目的:评估慢性心力衰竭(CHF)患者健康素养、医师信任度、预立医疗照护计划(ACP)准备度的现状，分析三者之间的路径作用机制。方法:方便抽样选取2020年12月至2021年12月在南京市某三甲医院心血管内科住院的211例CHF患者为研究对象，采用一般资料调查表、慢性病患者ACP准备度量表、心力衰竭特异性健康素养量表、维克森林医师信任量表进行调查，分析医师信任度在CHF患者健康素养与ACP准备度间的中介作用。结果:CHF患者健康素养总分为(31.46±10.29)分、医师信任度总分为(35.27±6.23)分、ACP准备度总分为(84.57±13.10)分。健康素养与医师信任度、ACP准备度均呈正相关(r分别为0.544、0.776，均P＜0.01)；医师信任度与ACP准备度呈正相关(r=0.672，P＜0.01)。中介作用显示，健康素养能正向预测ACP准备度(β=2.55，P＜0.001)；健康素养通过医生信任度对ACP准备度产生中介作用(β=0.849，95%CI 0.422~1.352，P＜0.001),医生信任度在健康素养与ACP准备度之间的中介效应占总效应的25%。结论:医务人员应开展以影响ACP准备度路径为依据的干预策略，提升CHF患者的健康素养，构建彼此信任的医患关系，提高ACP准备度。

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