Fit Of Structural Equation Models Research Articles

How to evaluate local fit (residuals) in large structural equation models.

Consistent with reporting standards for structural equation modelling (SEM), model fit should be evaluated at two different levels, global and local. Global fit concerns the overall or average correspondence between the entire data matrix and the model, given the parameter estimates for the model. Local fit is evaluated at the level of the residuals, or differences between observed and predicted associations for every pair of measured variables in the model. It can happen that models with apparently satisfactory global fit can nevertheless have problematic local fit. This may be especially true for relatively large models with many variables, where serious misspecification is indicated by some larger residuals, but their contribution to global fit is diluted when averaged together with all the other smaller residuals. It can be challenging to evaluate local fit in large models with dozens or even hundreds of variables and corresponding residuals. Thus, the main goal of this tutorial is to offer suggestions about how to efficiently evaluate and describe local fit for large structural equation models. An empirical example is described where all data, syntaxand output files are freely available to readers.

A Study of the Mediating Effect and Path of Customer Fit in Repeat Purchase Behavior in the Residential Market Driven by Digital Marketing Technology

Improving the repeat purchase intention of customers of real estate enterprises from marketing strategies is increasingly important for real estate enterprises to achieve the goal of stable and increasing long-term profits. This paper, driven by digital marketing technology, takes customer repeat purchase behavior in residential commodity market as the research object. The variables of brand community value, customer fit and repeat purchase behavior are first defined and selected. Then the relationship model of brand community value, customer fit and repeat purchase behavior was established, questionnaire research was conducted on mature real estate community members, and data analysis and structural equation model fitting were carried out using SPSS and AMOS software in order to test the mediating effect of customer fit in repeat purchase behavior in the residential market as well as the path. The study concluded that the standardized coefficient of customer fit on customers’ repeat purchase intention is 0.36, which has a significant positive effect. Meanwhile, customer fit has a mediating effect between the five dimensions of brand community value and repeat purchase behavior, and all five dimensions have a partial mediating effect in the process of influencing repeat purchase intention.

Social Cluster and Heritage Memory: A Study on the Space Perception of Zhaozhou Basin Horse Caravan Vernacular Architecture

Located in Dali, Yunnan, the Zhaozhou basin is home to many precious architectural heritages, particularly the historical horse caravan architecture. These buildings face the challenge of renewal and transformation. It is of great significance to explore the local population’s awareness of the architectural heritage of the horse caravan in order to protect the architectural heritage and facilitate rural revitalization. This study reviews the related research on “space perception”, establishes a theoretical framework of space perception under the architectural dimension, and develops hypotheses. The social cluster of typical settlements in the Zhaozhou basin is selected as the research object, and empirical analyses are carried out using SPSS and AMOS software. An analytical framework model of empirical research is constructed to evaluate the space perception of the current social population. The results of the reliability and validity tests of the questionnaire show that the CR is greater than 0.7 and that the AVE is greater than 0.5. The value of the structural equation model fitting index χ2/df is 1.863, which is less than 3. The model test results show that research hypotheses H1–H5 are supported; that is, space perception has a significant positive impact on cognition and local identity, cognition has a significant positive impact on local identity and space function, and place identity has a significant positive impact on space appeal. This study demonstrates the relationship between space perception and the architectural remains of the horse caravan, and it analyzes the human psychological perception behind the material space. The findings support the need for further conservation of the horse caravan architecture. This study further deepens the theory of space perception and its application in the study of vernacular architecture, which can provide a research path for the protection and development of vernacular architectural heritage.

Equivalence Testing Based Fit Index: Standardized Root Mean Squared Residual

A popular measure of model fit in structural equation modeling (SEM) is the standardized root mean squared residual (SRMR) fit index. Equivalence testing has been used to evaluate model fit in structural equation modeling (SEM) but has yet to be applied to SRMR. Accordingly, the present study proposed equivalence-testing based fit tests for the SRMR (ESRMR). Several variations of ESRMR were introduced, incorporating different equivalence bounds and methods of computing confidence intervals. A Monte Carlo simulation study compared these novel tests with traditional methods for evaluating model fit. The results demonstrated that certain ESRMR tests based on an analytic computation of the confidence interval correctly reject poor-fitting models and are well-powered for detecting good-fitting models. We also present an illustrative example with real data to demonstrate how ESRMR may be incorporated into model fit evaluation and reporting. Our recommendation is that ESRMR tests be presented in addition to descriptive fit indices for model fit reporting in SEM.

