{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,12]],"date-time":"2026-10-12T01:45:41Z","timestamp":1791769541283,"version":"4.3.4"},"reference-count":27,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,10,11]],"date-time":"2026-10-11T00:00:00Z","timestamp":1791676800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,10,11]],"date-time":"2026-10-11T00:00:00Z","timestamp":1791676800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal of Clinical Nursing"],"abstract":"ABSTRACT<\/jats:title>\n \n Background<\/jats:title>\n Heart failure is associated with psychological and behavioural challenges. Kinesiophobia and perceived nursing care may influence psychological outcomes, but their relationships remain unclear. This study examined the links between kinesiophobia, perceived nursing care, anxiety and depression in heart failure patients.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n A cross\u2010sectional descriptive\u2010correlational study using structural equation modelling was conducted with 300 hospitalized patients. Data were collected using the Tampa Scale for Kinesiophobia, Hospital Anxiety and Depression Scale and Patient\u2010Centred Care Scale and analysed via correlation multiple regression and structural equation modelling.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n Prevalence of high kinesiophobia was 39.3%, severe depression 43.7% and severe anxiety 17.0%. Kinesiophobia correlated positively with anxiety (\n r<\/jats:italic>\n \u2009=\u20090.119) and depression (\n r<\/jats:italic>\n \u2009=\u20090.290). Better perceived care correlated negatively with anxiety (\n r<\/jats:italic>\n \u2009=\u2009\u22120.142) and depression (\n r<\/jats:italic>\n \u2009=\u2009\u22120.241). Regression showed care negatively predicted anxiety (\n \u03b2<\/jats:italic>\n \u2009=\u2009\u22120.13) and kinesiophobia positively predicted depression (\n \u03b2<\/jats:italic>\n \u2009=\u20090.27). The final structural model revealed that care was negatively associated with anxiety (\n \u03b2<\/jats:italic>\n \u2009=\u2009\u22120.202) and depression (\n \u03b2<\/jats:italic>\n \u2009=\u2009\u22120.302), while kinesiophobia was positively associated only with depression (\n \u03b2<\/jats:italic>\n \u2009=\u20090.225), not anxiety (\n p<\/jats:italic>\n \u2009=\u20090.129). Model fit was suboptimal (RMSEA\u2009=\u20090.095).\n <\/jats:p>\n <\/jats:sec>\n \n Conclusion<\/jats:title>\n Although associations were modest, kinesiophobia and perceived nursing care were linked to psychological distress. Addressing movement\u2010related fears and patient\u2010centred care is important in multidimensional heart failure management.<\/jats:p>\n <\/jats:sec>\n \n Relevance to Clinical Practice<\/jats:title>\n Nurses should screen for kinesiophobia and psychological distress alongside routine assessments. Identifying fear\u2010related barriers to physical activity and addressing concerns through person\u2010centred communication, tailored education and appropriate referral can support more responsive and holistic nursing care.<\/jats:p>\n <\/jats:sec>\n \n Reporting Method<\/jats:title>\n The STROBE statement checklist was used as a guide to reporting this cross\u2010sectional study.<\/jats:p>\n <\/jats:sec>\n \n Patient\/Public Contribution<\/jats:title>\n No patient or public contribution was involved in the design, conduct, analysis or interpretation of this study.