Analysis of the influencing factors and action path of postoperative exercise volume in patients with acute type A aortic dissection

Si Qianqian; Han Chang; Lu Xiaofang; Wang Xin; Zhu Junming

doi:10.3760/j.issn.1673-4777.2025.08.004

Abstract：Objective To investigate the influencing factors and action path of postoperative exercise volume in patients with acute type A aortic dissection,so as to provide a reference for formulating targeted exercise intervention programs.Methods From December 2022 to June 2024,convenience sampling was used to select 268 patients with acute type A aortic dissection after operation in Beijing Anzhen Hospital,Capital Medical University as the research object.The general information questionnaire,fear of heart disease exercise scale,exercise self-efficacy scale,brief illness perception questionnaire and physical activity rating scale were used for investigation.Univariate analysis and Spearman correlation analysis were used to test the chain mediating effect between variables by Mplus7.4 software.Results Among 268 patients with acute type A aortic dissection after surgery,the total score of exercise volume was(18.0±7.0),which was at a low level.There were 40 patients(14.9％)with low exercise volume and 228 patients(85.1％)with moderate/high exercise volume.The patient's score on the cardiac disease exercise fear scale was(36.3±5.4),the score on the exercise self-efficacy scale was(62.1±15.8),and the score on the simple disease perception questionnaire was(41.2±8.5).Univariate analysis showed that age,education level,occupational status,history of hypertension,cardiac function classification and body mass index were the influencing factors of exercise volume in patients with acute type A aortic dissection after surgery(all P＜0.05).The direct effects of illness perception,exercise self-efficacy and exercise fear on the amount of exercise in patients with acute type A aortic dissection after surgery were established,with effect values of-0.339,0.636 and-0.241,respectively.Exercise self-efficacy indirectly affected the amount of exercise(moderate/high exercise)of patients through the mediating effect of illness perception,and the effect value was 0.097,accounting for 13.23％of the total effect.Exercise fear indirectly affected the amount of exercise(moderate/high exercise)through the single mediating effect of exercise self-efficacy and the chain mediating effect of exercise self-efficacy illness perception,and the effect value was-0.701,accounting for 74.41％of the total effect.Conclusion Clinical medical and nursing staff should pay attention to the influence of illness perception,exercise self-efficacy and exercise fear on the exercise volume of patients with acute type A aortic dissection after surgery,and develop scientific and accurate intervention programs to improve the exercise volume of patients with acute type A aortic dissection after surgery.