Abstract
This study aimed to identify latent classes of nursing dependency trajectories in patients with acute myocardial infarction (AMI) and examine factors associated with trajectory-class membership. This single-center longitudinal observational study included 260 patients with AMI admitted to Linquan County People's Hospital between January 2024 and January 2026. The study baseline was defined as the time point after successful emergency treatment and recovery of consciousness. Nursing dependency was assessed using the Care Dependency Scale (CDS) at baseline (T1), day 3 after admission (T2), discharge (T3), and 1 month after discharge (T4). Growth mixture modeling was used to identify distinct longitudinal trajectory classes. Clinical and psychosocial characteristics were subsequently evaluated using multinomial logistic regression to identify factors independently associated with trajectory-class membership. Four distinct nursing dependency trajectories were identified: High Independence-Slow Improvement Type (C1, n = 66, 25.4%), Moderate Dependency-Rapid Deterioration Type (C2, n = 54, 20.8%), High Dependency-Significant Improvement Type (C3, n = 90, 34.6%), and High Dependency-Slow Aggravation Type (C4, n = 50, 19.2%). Age, marital status, depressive and anxiety symptoms, social support, and history of underlying diseases showed independent class-specific associations with trajectory membership. Nursing dependency showed substantial interindividual heterogeneity among patients with AMI, with four distinct longitudinal trajectories identified. Factors associated with trajectory-class membership may help identify patients requiring closer nursing assessment and individualized follow-up; however, the effectiveness of interventions targeting these factors requires prospective evaluation.