{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,22]],"date-time":"2026-06-22T15:52:01Z","timestamp":1782143521477,"version":"3.54.5"},"reference-count":24,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,6,22]],"date-time":"2026-06-22T00:00:00Z","timestamp":1782086400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Med."],"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Kinesiophobia is highly prevalent in elderly patients with coronary heart disease (CHD) and severely limits participation in cardiac rehabilitation. However, phased, theory-based interventions targeting this population are lacking.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      This single-blind randomized controlled trial of 139 elderly CHD patients evaluated a staged cardiac rehabilitation intervention based on the Health Belief Model (HBM). The intervention group (\n                      <jats:italic>n<\/jats:italic>\n                      = 69) received a staged HBM-based programme plus usual care; the control group (\n                      <jats:italic>n<\/jats:italic>\n                      = 70) received usual care only. Outcomes (TSK-SV Heart, Barthel Index, SEE) were measured at admission (T0), discharge (T1), and 1 month (T2) and 3 months (T3) post-discharge.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Repeated-measures ANOVA revealed significant time, group, and interaction effects for all outcomes (\n                      <jats:italic>P<\/jats:italic>\n                      &amp;lt; 0.05). The intervention group showed significantly higher Barthel Index and SEE scores at T1, T2, and T3, and lower TSK-SV Heart scores at T2 and T3 versus controls (\n                      <jats:italic>P<\/jats:italic>\n                      &amp;lt; 0.05). Within the intervention group, kinesiophobia at T2\/T3 was lower than at T0\/T1, and self-efficacy at T1\u2013T3 was higher than at T0 (\n                      <jats:italic>P<\/jats:italic>\n                      &amp;lt; \u03b1'). No exercise-related adverse events occurred.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion<\/jats:title>\n                    <jats:p>A staged HBM-based cardiac rehabilitation programme reduces kinesiophobia, improves ADL, and enhances exercise self-efficacy in elderly CHD patients, with sustained effects and excellent safety. This nurse-led, low-cost programme can be integrated into standard cardiac rehabilitation pathways for older adults.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fmed.2026.1857532","type":"journal-article","created":{"date-parts":[[2026,6,22]],"date-time":"2026-06-22T15:40:42Z","timestamp":1782142842000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["A randomized controlled trial of staged cardiac rehabilitation based on the Health Belief Model on kinesiophobia, self-efficacy and activities of daily living in elderly patients with coronary heart disease"],"prefix":"10.3389","volume":"13","author":[{"given":"Xiaoqin","family":"Zheng","sequence":"first","affiliation":[{"name":"Department of Nursing, Suining Central Hospital","place":["Suining, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ya","family":"Tan","sequence":"additional","affiliation":[{"name":"Department of Nursing, 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