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<article xsi:noNamespaceSchemaLocation="http://jats.nlm.nih.gov/publishing/1.1/xsd/JATS-journalpublishing1-mathml3.xsd" dtd-version="1.1" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance"><front><journal-meta><journal-id journal-id-type="publisher-id">JCNR</journal-id><journal-title-group><journal-title>Journal of Clinical and Nursing Research</journal-title></journal-title-group><issn>2208-3685</issn><eissn>2208-3693</eissn><publisher><publisher-name>Bio-Byword Scientific Publishing Pty. Ltd.</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="doi">10.26689/jcnr.v10i2.13577</article-id><article-categories><subj-group subj-group-type="heading"><subject>Article</subject></subj-group></article-categories><title>Kinesiophobia in Primary Caregivers of Patients with Chronic Heart Failure: A Scoping Review</title><url>https://artdesignp.com/journal/JCNR/10/2/10.26689/jcnr.v10i2.13577</url><author>ChenJiaqi,LaiWenjuan,HeYumei,CaiMingjie,ZouPinmei,XuHui</author><pub-date pub-type="publication-year"><year>2026</year></pub-date><volume>10</volume><issue>2</issue><history><date date-type="pub"><published-time>2026-03-10</published-time></date></history><abstract>Objective: To conduct a scoping review of kinesiophobia among primary caregivers of patients with chronic heart failure (CHF). Methods: Following a scoping review methodological framework, PubMed, Web of Science, Embase, Cochrane Library, CINAHL, CNKI, SinoMed, Wanfang, and VIP were searched from inception to 30 June 2025. Relevant studies on kinesiophobia in primary caregivers of CHF patients were identified, summarized, and analyzed. Results: A total of 24 studies were included. Caregivers generally showed insufficient exercise-related knowledge, particularly regarding appropriate exercise intensity and risk recognition. At the cognitive–affective level, caregivers exhibited a pronounced “substitutive” kinesiophobia, characterized by excessive worry about potential adverse events induced by patients’ physical activity. At the behavioral level, this was reflected in restricting patients’ activities and avoiding assisting with exercise, which in turn reduced patients’ adherence to cardiac rehabilitation. Conclusion: Kinesiophobia among primary caregivers of CHF patients arises mainly from cognitive deficits and protective psychological mechanisms. Individualized education and professional guidance are needed to enhance caregivers’ exercise management competence and thereby optimize patients’ rehabilitation outcomes.</abstract><keywords/></article-meta></front><body/><back><ref-list><ref id="B1" content-type="article"><label>1</label><element-citation publication-type="journal"><p>Butler J, Yang M, Manzi M, et al., 2019, Clinical Course of Patients with Worsening Heart Failure with Reduced Ejection Fraction. Journal of the American College of Cardiology, 73(8): 935–944.</p><pub-id pub-id-type="doi"/></element-citation></ref><ref id="B2" content-type="article"><label>2</label><element-citation publication-type="journal"><p>GBD 2017 Disease and Injury Incidence and Prevalence Collaborators, 2018, Global, Regional, and National Incidence, Prevalence, and Years Lived with Disability for 354 Diseases and Injuries for 195 Countries and Territories, 1990–2017: A Systematic Analysis for the Global Burden of Disease Study 2017. Lancet, 392(10159).</p><pub-id pub-id-type="doi"/></element-citation></ref><ref id="B3" content-type="article"><label>3</label><element-citation publication-type="journal"><p>Savarese G, Becher P, Lund L, et al., 2023, Global Burden of Heart Failure: A Comprehensive and Updated Review of Epidemiology. Cardiovascular Research, 118(17): 3272–3287.</p><pub-id pub-id-type="doi"/></element-citation></ref><ref id="B4" content-type="article"><label>4</label><element-citation publication-type="journal"><p>Wang H, Li Y, 2022, Chinese Expert Consensus on the Comprehensive Management of Patients with Worsening Chronic Heart Failure 2022. Chinese Circulation Journal, 37(3): 215–225.