Article Impact Level: HIGH Data Quality: STRONG Summary of PLOS ONE, 19(9), e0309952. https://doi.org/10.1371/journal.pone.0309952 Dr. Heike Spaderna et al.
Points
- A cross-sectional study of 185 chronic heart failure (HF) patients examined the relationship between fear of physical activity (PA), heart-focused anxiety, trait anxiety, and self-reported PA levels.
- Higher New York Heart Association (NYHA) class and a greater number of HF medications, including antidepressants, were independently associated with increased fear of PA.
- Fear of PA was significantly linked to more avoidance behavior regarding PA and higher odds of not participating in sports or exercise, unlike other anxiety measures.
- Patients with a vigilant coping style, who focused on health threats, showed higher levels of fear of PA due to increased attention to cardiac symptoms and symptom distress.
- The findings suggest that fear of PA in HF patients is distinct from general anxiety and may be effectively reduced through targeted interventions addressing symptom distress and coping strategies.
Summary
In a cross-sectional study of 185 outpatients with chronic heart failure (HF) from five hospitals, researchers examined the associations between fear of physical activity (PA), heart-focused anxiety, trait anxiety, and self-reported PA levels. The participants had a mean age of 62 ± 11 years, a mean ejection fraction of 36.0% ± 12%, and 24% were women. Psychological characteristics were assessed using self-report questionnaires, including the Fear of Activity in Situations–Heart Failure (FActS-HF15) to measure fear of PA. The study also investigated whether personality-related coping styles, specifically vigilant coping (attention directed toward health threats), influenced fear of PA through symptom perception.
Multivariable regression analyses revealed that a higher New York Heart Association (NYHA) class was independently associated with increased fear of PA (β = 0.26, p = 0.036), as was a more significant number of HF medications including antidepressants (β = 0.25, p = 0.017). Among the anxiety measures, only fear of PA was independently associated with more avoidance behavior regarding PA (β = 0.45, standard error [SE] = 0.06, p < 0.001) and with increased odds of not participating in sports or exercise (odds ratio [OR] = 1.34, 95% confidence interval [CI] 1.03–1.74, p = 0.028). Attention to cardiac symptoms and symptom distress were positively associated with fear of PA (p < 0.001), explaining the higher fear of PA in patients with a vigilant coping style (p = 0.004).
The findings suggest that fear of PA, as measured by the FActS-HF15, is a specific type of anxiety in patients with HF, distinct from general heart-focused anxiety and trait anxiety. Symptom perception and distress play central roles in fear of PA, particularly among patients who habitually focus on health threats. These results indicate that tailored interventions targeting symptom distress and coping styles may effectively reduce fear of PA and promote increased physical activity in patients with HF.
Link to the article: https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0309952
References Spaderna, H., Brandenburg, V. M., Lauterbach, M., Partetzke, T. M., Schwab, S. U., Voss, F., & Kindermann, I. (2024). Associations of fear of physical activity, coping style and self-reported exercise behavior in patients with chronic heart failure. PLOS ONE, 19(9), e0309952. https://doi.org/10.1371/journal.pone.0309952
