运动自我效能在慢性心力衰竭患者运动恐惧与运动康复依从性间的中介效应

目的 探讨运动自我效能在慢性心力衰竭患者运动恐惧与运动康复依从性间的中介效应。方法 采用便利抽样法，于2021年2月—10月选取南京某三甲医院就诊的慢性心力衰竭患者，使用心脏病患者运动恐惧量表、运动自我效能量表、运动依从性量表对其进行调查。结果 慢性心力衰竭患者运动恐惧与运动自我效能呈负相关（r = - 0.315，P＜0.01），与运动康复依从性呈负相关（r = - 0.197，P＜0.01），运动自我效能与运动康复依从性呈正相关（r = 0.375；P＜0.01）。中介模型显示，运动恐惧对运动康复依从性的直接效应不显著（β = - 0.087，P＞0.05），运动自我效能在运动恐惧与运动康复依从性中起完全中介作用（β = 0.347，P＜0.01），中介效应占总效应的56.25%。结论 运动恐惧主要通过运动自我效能影响慢性心衰患者运动康复依从性，提示医护人员可以从运动自我效能出发，引导患者改善心理品质，增强其运动自我效能，以减轻运动恐惧，提高运动康复依从性。

Mediation effect of self-efficacy for exercise on the relationship between kinesiophobia and exercise rehabilitation adherence in patients with heart failure

Objective To explore the relationship between kinesiophobia and exercise rehabilitation adherence, and the mediating effect of self-efficacy for exercise in heart failure patients. Methods Convenience sampling was used for recruiting patients with heart failure from a grade A hospital in Nanjing from February 2021 to October 2021. Tampa Scale for Kinesiophobia Heart, the exercise adherence scale for patients with chronic heart failure, and self-efficacy for exercise were used for investigation. Results Kinesiophobia had a negative association with self-efficacy for exercise (r=-0.315, P<0.01) and with exercise rehabilitation adherence (r=-0.197, P<0.01). Self-efficacy for exercise was positively associated with exercise rehabilitation adherence (r=0.375, P<0.01). The structural equation model (SEM) showed the direct effect was not significant (β=-0.087, P>0.05) and the mediating variable self-efficacy for exercise (β=0.347, P<0.01) played a complete mediating role between kinesiophobia and exercise rehabilitation adherence, with the mediating effect accounting for 56.25% of the total effect. Conclusion Kinesiophobia mainly affects exercise rehabilitation adherence of patients with chronic heart failure through exercise self-efficacy. Medical staff can guide patients to improve their psychological quality and enhance their exercise self-efficacy, so as to reduce the fear of exercise and improve the compliance of exercise rehabilitation.