Abstract: Objective: To explore the role of self-efficacy and social support in the chain mediation between restricted diets burden and quality of life in patients with chronic heart failure. Methods: A total of 343 patients with chronic heart failure treated in the cardiology department of two grade A tertiary hospitals in Shaoyang in July 2023 were selected by convenience sampling method. Self-efficacy scale of chronic disease management, social support scale, restricted diets burden scale, and Minnesota heart failure quality of life questionnaire were used to the investigation. Results: There was a negative correlation between dietary restriction burden and self-efficacy and social support score (P<0.01), it was positively correlated with life quality score (P<0.01). Self-efficacy and social support scores were negatively correlated with quality of life scores (P<0.01). Pathway analysis showed that restricted diets burden directly affected the quality of life in patients with chronic heart failure. At the same time, there were three pathways, the mediating effect of restricted diets burden on quality of life through self-efficacy was 0.093[95%CI(0.022, 0.168)]; Restricted diets burden affected quality of life through social support, and the mediating effect was 0.144[95%CI(0.062, 0.233)], and the mediating effect of restricted diets burden on quality of life was 0.053[95%CI(0.022, 0.087)]. Conclusion: Restricted diets burden not only directly affects patients' quality of life, but also indirectly affects patients' quality of life through self-efficacy and social support. Medical staff can refer to this chain mediation, comprehensively consider the impact of self-efficacy and social support on the quality of life of restricted diets burden, and formulate a more scientific and complete dietary adherence intervention program to reduce the restricted diets burden of patients with chronic heart failure and improve their quality of life.

Key words: Heart failure, Restricted diets burden, Social support, Self-efficacy, Quality of life

摘要： 目的：探讨自我效能和社会支持在慢性心力衰竭患者限制饮食负担和生活质量之间的链式中介作用。方法：采取便利抽样法，选取 2023 年 7 月在邵阳市 2 所三级甲等医院心内科治疗的 343 例慢性心力衰竭患者为研究对象，采用慢性病管理自我效能量表、社会支持量表、限制饮食负担量表、明尼苏达心力衰竭生活质量问卷进行调查。结果：患者限制饮食负担与自我效能、社会支持评分呈负相关（P<0.01），与生活质量评分呈正相关（P<0.01）；自我效能和社会支持评分与生活质量评分呈负相关（P<0.01）。路径分析显示，慢性心力衰竭患者限制饮食负担直接影响生活质量；同时还存在 3 条路径。限制饮食负担通过自我效能影响生活质量，中介效应为 0.093[95%CI（0.022，0.168）]；限制饮食负担通过社会支持影响生活质量，中介效应为 0.144[95%CI（0.062，0.233）]；限制饮食负担通过自我效能和社会支持的链式中介作用影响生活质量，链式中介效应为 0.053[95%CI（0.022，0.087）]。结论：限制饮食负担不但对患者的生活质量产生直接影响，还通过自我效能和社会支持间接影响患者的生活质量；医护人员可以综合考虑自我效能和社会支持对限制饮食负担和生活质量的影响，制定更科学、更完善的饮食依从性干预方案，以降低慢性心力衰竭患者的限制饮食负担，提高生活质量。

关键词: 心力衰竭, 限制饮食负担, 社会支持, 自我效能, 生活质量