</p><pub-id pub-id-type="doi"/></element-citation></ref><ref id="B5" content-type="article"><label>5</label><element-citation publication-type="journal"><p>Zhao B, Liu Y, Yang H, et al., 2023, Meta-Analysis of Effects of Telerehabilitation on Patients with Chronic Heart Failure. Military Nursing, 40(12): 99–103.</p><pub-id pub-id-type="doi"/></element-citation></ref><ref id="B6" content-type="article"><label>6</label><element-citation publication-type="journal"><p>Wang J, Sun G, Gao M, et al., 2023, Research Progress on Exercise Fear in Patients with Cardiovascular Diseases. Chinese Journal of Rehabilitation Medicine, 38(5): 712–715.[7] Hoffmann J, Hellwig S, Brandenburg V, et al., 2018, Measuring Fear of Physical Activity in Patients with Heart Failure. International Journal of Behavioral Medicine, 25(3): 294–303.</p><pub-id pub-id-type="doi"/></element-citation></ref><ref id="B7" content-type="article"><label>7</label><element-citation publication-type="journal"><p>Qin J, Xiong J, Pan X, et al., 2022, Influencing Factors of Exercise Participation in Elderly Patients with Chronic Heart Failure: A Qualitative Study. Practical Journal of Cardiac Cerebral Pneumal and Vascular Disease, 30(5): 20–24.</p><pub-id pub-id-type="doi"/></element-citation></ref><ref id="B8" content-type="article"><label>8</label><element-citation publication-type="journal"><p>Fox M, Butler J, Sidani S, et al., 2022, Family Caregivers’ Preparedness to Support Physical Activity of Patients at Risk for Hospital Readmission in Rural Communities: An Interpretive Descriptive Study. BMC Health Services Research, 22: 907.</p><pub-id pub-id-type="doi"/></element-citation></ref><ref id="B9" content-type="article"><label>9</label><element-citation publication-type="journal"><p>Aromataris E, Lockwood C, Porritt K, et al., 2024, JBI Manual for Evidence Synthesis. JBI.</p><pub-id pub-id-type="doi"/></element-citation></ref><ref id="B10" content-type="article"><label>10</label><element-citation publication-type="journal"><p>Molloy G, Johnston D, Gao C, et al., 2006, Effects of an Exercise Intervention for Older Heart Failure Patients on Caregiver Burden and Emotional Distress. European Journal of Cardiovascular Prevention and Rehabilitation, 13(3): 381–387.</p><pub-id pub-id-type="doi"/></element-citation></ref><ref id="B11" content-type="article"><label>11</label><element-citation publication-type="journal"><p>Piamjariyakul U, Smith C, Werkowitch M, et al., 2012, Enhancing Heart Failure Home Management: Integrated Evidence for a New Family Caregiver Educational Plan. Applied Nursing Research, 25(4): 246–250.</p><pub-id pub-id-type="doi"/></element-citation></ref><ref id="B12" content-type="article"><label>12</label><element-citation publication-type="journal"><p>Bahrami M, Etemadifar S, Shahriari M, et al., 2014, Informational Needs and Related Problems of Family Caregivers of Heart Failure Patients: A Qualitative Study. Journal of Education and Health Promotion, 3: 113.</p><pub-id pub-id-type="doi"/></element-citation></ref><ref id="B13" content-type="article"><label>13</label><element-citation publication-type="journal"><p>Etemadifar S, Bahrami M, Shahriari M, et al., 2014, The Effectiveness of a Supportive Educative Group Intervention on Family Caregiver Burden of Patients with Heart Failure. Iranian Journal of Nursing and Midwifery Research, 19(3): 217–223.</p><pub-id pub-id-type="doi"/></element-citation></ref><ref id="B14" content-type="article"><label>14</label><element-citation publication-type="journal"><p>Etemadifar S, Bahrami M, Shahriari M, et al., 2015, Family Caregivers’ Experiences of Caring for Patients with Heart Failure: A Descriptive Exploratory Qualitative Study. Journal of Nursing Research, 23(2): 153–161.</p><pub-id pub-id-type="doi"/></element-citation></ref><ref id="B15" content-type="article"><label>15</label><element-citation publication-type="journal"><p>Wingham J, Frost J, Britten N, et al., 2015, Needs of Caregivers in Heart Failure Management: A Qualitative Study. Chronic Illness, 11(4): 304–319.