慢性肾脏病患者体力活动变化轨迹及影响因素的纵向研究

doi:10.3761/j.issn.0254-1769.2026.18.007

中华护理杂志 ›› 2026, Vol. 61 ›› Issue (18): 2503-2509.DOI: 10.3761/j.issn.0254-1769.2026.18.007

慢性肾脏病患者体力活动变化轨迹及影响因素的纵向研究

杜娟¹(), 苗金红²^,^*(), 朱昱洁¹, 张庆扬¹, 贾佳佳³, 鲁梦帆¹, 雷雨田⁴, 宋春花⁵

¹ 郑州大学第一附属医院护理部郑州市 450052
² 郑州大学第一附属医院质量控制处郑州市 450052
³ 郑州大学第三附属医院产科郑州市 450052
⁴ 郑州大学第一附属医院血液净化中心郑州市 450052
⁵ 郑州大学公共卫生学院郑州市 450052

收稿日期:2026-03-14 出版日期:2026-09-20 发布日期:2026-09-23
*通讯作者: *苗金红，E-mail：mjh_nurse@163.com
作者简介:杜娟：女，本科（硕士在读），护师，E-mail：juandu@gs.zzu.edu.cn
第一联系人：作者贡献声明
杜娟：研究设计、数据收集、数据整理、统计学分析、论文撰写；苗金红：研究指导、基金支持、论文审阅与修改；朱昱洁、张庆扬：数据收集与整理；贾佳佳、鲁梦帆、雷雨田：论文审阅和修改；宋春花：统计指导和论文审阅
基金资助:
郑州大学第一附属医院护理科研专项基金(HLKY2023003)

Physical activity trajectories among patients with chronic kidney disease and their influencing factors：a longitudinal study

DU Juan¹(), MIAO Jinhong²^,^*(), ZHU Yujie¹, ZHANG Qingyang¹, JIA Jiajia³, LU Mengfan¹, LEI Yutian⁴, SONG Chunhua⁵

¹ Department of Nursing， the First Affiliated Hospital of Zhengzhou University， Zhengzhou 450052， China
² Department of Quality Control， the First Affiliated Hospital of Zhengzhou University， Zhengzhou 450052， China
³ Department of Obstetrics， the Third Affiliated Hospital of Zhengzhou University， Zhengzhou 450052， China
⁴ Department of Blood Purification Center， the First Affiliated Hospital of Zhengzhou University， Zhengzhou 450052， China
⁵ School of Public Health， Zhengzhou University， Zhengzhou 450052， China

Received:2026-03-14 Online:2026-09-20 Published:2026-09-23
* Corresponding author: *MIAO Jinhong，E-mail：mjh_nurse@163.com
Funding program:
The First Affiliated Hospital of Zhengzhou University Nursing Scientific Research Special Fund(HLKY2023003)

摘要/Abstract

摘要：

目的探讨慢性肾脏病患者体力活动变化轨迹的潜在类别及影响因素，为制订个体化的体力活动干预策略提供依据。方法采用便利抽样法，选取2025年1—6月在河南省某三级甲等综合医院肾脏内科住院的259例慢性肾脏病非透析患者为调查对象。在患者出院前1 d，采用一般资料调查表、国际体力活动问卷长卷、计划行为理论量表、未来结果考虑量表、自我报告习惯指数量表、简式自我控制量表收集患者的基线资料；出院后1、3、6个月评估患者的体力活动水平。采用潜类别增长模型识别轨迹类别，采用多元Logistic回归分析慢性肾脏病患者体力活动变化轨迹的影响因素。结果共识别出3个慢性肾脏病患者体力活动变化轨迹类别，分别为中水平上升组（23.94%）、中水平下降组（27.03%）、低水平下降组（49.03%）。血红蛋白水平、慢性病共病数量、体力活动意图、未来结果考虑程度、体力活动习惯和自我调节能力是慢性肾脏病患者体力活动变化轨迹潜在类别的影响因素。结论慢性肾脏病患者体力活动变化轨迹存在群体异质性，医护人员可针对轨迹类别的影响因素制订针对性的干预措施，以提高其体力活动水平。

关键词: 慢性肾脏病, 体力活动, 变化轨迹, 潜在类别, 影响因素分析, 护理

Abstract:

Objective To explore the latent classes and influencing factors of physical activity trajectories among patients with chronic kidney disease，and to provide evidence for developing individualized physical activity intervention strategies. Methods A convenience sampling method was used to survey 259 non-dialysis patients with chronic kidney disease who were hospitalized in the department of nephrology of a tertiary A general hospital in Henan Province from January to June 2025. A day before discharge，baseline data were collected using a general information questionnaire，the International Physical Activity Questionnaire-long，the Theory of Planned Behavior Scale，the Consideration of Future Consequences Scale，the Self-Report Habit Index，and the Brief Self-Control Scale. Physical activity levels were assessed at 1，3，and 6 months after discharge. A latent class growth model was used to identify trajectory classes，and univariate and multivariable logistic regression analyses were performed to examine factors influencing physical activity trajectories among patients with chronic kidney disease. Results A total of 3 classes of physical activity trajectories were identified among patients with chronic kidney disease，namely a moderate-level increasing group（23.94%），a moderate-level decreasing group（27.03%），and a low-level decreasing group（49.03%）. Hemoglobin level，number of chronic disease comorbidities，physical activity intention，consideration of future consequences，physical activity habits，and self-regulation ability were influencing factors of the physical activity trajectory classes among patients with chronic kidney disease. Conclusions There is heterogeneity in physical activity trajectory classes among patients with chronic kidney disease. Health care professionals can develop targeted interventions based on the influencing factors of each trajectory class to improve patients’ physical activity levels.

Key words: Chronic Kidney Disease, Physical Activity, Trajectory, Latent Classes, Root Cause Analysis, Nursing Care

杜娟, 苗金红, 朱昱洁, 张庆扬, 贾佳佳, 鲁梦帆, 雷雨田, 宋春花. 慢性肾脏病患者体力活动变化轨迹及影响因素的纵向研究[J]. 中华护理杂志, 2026, 61(18): 2503-2509.

DU Juan, MIAO Jinhong, ZHU Yujie, ZHANG Qingyang, JIA Jiajia, LU Mengfan, LEI Yutian, SONG Chunhua. Physical activity trajectories among patients with chronic kidney disease and their influencing factors：a longitudinal study[J]. Chinese Journal of Nursing, 2026, 61(18): 2503-2509.

图/表 4

表1 General characteristics and univariate analysis of physical activity trajectory classes in patients with chronic kidney disease 注：括号外数据为例数，括号内数据为百分比（%）。eGFR为估算肾小球滤过率。1）χ2 值；2）H值；3）F 值。

Table 1

表2 慢性肾脏病患者体力活动变化轨迹潜类别增长模型拟合结果（n=259）

Table 2 Fitting results of latent class growth model for physical activity trajectories in patients with chronic kidney disease（n=259）

图1 慢性肾脏病患者体力活动变化轨迹类别注：T0为出院前1 d，T1为出院后1个月，T2为出院后3个月，T3为出院后6个月。

Figure 1 Physical activity trajectory classes in patients with chronic kidney disease

表3 慢性肾脏病患者体力活动变化轨迹类别的多元Logistic回归分析结果（n=259）

Table 3 Results of multivariate logistic regression analysis of physical activity trajectory classes in patients with chronic kidney disease（n=259）

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慢性肾脏病患者体力活动变化轨迹及影响因素的纵向研究

Physical activity trajectories among patients with chronic kidney disease and their influencing factors：a longitudinal study

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