Critical consciousness among undocumented immigrant college students: Responding to cultural stress and psychological distress.

Cultural stress is experienced by undocumented students when they encounter discrimination in higher education and society. In response, undocumented students engage in critical consciousness, while simultaneously experiencing psychological distress. A conceptual model is introduced to describe the links between cultural stress, critical consciousness development, and psychological distress. One hundred seventy-one undocumented college students were recruited to participate in this study and completed measures of cultural stress (discrimination). They also completed measures of psychological distress, critical consciousness, and social justice self-efficacy and outcome expectations. The proposed model was tested for global fit and path analysis in structural equation modeling. Indirect effects were probed to assess the mediating role of critical consciousness and psychological distress. The model fit the data excellently. Greater discrimination was associated with higher critical consciousness, which in turn was associated with elevated social justice self-efficacy and outcome expectations. Additionally, higher discrimination was also linked to greater psychological distress. The link between cultural stress and critical consciousness was not explained by psychological distress. This research expands theory by articulating the adaptive ways undocumented students respond to the conditions that cause cultural stress and psychological distress. This aligns with a growing literature documenting the psychology of undocumented immigrants' activism and advocacy. Findings may inform interventions by higher education institutional agents and research to offset cultural stress and psychological distress. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Spiritual needs of women with breast cancer: A structural equation model

PurposeThe purpose of this study was to develop a structural equation model (SEM) to explore the factors influencing the spiritual needs of breast cancer patients. MethodsA cross-sectional study was conducted in the breast surgery department of a tertiary hospital in China from September 2020 to December 2020; convenience sampling and questionnaires were used to facilitate sampling and data collection. A total of 220 female breast cancer patients were included in the study. The data were analysed using multiple linear regression and structural equation modelling. ResultsCompared with patients with other diseases, patients with breast cancer have greater spiritual needs (76.16 ± 13.19). Multivariate analysis revealed that religious beliefs, education level, social support, and resilience are important factors affecting the mental health of women with cancer (p < 0.05). The structural equation model fit well (RMSEA = 0.056, χ2p = 0.002). Social support directly affected spiritual needs (β = 0.607, p < 0.001) and indirectly affected spiritual needs through resilience (β = 0.353, p < 0.001). Resilience directly affected spiritual needs (β = 0.386, p < 0.05). Education level indirectly affected spiritual needs through social support (β = 0.307, p < 0.001). ConclusionThis study provides a theoretical basis for intervention measures to improve the spiritual needs of female breast cancer patients. Paying more attention to social support and resilience may help solve the problem of meeting the high spiritual needs of breast cancer patients. Further research is needed to develop interventions.

Direct and indirect effects of adiposity on markers of autonomic nervous system activity in older adults.

Several cardiovascular disease (CVD) risk factors (e.g., hypertension, poor glycemic control) can affect and be affected by autonomic nervous system (ANS) activity. Since excess adiposity can influence CVD development through its effect on hypertension and diabetes mellitus, it is important to determine how adiposity and altered ANS activity are related. The present study employed structural equation modeling to investigate the relation between adiposity and ANS activity both directly and indirectly through biological variables typically associated with glycemic impairment and cardiac stress in older adults. Utilizing the Atherosclerosis Risk in Communities (ARIC) dataset, 1,145 non-smoking adults (74±4.8 yrs, 62.8% female) free from known CVD, hypertension, and diabetes and not currently taking beta-blockers were evaluated for fasting blood glucose (FBG), insulin, and HbA1c concentrations, waist circumference (WC), blood pressure (BP), and markers of ANS activity. WC was recorded just above the iliac crest and was used to reflect central adiposity. Resting 2-minute electrocardiograph recordings, pulse wave velocity, and ankle-brachial index data were used to assess the root mean square of successive differences in RR intervals (RMSSD) and the pre-ejection period (PEP), markers of parasympathetic and sympathetic activity, respectively. FBG, insulin, and HbA1c inferred a latent variable termed glycemic impairment (GI), whereas heart rate and diastolic BP inferred a latent variable termed cardiac stress (CS). The structural equation model fit was acceptable [root mean square error of approximation = 0.050 (90% CI = .036, .066), comparative fit index = .970, Tucker Lewis Index = 0.929], with adiposity having both significant direct (β = 0.208, p = 0.018) and indirect (β = -.217, p = .041) effects on PEP through GI. Adiposity displayed no significant direct effect on RMSSD. CS displayed a significant pathway (β = -0.524, p = 0.035) on RMSSD, but the indirect effect of WC on RMSSD through CS did not reach statistical significance (β = -0.094, p = 0.137). These results suggest that adiposity's relation to ANS activity is multifaceted, as increased central adiposity had opposing direct and indirect effects on markers of sympathetic activity in this population of older adults.

