目的 分析慢性心力衰竭(chronic heart failure,CHF)患者出院过渡期体力活动(physical activity,PA)轨迹的潜在类别及影响因素。 方法 2020年12月至2021年11月，采用便利抽样法选取上海市某三级甲等医院心血管内科住院的205例CHF患者为研究对象，采用国际PA问卷长卷于患者出院时及出院后2周、2个月、3个月调查其PA水平。采用增长混合模型识别CHF患者出院过渡期PA轨迹类别，多元Logistic回归分析其影响因素。 结果 CHF患者出院过渡期PA变化轨迹可分为“少动降低组”(26.09%)、“多动不稳组”(14.13%)及“多动稳定组” (59.78%)。多元Logistic回归分析结果显示，年龄、N末端心房脑钠肽前体、CHF症状及运动恐惧是CHF患者PA轨迹类别的影响因素 (均P＜0.05)。 结论 CHF患者出院过渡期PA可分为3种变化轨迹，存在群体异质性。护士应基于患者PA变化轨迹的同质群体及影响因素，给予动态化、个体化的心脏康复干预措施。

Objective To analyze latent groups of physical activity（PA) trajectories among chronic heart failure（CHF) patients during the post-discharge transition period,as well as those influencing factors. Methods Convenient sampling was used to select 205 CHF patients from the Department of Cardiovasology in a tertiary hospital in Shanghai City from December,2020 to November,2021.The International Physical Activity Questionnaire（IPAQ) was used to investigate the patients’ PA levels at the time points of discharge,two weeks,two months and three months after discharge.Growth mixture modeling was adopted to identify different PA trajectories among CHF patients during the post-discharge transition period,and multiple logistic regression was used to analyze their influencing factors. Results The PA trajectories among CHF patients during the post-discharge transition period included ‘low and decreasing’ group（26.09%),‘high and unstable’ group（14.13%),and ‘high and stable’ group（59.78%).Multiple logistic regression analysis found that age,N-terminal pro-B-type natriuretic peptide,CHF symptoms and kinesiophobia were influencing factors of PA trajectories among CHF patients（all P＜0.05). Conclusions The PA trajectories among CHF patients during the post-discharge transition period can be divided into three groups with group heterogeneity.Nurses should provide dynamic and individualized cardiac rehabilitation interventions for those patients with the same PA trajectories considering the influencing factors.

R473.54

新华医院护理学科人才培养计划-“新苗人才”项目（Xhlxm006）；上海交通大学医学院护理学科建设项目