{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,19]],"date-time":"2026-08-19T06:27:53Z","timestamp":1787120873118,"version":"build-2736575974"},"reference-count":37,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,8,19]],"date-time":"2026-08-19T00:00:00Z","timestamp":1787097600000},"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. Psychol."],"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To examine whether social support and psychological resilience sequentially mediate the relationship between kinesiophobia (fear of movement) and autonomous motivation for cardiac rehabilitation (CR) among patients following cardiac surgery.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A cross-sectional survey was conducted with 167 adult patients recruited via convenience sampling from the Department of Cardiac Surgery at a tertiary hospital in China between January 2024 and June 2025. Eligible participants completed validated Chinese versions of the Social Support Rating Scale (SSRS), Connor-Davidson Resilience Scale (CD-RISC), Tampa Scale for Kinesiophobia-Heart Version (TSK-SV Heart), and the autonomy subscale of the Cardiac Rehabilitation Inventory (CRI) 3 months after hospital discharge. Spearman correlation analyses were used to assess bivariate relationships, and a serial mediation model (kinesiophobia \u2192 social support \u2192 resilience \u2192 CR autonomy) was tested using Hayes' PROCESS macro (Model 6, 10,000 bootstrap samples).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Participants reported mean scores of 27.49 \u00b1 4.57 for social support, 57.84 \u00b1 10.21 for resilience, 47.05 \u00b1 4.69 for kinesiophobia, and 17.52 \u00b1 3.00 for CR autonomy. Kinesiophobia was significantly negatively correlated with social support (\n                      <jats:italic>r<\/jats:italic>\n                      = \u22120.339,\n                      <jats:italic>p<\/jats:italic>\n                      &amp;lt; 0.01). Social support was positively associated with both resilience (\n                      <jats:italic>r<\/jats:italic>\n                      = 0.531,\n                      <jats:italic>p<\/jats:italic>\n                      &amp;lt; 0.01) and CR autonomy (\n                      <jats:italic>r<\/jats:italic>\n                      = 0.509,\n                      <jats:italic>p<\/jats:italic>\n                      &amp;lt; 0.01). The serial mediation model yielded a significant total indirect effect of \u22120.0880 (95% CI [\u22120.1453, \u22120.0330]), accounting for 85.5% of the total effect. Both the indirect path through social support alone (kinesiophobia \u2192 social support \u2192 CR autonomy;\n                      <jats:italic>ab<\/jats:italic>\n                      1 = \u22120.0599) and the full serial path through both mediators (kinesiophobia \u2192 social support \u2192 resilience \u2192 CR autonomy;\n                      <jats:italic>ab<\/jats:italic>\n                      3 = \u22120.0273) were statistically significant (\n                      <jats:italic>p<\/jats:italic>\n                      &amp;lt; 0.05). The direct effect of kinesiophobia on CR autonomy was non-significant after controlling for mediators.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Social support and psychological resilience jointly and sequentially mediate the relationship between kinesiophobia and reduced autonomous motivation for CR after cardiac surgery. This provides empirical support for integrating fear, relatedness, and competence within a self-determination framework in post-surgical recovery. The results advance mechanistic understanding of health behavior by identifying modifiable psychological pathways that may inform future theory-driven interventions to promote sustained engagement in cardiac rehabilitation.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fpsyg.2026.1782488","type":"journal-article","created":{"date-parts":[[2026,8,19]],"date-time":"2026-08-19T05:47:42Z","timestamp":1787118462000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Kinesiophobia and autonomous motivation for cardiac rehabilitation after cardiac surgery: sequential mediation by social support and psychological resilience"],"prefix":"10.3389","volume":"17","author":[{"given":"Ting","family":"Shen","sequence":"first","affiliation":[{"name":"Division of Critical Care Medicine, Deyang People's Hospital, Deyang","place":["Sichuan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ting","family":"Leng","sequence":"additional","affiliation":[{"name":"Division of Critical Care Medicine, Deyang People's Hospital, Deyang","place":["Sichuan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qi","family":"Peng","sequence":"additional","affiliation":[{"name":"Division of Critical Care Medicine, Deyang People's Hospital, Deyang","place":["Sichuan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qiuhong","family":"Chen","sequence":"additional","affiliation":[{"name":"Division of Critical Care Medicine, Deyang People's Hospital, Deyang","place":["Sichuan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lin","family":"Luo","sequence":"additional","affiliation":[{"name":"Division of Critical Care Medicine, Deyang People's Hospital, Deyang","place":["Sichuan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiahong","family":"Huang","sequence":"additional","affiliation":[{"name":"Division of Critical Care Medicine, Deyang People's Hospital, Deyang","place":["Sichuan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,8,19]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"e16864","DOI":"10.2196\/16864","article-title":"Biopsychosocial profiles of patients with cardiac disease in remote rehabilitation processes: mixed methods grounded theory approach","volume":"8","author":"Anttila","year":"2021","journal-title":"JMIR Rehabil. 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