目的 探讨老年慢性阻塞性肺疾病(chronic obstructive pulmonary disease,COPD)患者运动自我效能在运动恐惧和身体活动间的中介作用。方法 采用便利抽样法选取2023年11月至2024年1月南京中医药大学第二附属医院肺病科收治的230例COPD患者为研究对象，采用一般资料调查表、恐动症Tampa评分表(Tampa scale of kinesiophobia,TSK)、老年人体力活动问卷(physical activity scale for the elderly,PASE)和运动自我效能量表(exercise self-efficacy scale,ESE)对其进行调查。结果 老年COPD患者TSK、PASE和ESE总分分别为(43.22±0.41)分、(64.28±2.68)分、(43.26±1.64)分；TSK与PASE呈负相关(r=-0.34)，与ESE呈负相关(r=-0.47)；ESE与PASE呈正相关(r=0.35);ESE在TSK与PASE之间起部分中介作用(P＜0.01)，中介效应占总效应的52.82%。结论 运动恐惧可通过运动自我效能间接老年COPD患者活动，提示医护人员可采取策略舒缓患者的运动恐惧情绪，增强运动自我效能感，进而增加其身体活动水平。

Objective To explore the mediating effect of exercise self-efficacy on kinesiophobia and physical activity in elderly patients with chronic obstructive pulmonary disease(COPD).Methods The convenience sampling method was used to select a total of 230 COPD patients treated in the department of pulmonary in the Second Affiliated Hospital of Nanjing University of Chinese Medicine,from November 2023 to January 2024 as study subjects.The general information questionnaire,Tampa Scale of Kinesiophobia (TSK),Physical Activity Scale for the Elderly(PASE),and the Exercise Self-Efficacy Scale (ESE) were used for investigation.Results The total scores of TSK,PASE,and ESE in elderly patients with COPD were (43.22±0.41),(64.28±2.68),and (43.26±1.64),respectively.TSK was negatively correlated with PASE(r=-0.34),and negatively correlated with ESE(r=-0.47); ESE was positively correlated with PASE(r=0.35).ESE played a mediating role between TSK and PASE(P＜0＜01),with its mediating effect accounting for 52.82% of the total effect.Conclusions Kinesiophobia can indirectly affect physical activity through exercise self-efficacy,suggesting that medical staff can take measures to alleviate patients’ kinesiophobia,enhance exercise self-efficacy,and then improve their physical activity.

R473.56

老年长期照护教育部重点实验室开放基金项目（LNYBPY-2023-21）；2024年江苏省研究生培养创新工程研究生科研与实践创新计划项目(SJCX24_0852)；江苏省中医药科技发展计划项目（YB2020025）；南京中医药大学本科教育教学改革研究项目（NZYJG2022054）