<\/jats:p>\n <\/jats:sec>","DOI":"10.1111\/jocn.70597","type":"journal-article","created":{"date-parts":[[2026,10,12]],"date-time":"2026-10-12T01:42:36Z","timestamp":1791769356000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["The Relationship Between Kinesiophobia, Anxiety and Depression in Patients With Heart Failure: The Role of Patients' Perception of Nursing Care"],"prefix":"10.1111","author":[{"given":"Asma","family":"Pourmorad","sequence":"first","affiliation":[{"name":"Student Research Committee Ahvaz Jundishapur University of Medical Sciences Ahvaz Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4407-6993","authenticated-orcid":false,"given":"Simin","family":"Jahani","sequence":"additional","affiliation":[{"name":"Nursing Care Research Center in Chronic Diseases Ahvaz Jundishapur University of Medical Sciences Ahvaz Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marzieh","family":"Asadizaker","sequence":"additional","affiliation":[{"name":"Nursing Care Research Center in Chronic Diseases Ahvaz Jundishapur University of Medical Sciences Ahvaz Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Saeed","family":"Ghanbari","sequence":"additional","affiliation":[{"name":"Department of Biostatistics and Epidemiology, School of Health Ahvaz Jundishapur University of Medical Sciences Ahvaz Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ali","family":"Kardooni","sequence":"additional","affiliation":[{"name":"Atherosclerosis Research Center, Golestan Hospital Ahvaz Jundishapur University of Medical Sciences Ahvaz Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,10,11]]},"reference":[{"issue":"1","key":"e_1_2_14_2_1","doi-asserted-by":"crossref","DOI":"10.1016\/j.cpcardiol.2023.102041","article-title":"Clinical Outcomes With Nurse\u2010Coordinated Multidisciplinary Care in Patients With Heart Failure: A Systematic Review and Meta\u2010Analysis","volume":"49","author":"Ahmed M.","year":"2024","journal-title":"Current Problems in Cardiology"},{"key":"e_1_2_14_3_1","doi-asserted-by":"crossref","DOI":"10.1177\/13591053261457620","article-title":"Effects of Physical Activity on Anxiety and Depression Symptoms in Patients With Heart Failure: A Systematic Review and Meta\u2010Analysis of Randomized Controlled Trials","author":"An X.","year":"2026","journal-title":"Journal of Health Psychology"},{"issue":"1","key":"e_1_2_14_4_1","doi-asserted-by":"crossref","DOI":"10.1186\/s12912-024-01875-3","article-title":"The Mediating Role of Cardiac Patients' Perception of Nursing Care on the Relationship Between Kinesiophobia, Anxiety and Depression in Rural Hospitals: A Cross\u2010Sectional Study","volume":"23","author":"Atta M. H. R.","year":"2024","journal-title":"BMC Nursing"},{"issue":"12","key":"e_1_2_14_5_1","doi-asserted-by":"crossref","first-page":"2110","DOI":"10.1093\/ptj\/pzaa159","article-title":"Perceptions of Kinesiophobia in Relation to Physical Activity and Exercise After Myocardial Infarction: A Qualitative Study","volume":"100","author":"B\u00e4ck M.","year":"2020","journal-title":"Physical Therapy"},{"issue":"2","key":"e_1_2_14_6_1","doi-asserted-by":"crossref","first-page":"71","DOI":"10.34172\/jcs.2022.12","article-title":"Evaluating the Relationship Between Nursing Care Quality and Hospital Anxiety and Depression Among Old Patients With Cardiovascular Disease","volume":"11","author":"Bastani F.","year":"2022","journal-title":"Journal of Caring Sciences"},{"issue":"4","key":"e_1_2_14_7_1","doi-asserted-by":"crossref","first-page":"175","DOI":"10.1097\/HRP.0000000000000162","article-title":"Depression and Anxiety in Heart Failure: A Review","volume":"26","author":"Celano C. M.","year":"2018","journal-title":"Harvard Review of Psychiatry"},{"issue":"2","key":"e_1_2_14_8_1","first-page":"74","article-title":"Development and Psychometric Evaluation of Patient\u2010Centered Care Questionnaire in Cardiac Intensive Care Units","volume":"17","author":"Cheraghi M.","year":"2022","journal-title":"Iranian Journal of Nursing Research"},{"issue":"2","key":"e_1_2_14_9_1","doi-asserted-by":"crossref","first-page":"97","DOI":"10.1111\/nicc.12148","article-title":"Cardiac Patients' Perception of Patient\u2010Centred Care: A Qualitative Study","volume":"21","author":"Esmaeili M.","year":"2016","journal-title":"Nursing in