Abstract
BACKGROUND: Up to 70% of patients with rheumatoid arthritis (RA) experience kinesiophobia, a debilitating fear of movement that exacerbates physical limitations and psychological stress. However, effective interventions remain limited, particularly in resource-constrained settings. This study evaluated the feasibility, safety, and acceptability of an adapted Emotional Freedom Techniques (EFT) intervention for Chinese patients with RA. METHODS: A two-phase design was used. Phase 1 involved protocol validation and adaptation through the Delphi method. Phase 2 was a single-arm feasibility study involving 20 RA patients with kinesiophobia. The 4-week intervention included a 2-week supervised inpatient phase and a 2-week self-practice phase supported via WeChat. Feasibility (adherence, safety, satisfaction) and secondary outcomes (kinesiophobia, pain, pain anxiety, patient activation, and quality of life) were assessed. Data analysis included paired t-tests and thematic analysis of patient feedback. RESULTS: The adapted EFT protocol achieved expert consensus (I-CVI ≥ 0.80). Among participants, 80% met adherence criteria, no adverse events were reported, and 75-85% expressed satisfaction with the intervention. EFT was perceived as simple and accessible. Kinesiophobia scores decreased by 6.5 points (a 12.7% reduction; Hedges' g = 1.36), with moderate to large effects also seen for pain and anxiety. CONCLUSIONS: This adapted EFT intervention proved feasible, safe, and acceptable for Chinese RA patients with kinesiophobia. These findings support the potential for larger randomized controlled trials to rigorously evaluate effectiveness and long-term impact. CLINICAL TRIAL REGISTRATION: Chinese Clinical Trial Registry, ChiCTR2300076013. Date of registration: 21 September 2023.