The relationship between childhood adversity and sleep quality among rural older adults in China: the mediating role of anxiety and negative coping

BackgroundStudies have revealed the effects of childhood adversity, anxiety, and negative coping on sleep quality in older adults, but few studies have focused on the association between childhood adversity and sleep quality in rural older adults and the potential mechanisms of this influence. In this study, we aim to evaluate sleep quality in rural older adults, analyze the impact of adverse early experiences on their sleep quality, and explore whether anxiety and negative coping mediate this relationship.MethodsData were derived from a large cross-sectional study conducted in Deyang City, China, which recruited 6,318 people aged 65 years and older. After excluding non-agricultural household registration and lack of key information, a total of 3,873 rural older adults were included in the analysis. Structural equation modelling (SEM) was used to analyze the relationship between childhood adversity and sleep quality, and the mediating role of anxiety and negative coping.ResultsApproximately 48.15% of rural older adults had poor sleep quality, and older adults who were women, less educated, widowed, or living alone or had chronic illnesses had poorer sleep quality. Through structural equation model fitting, the total effect value of childhood adversity on sleep quality was 0.208 (95% CI: 0.146, 0.270), with a direct effect value of 0.066 (95% CI: 0.006, 0.130), accounting for 31.73% of the total effect; the total indirect effect value was 0.142 (95% CI: 0.119, 0.170), accounting for 68.27% of the total effect. The mediating effects of childhood adversity on sleep quality through anxiety and negative coping were significant, with effect values of 0.096 (95% CI: 0.078, 0.119) and 0.024 (95% CI: 0.014, 0.037), respectively. The chain mediating effect of anxiety and negative coping between childhood adversity and sleep quality was also significant, with an effect value of 0.022 (95% CI: 0.017, 0.028).ConclusionsAnxiety and negative coping were important mediating factors for rural older adult’s childhood adversity and sleep quality. This suggests that managing anxiety and negative coping in older adults may mitigate the negative effects of childhood adversity on sleep quality.

Improvement of the GFI and AGFI indexes in structural equation models by the covariance between repetitions in the observed variables

Although there are methods that relate a set of repeated observed variables to the fit of structural equation models, there are some deficiencies in the quality-of-fit indexes proposed in the literature, as they do not include characteristics of data with repeated observed variables. Thus, this study aims to propose an improvement in the GFI and AGFI indexes by incorporating a correction that considers repetitions in the observed variables. Several designs are considered to validate this proposal as a function of the criteria that determine the quality of fit, as well as the presence of outliers. In this context, the improvement is given to the indexes built in the least square and likelihood approaches, and their advantages and disadvantages are compared with conventional indexes using the Monte Carlo simulation. The improvement of the GFI and AGFI indexes to incorporate the effect of repetitions of the observed variables was promising, as it presented robustness properties relative to the presence of outliers and showed diagnostic evidence of a model with good and poor fit. It is recommended to use up to four repetitions to avoid numerical problems when computing the index estimates.

Interplay between Organizational Learning and Departmental Performance: Implications for Change in Ethiopian Public Research Universities