</p><pub-id pub-id-type="doi"/></element-citation></ref><ref id="B16" content-type="article"><label>16</label><element-citation publication-type="journal"><p>Cameron J, Rhodes K, Ski C, et al., 2016, Carers’ Views on Patient Self-Care in Chronic Heart Failure. Journal of Clinical Nursing, 25(1–2): 144–152.</p><pub-id pub-id-type="doi"/></element-citation></ref><ref id="B17" content-type="article"><label>17</label><element-citation publication-type="journal"><p>He J, Jiang W, 2016, Qualitative Study of the Burden of Caregivers in Families of Stay-at-Home Patients with Chronic Heart Failure. Military Nursing, 33: 26–28 + 43.</p><pub-id pub-id-type="doi"/></element-citation></ref><ref id="B18" content-type="article"><label>18</label><element-citation publication-type="journal"><p>Wingham J, Frost J, Britten N, 2017, Behind the Smile: Qualitative Study of Caregivers’ Anguish and Management Responses While Caring for Someone Living with Heart Failure. BMJ Open, 7(7): e014126.</p><pub-id pub-id-type="doi"/></element-citation></ref><ref id="B19" content-type="article"><label>19</label><element-citation publication-type="journal"><p>Natasa S, Mitja L, Jerneja F, 2020, Living with Chronic Heart Failure: Exploring Patient, Informal Caregiver, and Healthcare Professional Perceptions. International Journal of Environmental Research and Public Health, 17(8): 2666.</p><pub-id pub-id-type="doi"/></element-citation></ref><ref id="B20" content-type="article"><label>20</label><element-citation publication-type="journal"><p>Zhang Y, Li L, 2021, Current Status and Influencing Factors of Care Capacity of Patients with Chronic Heart Failure and Their Primary Caregivers. Journal of Dali University, 6(4): 71–79.</p><pub-id pub-id-type="doi"/></element-citation></ref><ref id="B21" content-type="article"><label>21</label><element-citation publication-type="journal"><p>Schutz S, Walthall H, 2022, Needs and Experiences of Caregivers of People with Heart Failure: A Qualitative Study. Heart and Lung, 54: 42–48.</p><pub-id pub-id-type="doi"/></element-citation></ref><ref id="B22" content-type="article"><label>22</label><element-citation publication-type="journal"><p>Birtwistle S, Jones I, Murphy R, et al., 2022, Lived Experiences of Physical Activity Post-Myocardial Infarction: A Longitudinal Study. Disability and Rehabilitation, 44(14): 3661–3670.</p><pub-id pub-id-type="doi"/></element-citation></ref><ref id="B23" content-type="article"><label>23</label><element-citation publication-type="journal"><p>Najjar C, Dima D, Goldfarb M, 2021, Patient and Family Perspectives on Early Mobilization in Acute Cardiac Care. CJC Open, 4(2): 230.</p><pub-id pub-id-type="doi"/></element-citation></ref><ref id="B24" content-type="article"><label>24</label><element-citation publication-type="journal"><p>Purcell C, Purvis A, Cleland J, et al., 2023, Home-Based Cardiac Rehabilitation for Heart Failure Patients and Caregivers: A Mixed-Methods Study. European Journal of Cardiovascular Nursing, 22(8): 804–813.</p><pub-id pub-id-type="doi"/></element-citation></ref><ref id="B25" content-type="article"><label>25</label><element-citation publication-type="journal"><p>Linda C, Sk F, Ta L, et al., 2023, Improvement in Heart Failure Self-Care and Patient Readmissions with Caregiver Education. Western Journal of Nursing Research, 45(5): 402–415.</p><pub-id pub-id-type="doi"/></element-citation></ref><ref id="B26" content-type="article"><label>26</label><element-citation publication-type="journal"><p>Li F, Zhang X, Chen J, 2024, Practical Journal of Cardiac Cerebral Pneumal and Vascular Disease. Practical Journal of Cardiac Cerebral Pneumal and Vascular Disease, 32(6): 112–116.</p><pub-id pub-id-type="doi"/></element-citation></ref><ref id="B27" content-type="article"><label>27</label><element-citation publication-type="journal"><p>Marzban A, Akbari M, Moradi M, et al., 2024, Effect of Emotional Freedom Techniques on Anxiety and Caregiver Burden in Heart Failure. Journal of Education and Health Promotion, 13: 128.