Construction and evaluation of a model to identify early postoperative kinesiophobia in patients with lumbar degenerative diseases: a cross-sectional study.

Objectives: This study investigated the prevalence of early postoperative kinesiophobia in patients with lumbar degenerative diseases (LDDs) who had undergone surgery. The aim was to identify associated factors influencing kinesiophobia, and to develop a nomogram to provide a screening tool to identify early postoperative kinesiophobia in patients with LDDs. Methods: A cross-sectional study was designed to investigate the prevalence of kinesiophobia in patients with LDDs. Data on 301 patients with LDDs, who had undergone lumbar fusion surgery in the Second Affiliated Hospital of Fujian Medical University from January 2023 to August 2023, was used as the training set, while data on 101 patients at the Quanzhou Orthopedic-Traumatological Hospital from September 2023 to November 2023 was used as the test set. A model was constructed by using the results of univariate logistic regression analyses, and was assessed in terms of the accuracy, recall, kappa value, and F1 score. The performance evaluation of this model is based on its ability to distinguish and calibrate early postoperative kinesiophobia, as well as its clinical practicality. Moreover, the entire process was implemented according to the Transparent Reporting of a multivariable prediction model for Individual Prognosis or Diagnosis checklist. Results: The prevalence of kinesiophobia among patients with LDDs in the entire dataset was 62.69% (252/402), with a prevalence of 61.13% (184/301) and 67.33% (68/101) in the training and test sets, respectively. Age, sex, intensity of pain, anxiety, depression, self-efficacy, and social support were identified as independent associated factors in the multivariate logistic regression analysis, and a nomogram was developed based on them. The area under the curve, accuracy, sensitivity, and specificity of the model on the training and test sets were 0.931 (0.890, 0.972) and 0.874 (0.781, 0.966), 0.937 (0.904, 0.959) and 0.861 (0.781, 0.916), 0.957 (0.917, 0.978) and 0.838 (0.733, 0.907), and 0.906 (0.839, 0.947) and 0.909 (0.764, 0.969), respectively. Furthermore, the values of the Hosmer-Lemeshow test on the training and test sets were Conclusion: The proposed model accurately identified early postoperative kinesiophobia in patients with LDDs based on their age, sex, intensity of pain, anxiety, depression, self-efficacy and social support. The model delivered sound performance in terms of discrimination, calibration, and clinical applicability. Furthermore, the nomogram model and online web-based calculator were easy to use for nurses, and enabled them to quickly identify early postoperative kinesiophobia in patients with LDDs.