Literacy abilities are crucial for economic progress and community welfare, with higher education recognizing them as vital for problem-solving, critical thinking, continuous learning, and effective functioning for both experienced educators and the new student cohorts. The study examined the interplay between organizational learning and departmental performance, and its implications for changes in Ethiopian Public Research Universities. The researchers used the framework that focuses on seven distinct dimensions of organization learning (OL) namely continuous learning, inquiry and dialogue, collective and collaborative efforts of organizational members, empowerment, embedded system, system connection and strategic leadership and departmental performance (DP) which consists of three dimensions teaching-learning, research and community services. The researchers employed embedded mixed methods design (QUAN + qual) to examine the interplay between organizational learning (OL) and departmental performance (DP). The researchers selected four public research universities using simple random sampling technique. Then, they selected 1,176 respondents (969 instructors and 207 department heads) from target population using simple random sampling technique. The researchers adapted standardized questionnaires and collected quantitative data using questionnaires, and analyzed using descriptive statistics (mean standard deviation), and inferential statistics (multiple correlations, multiple regressions structural equation modeling). Qualitative data was collected using semi-structured interview from 14 key informants who were selected using the purposive sampling technique based on their rich lived experiences of teaching-learning, research and leadership in higher education institutions. The qualitative data was thematically analyzed. The finding of the study showed that the structural equation model fit to the data. It was also found that the correlations between the different dimensions of organizational learning practices and departmental performance ranged between low and moderate. There were positive significant and moderate correlations between each dimension of organizational learning and departmental performance. The organizational dimensions accounted the largest cumulative variance to departmental performance dimensions; research (R2 = 40.70%; β =.638, p.001); community service (R2 = 33.50%; β =.579, p.001) and teaching-learning (R2 = 24.60%; β =.496, p .001). The study showed that the presence of formal and informal organizational learning cultures in universities enhance departmental performances. Therefore, the Ethiopian public research universities should create effective organizational learning systems to improve departmental performances.

Exploring Fashion Hair Dyeing Behavior through the Stimulus-Response Model: The Mediating Effects of Professional Technology and Transaction Interaction

This study was conducted to explore hair dyeing behaviors among Taiwanese adolescents; analyze future market trends for fashion hair dyes; investigate the effects of social media, fashion trends, and product awareness on behavioral intentions; identify the mediating effects of professional technology and transaction interactions on behavioral intentions; and validate the overall fit of a model outlining the interrelationships between the aforementioned factors.This study was conducted in general and vocational schools across northern, central, and southern Taiwan. Students were surveyed between February 7, 2023, and July 21, 2023.&#x0D; Drawing inspiration from the Stimulus-Organism-Response theory, we constructed a comprehensive model incorporating six dimensions—social media, fashion trends, product awareness, transaction interaction, professional technology, and behavioral intention. The survey gathered 370 valid responses, primarily from female students in technical senior high schools. Students’ responses on a 32-item questionnaire were rated on a 5-point Likert scale. Reliability analysis, partial least squares structural equation modeling, and validity analysis were performed to assess the study model.Our findings revealed a high reliability and a good fit in structural equation modeling. Validity analysis confirmed convergent and discriminant validity. Bootstrapping revealed substantial differences between ordinary and technical high schools in hair dyeing behaviors. Professional technology mediated the correlation between fashion trends and behavioral intentions and that between product awareness and behavioral intentions.This study advances our theoretical understanding and offers valuable practical insights for businesses in the hair care industry. The application of the Stimulus-Organism-Response theory revealed adolescents’ complex hair dyeing behaviors. The observed model fit indicates the relevance of this framework in explaining the multifaceted dynamics of consumer decision-making. Regarding practical benefits, this study guides businesses toward natural hair dyes aligned with consumers’ health and environmental preferences.

A Structural Equation Model of Writing Anxiety, Writing Motivation and Academic Motivation of Students

Writing anxiety causes various problems in the writing process, makes it difficult for the person to produce text and can prevent the act of writing. Writing motivation supports writing skills by affecting the writing process positively. The purpose of this research is to determine relationships between students' writing anxiety, writing motivation and academic motivation. The research was carried out with the correlational desing in the quantitative method. The population of this research consist of secondary school students and the sample consist of 1037 secondary school students, 577 of whom are females (55.64%) and 460 of them are males (44.36%) in Elazig province centre in 2020-2021 academic year. As a result of the correlation test, hierarchical regression analysis, it was determined that students' writing anxiety meaningful was predicted the writing motivation (r=-.65/strong) and academic motivations (r=-.37/medium) by 53%. Structural equation model fit was verified. While writing process, avoidance and writing pleasure latent variables explain 11% of consubstantiated extrinsic motivation, this rate increased to 45% when writing motivation was added to the equality. Although writing process, avoidance and writing pleasure variables explained 39% of the unmotivation and 32% of the extrinsic motivation reflected internal, it was observed that the regression coefficient for the two equations increased to 70% with the addition of writing motivation as the predictive variable.

