Dependence, Frailty, and Kinesiophobia on Early Postoperative Mobilization and Self-Care Ability in Patients Undergoing Lumbar Disc Herniation Surgery

Lumbar disc herniation is one of the most common spinal disorders affecting functional capacity and quality of life. Although conservative treatment is effective for many patients, a substantial proportion require surgical intervention because of persistent symptoms or neurological impairment. The primary goals of surgery are pain relief, prevention of complications, restoration of functional independence, and improvement of quality of life.

Recovery after lumbar disc herniation surgery varies considerably among individuals. Factors such as dependency in activities of daily living, frailty, and kinesiophobia may influence patients' ability to mobilize early after surgery and perform self-care activities. Dependency reflects the level of assistance required for daily living activities, frailty indicates reduced physiological reserve and increased vulnerability to stressors, and kinesiophobia refers to an excessive fear of movement resulting from concerns about pain or reinjury. These characteristics may adversely affect postoperative recovery by limiting participation in early mobilization and delaying the restoration of self-care ability.

Although previous studies have examined the relationships between these variables and different health outcomes in various surgical populations, evidence regarding their combined influence on postoperative mobilization and self-care following lumbar disc herniation surgery remains limited. Identifying patients with unfavorable preoperative characteristics may facilitate early recognition of individuals at risk for delayed recovery and support the development of individualized nursing interventions.

This prospective observational study will be conducted in the Neurosurgery Clinic of Aydın Adnan Menderes University Research and Application Hospital. Adult patients scheduled for lumbar disc herniation surgery will be recruited consecutively. Data will be collected at two time points: one day before surgery and on the first postoperative day. Preoperative assessments will include a Patient Information Form, the Katz Activities of Daily Living Scale, the FRAIL Scale, and the Tampa Scale for Kinesiophobia. On the first postoperative day, mobilization will be evaluated using the Patient Mobility Scale and the Observer Mobility Scale, while self-care agency will be assessed using the Exercise of Self-Care Agency Scale.

The primary objective of the study is to determine the effects of preoperative dependency, frailty, and kinesiophobia on postoperative mobilization and self-care agency. The results are expected to contribute to the identification of modifiable preoperative factors influencing early postoperative recovery and provide evidence to support nursing assessment, perioperative care planning, and individualized rehabilitation strategies for patients undergoing lumbar disc herniation surgery.