Physical Activity Changes and Related Factors in Chronic Heart Failure Patients During the Post-Discharge Transition Period: A Longitudinal Study

Abstract

Background Physical activity (PA) is essential and effective for chronic heart failure (CHF) patients. Greater understanding of the longitudinal changes in PA and its association factors during the post-discharge transition period may help create interventions for improving PA. The aims of this study are: 1) to compare the change of PA; 2) to examine the associated factors of PA change; 3) to verify the mediating pathways between the factors and PA during the post-discharge transition period in CHF patients. Methods A total of 209 CHF patients were recruited using a longitudinal study design. Structured questionnaires were used to assess PA, CHF-related symptoms, kinesiophobia, and demographics, disease characteristics. PA questionnaire was investigated: (1) during admission, (2) two weeks after discharge, (3) two months after discharge, and (4) three months after discharge. Additional three questionnaires were collected during admission. Generalized estimating equation models (GEE) were fitted to identify variables associated with PA over time. We followed STROBE checklist for reporting the study. Results PA of CHF patients decreased unevenly, with the lowest level at two weeks after discharge. CHF-related symptoms and kinesiophobia were significantly associated with PA change trend over time. Compared with before hospitalization, increase in CHF-related symptoms at two weeks and two months after discharge were significantly associated with a decrease in PA. In the path analysis, CHF-related symptoms related to PA not only directly but also indirectly through kinesiophobia. Conclusion PA was changed during the post-discharge transition period and associated with CHF-related symptoms and kinesiophobia in CHF patients. Improving kinesiophobia may help reduce CHF-related symptoms and improve PA. Trial Registration: The study was registered in the Chinese Clinical Trial Registry (11/10/2022 ChiCTR2200064561 retrospectively registered)