</p><pub-id pub-id-type="doi"/></element-citation></ref><ref id="B28" content-type="article"><label>28</label><element-citation publication-type="journal"><p>Wu Q, Pei H, Zhang L, et al., 2024, Self-Care Challenges in Heart Failure: Perspectives of Patients and Caregivers. Geriatric Nursing, 58: 446–458.</p><pub-id pub-id-type="doi"/></element-citation></ref><ref id="B29" content-type="article"><label>29</label><element-citation publication-type="journal"><p>Alaei A, Babaei S, Farzi S, et al., 2024, Effect of a Supportive-Educational Program Based on the COPE Model on Caregiver Burden. BMC Nursing, 23: 72.</p><pub-id pub-id-type="doi"/></element-citation></ref><ref id="B30" content-type="article"><label>30</label><element-citation publication-type="journal"><p>Noonan M, Frost J, Dalal H, et al., 2024, Caregiver Presence in Home-Based Cardiac Rehabilitation Improves Quality of Life. European Journal of Cardiovascular Nursing, 23(1): 90–94.</p><pub-id pub-id-type="doi"/></element-citation></ref><ref id="B31" content-type="article"><label>31</label><element-citation publication-type="journal"><p>Ao C, Hu S, Zhan L, 2025, Exercise Rehabilitation Based on Medical Care–Family Integration in Older Heart Failure Patients. World Journal of Psychiatry, 15(6): 105855.</p><pub-id pub-id-type="doi"/></element-citation></ref><ref id="B32" content-type="article"><label>32</label><element-citation publication-type="journal"><p>Tsami A, Koutelekos I, Gerogianni G, et al., 2025, Quality of Life in Heart Failure Patients: Effects of Anxiety and Depression. Journal of Cardiovascular Development and Disease, 12(4): 137.</p><pub-id pub-id-type="doi"/></element-citation></ref><ref id="B33" content-type="article"><label>33</label><element-citation publication-type="journal"><p>Kitko L, McIlvennan C, Bidwell J, et al., 2020, Family Caregiving for Individuals with Heart Failure: A Scientific Statement. Circulation, 141(22): e864–e878.</p><pub-id pub-id-type="doi"/></element-citation></ref><ref id="B34" content-type="article"><label>34</label><element-citation publication-type="journal"><p>McHorney C, Mansukhani S, Anatchkova M, et al., 2021, Impact of Heart Failure on Patients and Caregivers: A Qualitative Study. PLOS One, 16(3): e0248240.</p><pub-id pub-id-type="doi"/></element-citation></ref><ref id="B35" content-type="article"><label>35</label><element-citation publication-type="journal"><p>Zhai S, Chu F, Tan M, et al., 2023, Digital Health Interventions to Support Family Caregivers: A Systematic Review. Digital Health, 9: 20552076231171967.</p><pub-id pub-id-type="doi"/></element-citation></ref><ref id="B36" content-type="article"><label>36</label><element-citation publication-type="journal"><p>Riffin C, Wolff J, Butterworth J, et al., 2021, Challenges and Approaches to Involving Family Caregivers in Primary Care. Patient Education and Counseling, 104(7): 1644–1651.</p><pub-id pub-id-type="doi"/></element-citation></ref><ref id="B37" content-type="article"><label>37</label><element-citation publication-type="journal"><p>Longhini J, Gauthier K, Konradsen H, et al., 2025, Effectiveness of Nursing Interventions to Improve Self-Care in Heart Failure: A Meta-Analysis. BMC Nursing, 24(1): 286.</p><pub-id pub-id-type="doi"/></element-citation></ref><ref id="B38" content-type="article"><label>38</label><element-citation publication-type="journal"><p>Thodi M, Bistola V, Lambrinou E, et al., 2023, Nurse-Led Educational Intervention in Heart Failure Patients and Caregivers. European Journal of Cardiovascular Nursing, 22(7): 709–718.</p><pub-id pub-id-type="doi"/></element-citation></ref><ref id="B39" content-type="article"><label>39</label><element-citation publication-type="journal"><p>Li W, Tu H, Peng Y, et al., 2024, Meta-Synthesis of Psychological Experiences of Kinesiophobia in Cardiovascular Disease Patients. Military Nursing, 41(12): 95–99.