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

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