Critical Care"},{"issue":"6","key":"e_1_2_14_10_1","doi-asserted-by":"crossref","DOI":"10.1093\/ptj\/pzaf050","article-title":"Relationship Between Fear of Movement and Physical Activity in Patients With Cardiac, Rheumatologic, Neurologic, Pulmonary, or Pain Conditions: A Systematic Review and Meta\u2010Analysis","volume":"105","author":"Goubran M.","year":"2025","journal-title":"Physical Therapy"},{"issue":"2","key":"e_1_2_14_11_1","doi-asserted-by":"crossref","first-page":"181","DOI":"10.1016\/j.cardfail.2021.07.024","article-title":"Prevalence, Temporal Change, and Determinants of Anxiety and Depression in Hospitalized Patients With Heart Failure","volume":"28","author":"Hamatani Y.","year":"2022","journal-title":"Journal of Cardiac Failure"},{"issue":"4","key":"e_1_2_14_12_1","doi-asserted-by":"crossref","first-page":"1282","DOI":"10.1111\/jocn.16947","article-title":"Effects of Nurse\u2010Led Self\u2010Care Interventions on Health Outcomes Among People With Heart Failure: A Systematic Review and Meta\u2010Analysis","volume":"33","author":"Huang Z.","year":"2024","journal-title":"Journal of Clinical Nursing"},{"key":"e_1_2_14_13_1","first-page":"379","article-title":"Reliability and Validity of Anxiety and Depression Hospital Scales (HADS): Iranian Patients With Anxiety and Depression Disorders","volume":"67","author":"Kaviani H.","year":"2009","journal-title":"Tehran University Medical Journal"},{"issue":"1","key":"e_1_2_14_14_1","doi-asserted-by":"crossref","DOI":"10.1186\/s12912-023-01689-9","article-title":"Individual and Systems\u2010Related Factors Associated With Heart Failure Self\u2010Care: A Systematic Review","volume":"23","author":"Kleman C.","year":"2024","journal-title":"BMC Nursing"},{"issue":"1","key":"e_1_2_14_15_1","doi-asserted-by":"crossref","DOI":"10.1038\/s41598-024-69929-9","article-title":"Prevalence and Influencing Factors of Kinesiophobia in Patients With Heart Disease: A Meta\u2010Analysis and Systematic Review","volume":"14","author":"Liu L.","year":"2024","journal-title":"Scientific Reports"},{"issue":"1","key":"e_1_2_14_16_1","doi-asserted-by":"crossref","DOI":"10.1097\/00002508-199103000-00053","article-title":"The Tampa Scale: A Measure of Kinisophobia","volume":"7","author":"Miller R. P.","year":"1991","journal-title":"Clinical Journal of Pain"},{"key":"e_1_2_14_17_1","doi-asserted-by":"crossref","DOI":"10.3389\/fcvm.2025.1703928","article-title":"Kinesiophobia in Patients With Heart Failure: Concept Analysis Using Rodgers' Evolutionary Approach","volume":"12","author":"Qin Z.","year":"2025","journal-title":"Frontiers in Cardiovascular Medicine"},{"issue":"2","key":"e_1_2_14_18_1","first-page":"197","article-title":"Psychometric Properties of the Tampa Scale for Kinesiophobia Amongst Iranian Patients With Chronic Persistent Pain","volume":"13","author":"Rahmati N.","year":"2014","journal-title":"Payesh (Health Monitor)"},{"issue":"5","key":"e_1_2_14_19_1","doi-asserted-by":"crossref","first-page":"1090","DOI":"10.1016\/j.pain.2011.01.028","article-title":"Norming of the Tampa Scale for Kinesiophobia Across Pain Diagnoses and Various Countries","volume":"152","author":"Roelofs J.","year":"2011","journal-title":"Pain"},{"issue":"3","key":"e_1_2_14_20_1","doi-asserted-by":"crossref","first-page":"221","DOI":"10.1093\/eurjcn\/zvad072","article-title":"Kinesiophobia and Associated Variables in Patients With Heart Failure","volume":"23","author":"Sentandreu\u2010Ma\u00f1\u00f3 T.","year":"2024","journal-title":"European Journal of Cardiovascular Nursing"},{"issue":"3","key":"e_1_2_14_21_1","doi-asserted-by":"crossref","first-page":"363","DOI":"10.1016\/0304-3959(94)00279-N","article-title":"Fear of Movement\/(Re) Injury in Chronic Low Back Pain and Its Relation to Behavioral Performance","volume":"62","author":"Vlaeyen J. 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