老年慢性心力衰竭患者运动恐惧现状及影响因素研究

Current Status and Influencing Factors of Kinesiophobia in Elderly Patients with Chronic Heart Failure

摘要: 目的：探讨老年慢性心力衰竭患者运动恐惧的发生情况及其影响因素，为制定干预策略提供依据。方法：采用便利抽样法，选取2024年7月至2025年3月湖北省3所三级甲等医院179例老年慢性心力衰竭住院患者开展横断面研究，采用心脏病运动恐惧量表评估运动恐惧水平，运用二元Logistic回归分析其影响因素。结果：179例患者中，104例(58.10%)存在运动恐惧。Logistic回归分析显示，非焦虑状态为保护因素(OR = 0.26, 95% CI: 0.11~0.63)；心功能III级(OR = 3.23, 95% CI: 0.99~10.50)、IV级(OR = 4.42, 95% CI: 1.23~15.80)、体力劳动(OR = 5.36, 95% CI: 1.86~15.49)、疲劳(OR = 2.51, 95% CI: 1.10~5.73)及负性疾病感知(OR = 1.09, 95% CI: 1.01~1.17)为危险因素。结论：老年慢性心力衰竭患者运动恐惧发生率较高，且受多因素影响，应将运动恐惧管理纳入常规护理，通过心理干预、运动指导及个体化康复措施降低运动恐惧水平，改善预后。

Abstract: Objective: To investigate the prevalence of kinesiophobia and its influencing factors among elderly patients with chronic heart failure, and to provide evidence for targeted interventions. Methods: A cross-sectional study was conducted using convenience sampling. A total of 179 elderly inpatients with chronic heart failure were recruited from three tertiary hospitals in Hubei Province, China, between July 2024 and March 2025. Kinesiophobia was assessed using the Tampa Scale for Kinesiophobia Heart (TSK-SV Heart). Binary logistic regression analysis was performed to identify factors associated with kinesiophobia. Results: Among the 179 participants, 104 (58.10%) exhibited kinesiophobia. Logistic regression analysis showed that absence of anxiety was a protective factor (OR = 0.26, 95% CI: 0.11~0.63). New York Heart Association (NYHA) class III (OR = 3.23, 95% CI: 0.99~10.50) and class IV (OR = 4.42, 95% CI: 1.23~15.80), engagement in physical labor (OR = 5.36, 95% CI: 1.86~15.49), fatigue (OR = 2.51, 95% CI: 1.10~5.73), and negative illness perception (OR = 1.09, 95% CI: 1.01~1.17) were identified as risk factors for kinesiophobia. Conclusion: Kinesiophobia is highly prevalent among elderly patients with chronic heart failure and is influenced by multiple factors. Incorporating kinesiophobia management into routine nursing care, including psychological support, exercise guidance, and individualized rehabilitation programs, may help reduce kinesiophobia and improve clinical outcomes.