysis showed that exercise fear had a significant indirect effect on physical activity self-management behaviors through self-efficacy(-0.816, 95%CI -0.925 to-0.707), accounting for 46.26% of the total effect of exercise fear on physical activity self-management behaviors. Conclusion: For MHD patients, self-efficacy is significantly correlated with kinesiophobia and SMBPA. At the same time, exercise fear can indirectly affect SMBPA through self-efficacy, suggesting that it is necessary to reduce the level of exercise fear in MHD patients through targeted interventions, so as to stimulate self-efficacy, improve the SMBPA and the prognosis of patients, and reduce the occurrence and development of complications. |
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