基层官兵军事训练伤康复期疼痛、疼痛灾难化、领悟社会支持与运动恐惧关系的结构方程模型构建研究

邵梦琪; 李佳楠; 徐茂林; 日火英支; 许艳; 宋杰; 苏清清; 孟祥飞; 高远

doi:10.12435/j.issn.2095-5227.25041004

基层官兵军事训练伤康复期疼痛、疼痛灾难化、领悟社会支持与运动恐惧关系的结构方程模型构建研究

Construction of a structural equation model for pain, pain catastrophizing, perceived social support with kinesiophobia during rehabilitation period of military training injuries in grassroots soldiers

摘要

摘要:
背景基层官兵军事训练伤康复期运动恐惧影响康复效果，并与疼痛、疼痛灾难化认知与社会支持因素复杂交互，其机制尚未明确。
目的借助结构方程模型，探讨基层官兵军事训练伤康复期疼痛、疼痛灾难化、领悟社会支持与运动恐惧的交互作用机制，为军事训练伤康复期的心理干预提供理论依据。
方法采用便利抽样法，选取2024年10月至2025年3月15个基层单位的627例军事训练伤康复期基层官兵作为研究对象。通过一般资料调查表、运动恐惧Tampa量表(tampa scale for kinesiophobia，TSK)、视觉模拟评分量表(visual analogue scale，VAS)、疼痛灾难化量表(pain catastrophizing scale，PCS)和领悟社会支持量表(perceived social support scale，PSSS)进行调查，构建结构方程模型分析变量间路径关系。
结果 627例基层官兵中，中位TSK得分为33(IQR：23 ~ 38)分，运动恐惧发生率为32.22%(202/627)。结构方程模型显示：疼痛(β=0.202)及疼痛灾难化(β=0.397)对运动恐惧呈显著正向影响(P＜0.001)。领悟社会支持的直接效应不显著(P=0.717)，却可通过三条负向间接路径影响运动恐惧，即经疼痛(β=-0.041)、疼痛灾难化(β=-0.079)及“疼痛→疼痛灾难化”(β=-0.023)对运动恐惧产生间接影响(P＜0.001)。此外，疼痛还可通过影响疼痛灾难化间接影响运动恐惧(β=0.112，P＜0.001)。
结论基层官兵康复期运动恐惧主要由疼痛和疼痛灾难化直接驱动，领悟社会支持通过缓解疼痛与灾难化认知间接发挥保护作用。研究结果为制定以提升社会支持、改善灾难化认知、优化疼痛管理为核心的干预策略提供了实证支持。

Abstract:
Background Kinesiophobia during the rehabilitation period of military training injuries in grassroots soldiers affects recovery outcomes and is intricately interrelated with pain, pain catastrophizing cognition, and social support factors, but the underlying mechanisms remain unclear.
Objective To explore the interaction mechanisms among pain, pain catastrophizing, perceived social support, and kinesiophobia during the rehabilitation period of military training injuries in grassroots soldiers using a structural equation model, and provide theoretical reference for psychological interventions during the rehabilitation period.
Methods A convenience sampling method was used to select 627 grassroots soldiers in the rehabilitation period of military training injuries from 15 grassroots units from October 2024 to March 2025. Data were collected using the general information questionnaire, the tampa scale for kinesiophobia (TSK), the visual analogue scale (VAS), the pain catastrophizing scale (PCS), and the perceived social support scale (PSSS). A structural equation model was constructed to analyze the path relationships among the variables.
Results Among the 627 participants, the median TSK score was 33 (IQR: 23 ~ 38) points, and the prevalence of kinesiophobia was 32.22% (202/627). The structural equation model revealed that pain (β=0.202) and pain catastrophizing (β=0.397) exerted significant positive effects on kinesiophobia (P < 0.001). Perceived social support showed no direct effect (P=0.717), yet influenced kinesiophobia through three negative indirect pathways, via pain (β=-0.041), via pain catastrophizing (β=-0.079), and via the sequential "pain → pain catastrophizing" chain (β=-0.023, P < 0.001). Additionally, pain was found to indirectly contribute to kinesiophobia by increasing pain catastrophizing (β=0.112, P < 0.001), demonstrating a significant mediation effect in the model.
Conclusion Kinesiophobia during rehabilitation among grassroots soldiers is primarily driven directly by pain and pain catastrophizing, while perceived social support exerts protective effects indirectly by alleviating pain and catastrophic cognitions. These findings provide empirical support for developing intervention strategies centered on enhancing social support, modifying catastrophic thinking, and optimizing pain management.

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