【摘要】 目的 探究焦虑和抑郁在老年慢性阻塞性肺疾病(COPD)患者运动自我效能与运动恐惧的链式中介作用。方法 选取2025年1月至5月于河北省承德医学院附属医院呼吸内科治疗的COPD患者264例，采用一般人口学资料调查表、恐动症量表、运动自我效能量表、医院焦虑抑郁量表进行问卷调查。结果 COPD患者的运动自我效能与运动恐惧呈负相关(r=-0.788,P<0.01)，运动自我效能与焦虑、抑郁呈负相关(r=-0.438、-0.770,P<0.01)，焦虑、抑郁与运动恐惧呈正相关(r=0.548、0.749,P<0.01)。直接路径分析结果显示，效应值为-1.851(95%CI=-2.240～-1.461)。链式中介模型结果显示，焦虑和抑郁在运动自我效能和运动恐惧之间的中介效应显著，中介效应量分别为-0.200(95%CI=-0.408～-0.019)、-0.317(95%CI=-0.663～-0.017)；且焦虑与抑郁的中介效应也显著，中介效应量为-0.151(95%CI=-0.313～-0.008)。结论 COPD患者运动自我效能水平较高会降低运动恐惧水平，同时焦虑、抑郁的情绪会加重运动自我效能对运动恐惧的影响。更多还原

【Abstract】 Objective To explore the chain mediating effects of anxiety and depression on exercise self-efficacy and exercise fear in older adults with chronic obstructive pulmonary disease(COPD).Methods A total of 264 COPD patients treated in the Department of Respiratory Medicine of Chengde Medical College Affiliated Hospital in Hebei Province from January to May 2025 were selected.A questionnaire survey was conducted using general demographic data, kinesophobia scale, exercise self-efficacy scale, and hospital anxiety and depression scale. Results The exercise self-efficacy of COPD patients was negatively correlated with exercise fear(r =-0.788, P<0.01), negatively correlated with anxiety and depression(r =-0.438,-0.770, P<0.01), and anxiety and depression were positively correlated with exercise fear(r =0.548,0.749,P<0.01).The results of direct path analysis showed that the effect size was-1.851(95%CI=-2.240 to-1.461).The results of the chain mediation model showed that the mediating effects of anxiety and depression between exercise self-efficacy and exercise fear were significant,with the mediating effect sizes being-0.200(95%CI=-0.408 to-0.019) and-0.317(95%CI=-0.663 to-0.017),respectively.Moreover,the mediating effect between anxiety and depression was also significant,with a mediating effect size of-0.151(95%CI=-0.313 to-0.008).Conclusion A higher level of exercise self-efficacy in patients with COPD can reduce the level of exercise fear. Meanwhile, anxiety and depression can aggravate the impact of exercise self-efficacy on exercise fear.更多还原