Objective: To explore the effects of imagination-reality exposure therapy on exercise fear in patients with chronic heart failure combined with hypertension. Methods: A total of 126 patients with chronic heart failure combined with hypertension who were hospitalized in the cardiology department were included from February 2020 to January 2022 by convenience sampling method. According to the random number table method, the patients were divided into the observation group and the control group with 63 cases in each group. The control group received routine nursing intervention, and the observation group received imagination-reality exposure therapy on the basis of routine nursing intervention for 12 weeks. The scores of Chinese version of the Tampa Scale for Kinesiophobia Heart (TSK-Heart-C), Self-efficacy for Exercise (SEE) and Connor-Davidson Resilience Scale(CD-RISC) were compared between the two groups. Results: During the study period, 4 cases dropped out of the study with 2 cases in each group. Finally, 61 cases in each group were included in the study. After intervention, the scores of exercise avoidance, perceived risk, self-dysfunction, exercise fear and total TSK-Heart-C in the observation group were significantly lower than those of the control group （P<0.05）；the SEE and CD-RISC scores of the observation group were significantly higher than those of the control group（P<0.05）. Conclusion: Imagination-reality exposure therapy can improve the exercise self-efficacy and psychological resilience of patients with chronic heart failure combined with hypertension with exercise fear, and reduce exercise fear.

目的：探讨想象-现实暴露疗法在慢性心力衰竭合并高血压患者运动恐惧中的应用效果。 方法：便利抽样法选取 2020 年 2 月至2022 年 1 月心内科住院的慢性心力衰竭合并高血压的运动恐惧患者 126 例。 按随机数字表法分为观察组和对照组各 63 例。 对照组 给予常规护理干预，观察组在对照组基础上进行想象-现实暴露疗法干预，干预 12 周。干预前后比较两组中文版心脏病运动恐惧量表（TSK-Heart-C）、运动自我效能量表（SEE）、心理弹性量表（CD-RISC）评分。 结果：研究期间，观察组脱落 2 例，对照组脱落 2 例，最终两组各 61 例完成研究。 干预后，观察组运动回避、感知危险、自我功能失调、运动恐惧、TSK-Heart-C 总分均低于对照组，差异有统计学意义（P<0.05）；观察组 SEE 评分、CD-RISC 评分高于对照组，差异有统计学意义（P<0.05）。 结论：想象-现实暴露疗法能够提高慢性心力衰竭合并高血压患者的运动自我效能与心理弹性水平，降低运动恐惧。