Analysis of Weather Prediction, Resource Management, and Land Optimization on the Application of Big Data Analytics in Agricultural Land Utilization in Agrarian Areas of West Java

This research investigates the impact of Weather Prediction, Resource Management, and Land Optimization on the adoption of Big Data Analytics in agricultural land utilization within the agrarian region of West Java. Employing a quantitative approach, the study integrates measurement model analysis, structural equation modeling, demographic profiling, and model fit assessment to comprehensively explore the intricate dynamics of technological adoption in agriculture. Results indicate that Land Optimization, Resource Management, and Weather Prediction significantly influence the adoption of Big Data Analytics. Demographic factors such as gender, age, education, and farming experience demonstrate varying correlations with key variables. The model exhibits strong fit, and approximately 60.2% of the variance in Big Data Analytics adoption is explained by the combined influence of the identified factors. This study contributes nuanced insights to inform policy and practice for sustainable and technology-driven agriculture in West Java.

Mathematics study habits through an ethnomathematics approach and entrepreneurial behavior of mathematics education students

This research aims to determine whether there is a positive correlation between mathematics learning habits through an ethnomathematics approach and entrepreneurial behavior. This research is survey research conducted by mathematics education students in Bengkulu and Lubuklinggau. The sample for this research consisted of 70 students. There are two questionnaires as research instruments. Both are a questionnaire on mathematics learning habits using an ethnomathematics approach, and an entrepreneurial behavior questionnaire. The result of this research is that the complete structural equation model fit test is a good fit, which means that the empirical structural equation model is suitable with the theoretical (conceptual) structural equation model. The results of the hypothesis test show that the calculated t value is 11.364 &gt; 1.96, which means Ho is rejected, meaning that this research hypothesis is accepted. The conclusion is that there is a positive correlation between mathematics learning habits through an ethnomathematics approach and entrepreneurial behavior.

Testing structural equation model fit in psychological studies: A replication study using equivalence testing

Testing structural equation model fit in psychological studies: A replication study using equivalence testing

Designing and Validation of the Leadership Competency Scale in Medicine

Background: Leadership competencies in medicine are the key factors in improving the performance of physicians and the health system. The aim of the present study was to design and validate the leadership competencies scale in medicine.&#x0D; Methods: This research was conducted with a qualitative-quantitative approach. The research sample consisted of 12 physician managers in the qualitative stage and 15 people in the content validity evaluation stage using purposive sampling method. In the preliminary implementation stage of the questionnaire, 35 people were selected by convenience sampling and the main implementation stage of the questionnaire 306 students, faculty members, and medical graduate managers were selected using relative stratified random method. Qualitative data were collected by semi-structured interview and quantitative data by questionnaire. To analyze the qualitative data, the Esterberg analysis method was used, and to evaluate the construct validity, confirmatory factor analysis with Smart-PLS3 software was used. To evaluate the validity of quantitative data, content validity index, content validity ratio, Cronbach's alpha coefficient, convergent validity, and structural equation model fit indices were used. The criteria of credibility, transferability, dependability, and conformability were used using triangulation to evaluate the validity of the qualitative research data.&#x0D; Results: Competencies and parameters of the questionnaire were extracted into 17 competences and 123 concepts through the coding of interview texts and converted into a questionnaire in 101 items. The content validity of 100 items was valid. The results of factor analysis showed that the factor load of 99 items was valid and 17 components explained the structure of leadership competencies. Based on the fit indices of the model, the measurement scale of leadership competencies in medicine was valid in 17 components and 99 items. These components include perception and impression management, professional ethics, conflict management, problem solving, discipline, informal organization, public communication skills, interpersonal relationship skills, listening, cultural management, professional culture, innovation and creativity, motivation, emotional intelligence, change management, feeling management, participative management.&#x0D; Conclusion: Attention to the curriculum of leadership competencies in medical education and the application of this scale can improve the quality of leadership in the health system.