</p><pub-id pub-id-type="doi"/></element-citation></ref><ref id="B40" content-type="article"><label>40</label><element-citation publication-type="journal"><p>Wang C, Yu M, Liu C, et al., 2024, Status and Influencing Factors of Caregiver Readiness in Elderly Patients with Chronic Heart Failure. Chinese Journal of Nursing, 59(14): 1706.</p><pub-id pub-id-type="doi"/></element-citation></ref><ref id="B41" content-type="article"><label>41</label><element-citation publication-type="journal"><p>Ahmad F, Bowles K, Alexander M, et al., 2015, Comparing Perspectives of Patients, Caregivers, and Clinicians on Heart Failure Management. Journal of Cardiac Failure, 22.</p><pub-id pub-id-type="doi"/></element-citation></ref><ref id="B42" content-type="article"><label>42</label><element-citation publication-type="journal"><p>Kim E, Oh S, Son Y, 2020, Caring Experiences of Family Caregivers of Patients with Heart Failure: A Meta-Ethnographic Review. European Journal of Cardiovascular Nursing, 19(6): 473–485.</p><pub-id pub-id-type="doi"/></element-citation></ref><ref id="B43" content-type="article"><label>43</label><element-citation publication-type="journal"><p>Coull A, Pugh G, 2021, Maintaining Physical Activity Following Myocardial Infarction: A Qualitative Study. BMC Cardiovascular Disorders, 21(1): 105.</p><pub-id pub-id-type="doi"/></element-citation></ref><ref id="B44" content-type="article"><label>44</label><element-citation publication-type="journal"><p>Tierney S, Elwers H, Sange C, et al., 2011, Influences on Physical Activity in People with Heart Failure: A Qualitative Study. International Journal of Nursing Studies, 48(10): 1234–1243.</p><pub-id pub-id-type="doi"/></element-citation></ref><ref id="B45" content-type="article"><label>45</label><element-citation publication-type="journal"><p>Polikandrioti M, Tsami A, Tsoulou V, et al., 2025, Quality of Life, Anxiety, and Depression in Caregivers of Heart Failure Patients. Health Care, 13(16): 1986.</p><pub-id pub-id-type="doi"/></element-citation></ref><ref id="B46" content-type="article"><label>46</label><element-citation publication-type="journal"><p>Lv Q, Chang H, Wang Y, et al., 2025, Co-Occurring Self-Efficacy, Anxiety, and Depression in Heart Failure Caregivers. BMC Nursing, 24(1): 351.</p><pub-id pub-id-type="doi"/></element-citation></ref><ref id="B47" content-type="article"><label>47</label><element-citation publication-type="journal"><p>Birtwistle S, Jones I, Murphy R, et al., 2021, Family Support for Physical Activity Post-Myocardial Infarction. Nursing and Health Sciences, 23(1): 227–236.</p><pub-id pub-id-type="doi"/></element-citation></ref><ref id="B48" content-type="article"><label>48</label><element-citation publication-type="journal"><p>Liu J, Guo W, Gao W, et al., 2024, Meta-Synthesis of Qualitative Research on Kinesiophobia in Cardiac Rehabilitation Patients. Chinese Journal of Nursing, 59(4): 474–481.</p><pub-id pub-id-type="doi"/></element-citation></ref><ref id="B49" content-type="article"><label>49</label><element-citation publication-type="journal"><p>Yu D, Qiu C, Li P, et al., 2024, Effects of Dyadic Care Interventions for Heart Failure: A Systematic Review and Meta-Analysis. International Journal of Nursing Studies, 157: 104829.</p><pub-id pub-id-type="doi"/></element-citation></ref><ref id="B50" content-type="article"><label>50</label><element-citation publication-type="journal"><p>Saber S, Rahimian B, 2024, Enhancing Caregiver Resilience: A Systematic Review of Interventions for Chronic Disease Management. Biosocial Health Journal, 1(4): 179–187.</p><pub-id pub-id-type="doi"/></element-citation></ref><ref id="B51" content-type="article"><label>51</label><element-citation publication-type="journal"><p>Kokorelias K, Chiu M, Paul S, et al., 2025, Use of Virtual and Augmented Reality to Support Caregiver Resilience: A Scoping Review. Cureus, 16(7): e64082.</p><pub-id pub-id-type="doi"/></element-citation></ref></ref-list></back></article>
