摘要目的:针对全膝关节置换术（TKA）患者运动恐惧，构建基于能力、机会、动机-行为（COM-B）理论模型的TKA患者运动恐惧康复护理方案，为临床工作人员实施康复治疗提供参考。方法:2023年8—12月，采用文献分析法，结合COM-B理论模型与康复锻炼相关指南、专家共识初步构建方案，通过2轮德尔菲专家函询形成TKA患者运动恐惧康复护理方案，运用层次分析法计算各个条目的权重。结果:纳入专家15名，男4名，女11名，年龄（45.80 ± 5.72）岁。2轮专家函询问卷有效回收率均为15/15，专家权威系数分别为0.860和0.875，Kendall协调系数分别为0.155和0.172，差异均有统计学意义（ χ 2 = 97.70、105.91，均 P<0.01）。最终构建的TKA患者运动恐惧康复护理方案包括3项一级指标、8项二级指标、25项三级指标。 结论:基于COM-B理论模型构建的TKA患者运动恐惧康复护理方案具有科学性及实用性，能够为临床工作人员提供实践依据。

abstractsObjective:To construct a rehabilitation nursing program for total knee arthroplasty (TKA) patients with kinesiophobia based on capacity, opportuniy, motivation-behavior (COM-B) theoretical model, and to provide reference for clinical staff to implement rehabilitation treatment.Methods:From August to December 2023, literature analysis was used to construct a preliminary program, combined the COM-B theoretical model with the rehabilitation exercise guidelines and expert consensus. The rehabilitation nursing program for TKA patients with kinesiophobia was formed through 2 rounds of Delphi expert correspondence consultation, and the analytic hierarchy process was used to calculate the weight of each item.Results:A total of 15 experts were included, including 4 males and 11 females, aged (45.80 ± 5.72) years old. The effective recovery rate of the 2 rounds of expert correspondence questionnaires were 15/15, the expert authority coefficients were 0.860 and 0.875, and the Kendall coordination coefficients were 0.155 and 0.172, and the differences were statistically significant ( χ2 = 97.70, 105.91, both P<0.01). The final rehabilitation nursing program for TKA patients with kinesiophobia included 3 primary indexes, 8 secondary indexes and 25 tertiary indexes. Conclusions:The rehabilitation nursing program for TKA patients with kinesiophobia constructed based on COM-B theoretical model is scientific and practical, and can provide a practical basis for clinical staff.