{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T03:53:41Z","timestamp":1787025221738,"version":"build-2736575974"},"reference-count":60,"publisher":"MJS Publishing, Medical Journals Sweden AB","license":[{"start":{"date-parts":[[2025,11,25]],"date-time":"2025-11-25T00:00:00Z","timestamp":1764028800000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JRM"],"abstract":"<jats:p>Objective: To explore the mediating role of exercise self-efficacy in the relationship between pain catastrophizing, kinesiophobia, and exercise adherence in patients post-cardiovascular surgery.\nDesign: Cross-sectional study.\nSubjects\/Patients: A total of 278 adult patients who underwent elective cardiovascular surgeries between March 2023 and February 2025 at a tertiary hospital in China.\nMethods: Participants completed standardized instruments measuring pain catastrophizing, kinesiophobia, exercise self-efficacy, and exercise adherence. Statistical analysis was performed using SPSS 29.0, R 4.4.5, and Zstats 1.0, including mediation analysis.\nResults: Pain catastrophizing significantly negatively correlated with exercise self-efficacy (r\u2009=\u2009\u20130.830, p&lt;0.001) and adherence (r\u2009=\u2009\u20130.953, p\u2009&lt;\u20090.001), while positively correlating with kinesiophobia (r\u2009=\u20090.295, p\u2009&lt;\u20090.001). Kinesiophobia negatively correlated with self-efficacy (r\u2009=\u2009\u20130.252, p\u2009&lt;\u20090.001) and adherence (r\u2009=\u2009\u20130.277, p&lt;0.001). Exercise self-efficacy positively correlated with adherence (r\u2009=\u20090.699, p&lt;0.001). Mediation analysis revealed that self-efficacy partially mediated the relationship between pain catastrophizing and adherence (\u03b2\u2009=\u2009\u20131.11, p&lt;0.001) and between kinesiophobia and adherence (\u03b2\u2009=\u2009\u20130.30, p\u2009&lt;\u20090.001).\nConclusion: Exercise self-efficacy is a critical mediator in how psychological factors like pain catastrophizing and kinesiophobia influence exercise adherence post-cardiovascular surgery. Enhancing self-efficacy may improve rehabilitation outcomes.<\/jats:p>","DOI":"10.2340\/jrm.v57.43853","type":"journal-article","created":{"date-parts":[[2025,11,26]],"date-time":"2025-11-26T07:18:29Z","timestamp":1764141509000},"page":"jrm43853","source":"Crossref","is-referenced-by-count":2,"title":["Pain catastrophizing, kinesiophobia, and exercise adherence in postoperative cardiovascular surgery patients: the mediating role of exercise self-efficacy"],"prefix":"10.2340","volume":"57","author":[{"given":"Jingfang","family":"Wang","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yufang","family":"Chen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1183","published-online":{"date-parts":[[2025,11,25]]},"reference":[{"key":"133984","doi-asserted-by":"crossref","unstructured":"Shemin RJ. The future of cardiovascular surgery. 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