关键词: 慢性心力衰竭；自我管理；轨迹；潜类别增长模型；纵向研究

Abstract: Objective: To identify the self-management trajectories of older patients with Chronic Heart Failure (CHF) and to analyze the predictive factors of different trajectories. Methods: A convenience sampling was used to recruit 213 older patients with CHF who were hospitalized in a cardiology ward of a tertiary grade A hospital in Yinchuan from December 2021 to June 2022. The first questionnaire survey was conducted during hospitalization, and follow-up surveys were conducted 1 month, 3 months, 6 months and 12 months after discharge. A latent class growth model was used to identify different categories of patients' self-management behavior change. Multiple Logistic regression was used to analyze the predictors of trajectory categories. Results: Totally 173 patients completed the all follow-up surveys. Three self-management trajectories of older patients with CHF were identified, namely "low level-declining" (29.5%), "moderate level-maintaining" (39.9%), and "high level-increasing" (30.6%). The results of multiple Logistic regression analysis showed that social support, self-efficacy, personal monthly income, place of residence, and gender were factors influencing the trajectory of self-management in older patients with CHF (P<0.05). Conclusion: Older patients with CHF shows different trajectories of self-management. Targeted measures should be developed based on the characteristics of patients' self-management trajectories to help patients maintain good self-management behaviors.

Key words: Chronic Heart Failure; self-management; trajectory; latent class growth model; longitudinal study