Abstract:

Objective This review aims to examine the literature on postoperative exercise-related fear in geriatric orthopedic patients，elucidating current trends，risk factors，adverse effect，evaluative instruments and interventions to aid their rehabilitation. Methods Employing the scoping review framework of Arksey and O’Malley，a systematic electronic search was performed across databases including CNKI，Wanfang Database，China Biomedical Literature Database，Web of Science，PubMed，CINAHL，and the Cochrane Library of Evidence-Based Medicine，up to June 17，2023. Literature screening，summarization，and analysis were collaboratively conducted by 2 researchers. Results Finally，19 relevant publications were included. Evidence indicates a prevalence of exercise-related fear after orthopedic surgery in the elderly ranging from 27.27% to 67.98%，contributing to significant negative health outcomes. 2 assessment tools were identified，including Tampa Scale for Kinesiophobia（TSK-17）（the most commonly used） and Tampa Scale for Kinesiophobia（TSK-11）. Key determinants of exercise fear encompass demographic elements，sleep quality，socio-psychological aspects，pain intensity，and exercise self-efficacy. Interventions currently included cognitive-behavioral therapy，functional exercise，health education，and multifaceted intervention strategies. Conclusion The high incidence of postoperative exercise-related fear in the geriatric orthopedic cohort is influenced by various factors，and it is necessary to promote the development of culturally adapted evaluative tools. Immediate identification and intervention for this fear in such patients are crucial. To date，cognitive-behavioral therapy is the predominant intervention，typically administered in hospital settings. Future strategies should extend to home and community environments，embrace longitudinal studies，and integrate digital technology for comprehensive management.

Key words: Aged, Orthopaedic, Postoperative, Kinesiophobia, Scoping Review, Evidence-Based Nursing

摘要：

目的 对骨科老年患者术后运动恐惧的研究进行范围审查，梳理运动恐惧的现状、危险因素、不良影响、测评工具和干预方法等，为促进患者积极康复提供参考依据。方法 以范围综述方法学为指导，计算机检索中国知网、万方数据库、中国生物医学文献数据库、Web of Science、PubMed、CINAHL、Cochrane Library数据库，检索时限为建库至2023年6月17日，由2名研究者筛选文献、汇总和系统分析。结果 最终纳入19篇文献。骨科老年患者术后运动恐惧的发生率为27.27%~67.98%，主要应用坦帕运动恐惧评分量表和恐动症简表2种运动恐惧测评工具。患者运动恐惧的影响因素包括人口学因素、睡眠状态、社会心理因素、疼痛程度、运动自我效能。干预方法包括认知行为疗法、功能锻炼、健康教育及综合干预措施等。结论 骨科老年患者术后运动恐惧发生率较高，受多重因素影响，还需要加强在骨科老年患者中的本土化测评工具研究，及时识别骨科老年患者术后运动恐惧。骨科老年患者术后运动恐惧目前最常用的干预方法是认知行为疗法，干预时间尚停留在住院期间，未来有待在家庭和社区中、互联网技术层面发展和完善。

关键词: 老年, 骨科, 术后, 运动恐惧, 范围综述, 循证护理学