The Impact of Somatic Symptoms on kinesiophobia after Esophagectomy among Cancer Patients: The Mediating Roles of Intrusive Rumination and Avoidant Coping

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Abstract Purpose Cancer patients who undergo esophagectomy are prone to developing kinesiophobia, which adversely affects their disease prognosis and quality of life. Somatic symptoms are closely related to kinesiophobia, but the mechanisms underlying this relationship remain unclear. Therefore, the current study aimed to explore the chain-mediation roles of intrusive rumination and avoidant coping in the relationship between somatic symptoms and kinesiophobia in cancer patients who underwent esophagectomy. Methods A cross-sectional study was conducted in China from February 2023 to December 2023. A total of 279 postesophagectomy cancer patients were evaluated using the Symptom Check List 90 (SCL-90), Event Related Rumination Inventory (ERRI), Medical Coping Modes Questionnaire (MCMQ), and Tampa Scale of Kinesiophobia (TSK-11). Results Kinesiophobia was significantly positively correlated with somatic symptoms, intrusive rumination, and avoidant coping(P < 0.01). Somatic symptoms had a direct impact on kinesiophobia[B = 0.280, 95%CI(0.202, 0.359)]. Furthermore, somatic symptoms could also indirectly affect kinesiophobia through the separate mediating effects of intrusive rumination[B = 0.197, 95%CI(0.139 0.257)] and avoidant coping[B = 0.045, 95%CI(0.016, 0.085)], as well as through the chain-mediated effects of intrusive rumination-avoidant coping[B = 0.023, 95%CI(0.011, 0.041)]. Conclusions This study suggested that health care professionals can prevent the occurrence of kinesiophobia in postesophagectomy cancer patients by alleviating somatic symptoms, altering patients' intrusive rumination patterns, and guiding patients to actively cope with the disease.

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