Impact of Socialization Tactics on Socialization-Specific Adjustment Via PsyCap: A Lens of COR Theory

Based on conservation of resources (COR) theory, this study proposes an integrative model, whereby socialization caravan passageways—socialization tactics—shape a resource caravan of PsyCap (psychological capital) that newcomers rely upon to achieve socialization-specific adjustment outcomes. SmartPLS 3.0 is mainly used to analyze the data and this model exhibits acceptable levels of structural equation modeling (SEM) fit indices in a sample of 368 respondents from 16 luxury hotels in Hainan Province, China. Study results indicate that socialization tactics have a positive influence on PsyCap, which in turn affects all six adjustment outcomes including task mastery, fitting in, standing out, role negotiation, membership identification, and interpersonal relationships. Our findings are informative and valuable because socialization resources theory (SRT) represents a new approach to capturing the dynamics of newcomer socialization phenomenon with important implications for theory, research, and practice.

Evaluating the Effect of Planned Missing Designs in Structural Equation Model Fit Measures

In a planned missing design, the nonresponses occur according to the researcher’s will, with the goal of increasing data quality and avoiding overly extensive questionnaires. When adjusting a structural equation model to the data, there are different criteria to evaluate how the theoretical model fits the observed data, with the root mean square error of approximation (RMSEA), standardized root mean square residual (SRMR), comparative fit index (CFI) and Tucker–Lewis index (TLI) being the most common. Here, I explore the effect of the nonresponses due to a specific planned missing design—the three-form design—on the mentioned fit indices when adjusting a structural equation model. A simulation study was conducted with correctly specified model and one model with misspecified correlation between factors. The CFI, TLI and SRMR indices are affected by the nonresponses, particularly with small samples, low factor loadings and numerous observed variables. The existence of nonresponses when considering misspecified models causes unacceptable values for all the four fit indexes under analysis, namely when a strong correlation between factors is considered. The results shown here were performed with the simsem package in R and the full information maximum-likelihood method was used for handling missing data during model fitting.

Equivalence testing to judge model fit: A Monte Carlo simulation.

Decades of published methodological research have shown the chi-square test of model fit performs inconsistently and unreliably as a determinant of structural equation model (SEM) fit. Likewise, SEM indices of model fit, such as comparative fit index (CFI) and root-mean-square error of approximation (RMSEA) also perform inconsistently and unreliably. Despite rather unreliable ways to statistically assess model fit, researchers commonly rely on these methods for lack of a suitable inferential alternative. Marcoulides and Yuan (2017) have proposed the first inferential test of SEM fit in many years: an equivalence test adaptation of the RMSEA and CFI indices (i.e., RMSEAt and CFIt). However, the ability of this equivalence testing approach to accurately judge acceptable and unacceptable model fit has not been empirically tested. This fully crossed Monte Carlo simulation evaluated the accuracy of equivalence testing combining many of the same independent variable (IV) conditions used in previous fit index simulation studies, including sample size (N = 100-1,000), model specification (correctly specified or misspecified), model type (confirmatory factor analysis [CFA], path analysis, or SEM), number of variables analyzed (low or high), data distribution (normal or skewed), and missing data (none, 10%, or 25%). Results show equivalence testing performs rather inconsistently and unreliably across IV conditions, with acceptable or unacceptable RMSEAt and CFIt model fit index values often being contingent on complex interactions among conditions. Proportional z-tests and logistic regression analyses indicated that equivalence tests of model fit are problematic under multiple conditions, especially those where models are mildly misspecified. Recommendations for researchers are offered, but with the provision that they be used with caution until more research and development is available. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Correlates of musculoskeletal pain and kinesiophobia in older adults with heart failure: A structural equation model

The study aimed to study the influence of musculoskeletal pain on kinesiophobia in patients with heart failure. This cross-sectional study recruited 107 heart failure patients aged 73.18±12.68 years (57% men) from an outpatient setting. Participants self-reported pain using the Musculoskeletal System Assessment Inventory and the Cornell Musculoskeletal Discomfort Questionnaire. Kinesiophobia was assessed with the Tampa Scale for Kinesiophobia-11. About 62% reported musculoskeletal pain, with knees (16.8%) and lower back (12.%) being the most painful locations. About 31% reported moderate levels and 24% indicated high levels of kinesiophobia. There were positive and significant associations between the indicators of pain and kinesiophobia. Results showed an adequate structural equation model fit to the data with musculoskeletal pain factors explaining 22.09% of the variance in kinesiophobia. Assessment of kinesiophobia in patients with heart failure with musculoskeletal pain is essential to improve self-care and overall quality of life.