炎症性肠病患者恐惧疾病进展潜在类别的影响因素分析及护理启示

doi:10.3761/j.issn.0254-1769.2024.03.009

摘要/Abstract

摘要：

目的探究炎症性肠病患者恐惧疾病进展的潜在剖面类别，并分析不同类别的影响因素。方法采用便利抽样法，选取2022年7月—2023年7月在南京市某三级甲等医院住院的炎症性肠病患者作为调查对象。使用一般资料调查表、中文版恐惧疾病进展简化量表、中文版炎症性肠病自我效能量表和社会支持评定量表进行调查。对炎症性肠病患者恐惧疾病进展进行潜在剖面分析，并通过单因素分析和多元Logistic回归分析探讨其影响因素。结果共回收问卷310份，其中有效问卷303份，有效问卷回收率为97.74%。潜在剖面分析结果显示，炎症性肠病患者恐惧疾病进展分为“低恐惧风险-疾病适应组”（n=127，41.91%）、“中恐惧风险-疾病困扰组”（n=139，45.88%）、“高恐惧风险-功能失调组”（n=37，12.21%）3个潜在剖面类别。其影响因素包括居住地、自评经济压力水平、疾病分期、自我效能（P<0.05）。结论炎症性肠病患者恐惧疾病进展水平具有明显的异质性。护理人员应根据该分类特点制订个性化干预策略，着重提高患者的自我效能，提升其疾病、压力及情绪管理水平。

关键词: 炎性肠疾病, 恐惧疾病进展, 潜在剖面分析, 影响因素分析, 护理

Abstract:

Objective To explore the potential categories and influencing factors of the fear of progression in patients with inflammatory bowel diseases（IBD）. Methods IBD patients who received inpatient treatment in a tertiary hospital in Nanjing from July 2022 to July 2023 were selected as the study subjects by convenience sampling method. The General Demographic Information Questionnaire，the Chinese version of the Fear of Progression Questionnaire-Short Form（FoP-Q-SF），the Chinese version of Inflammatory Bowel Disease Self-efficacy Scale（IBD-SES），and Social Support Rating Scale（SSRS） were administered to the participants. We applied one-way ANOVA and Logistic regression analysis to identify the factors associated with the potential categories of the fear of progression. Results A total of 303 returned questionnaires（out of the 310） were valid，resulting an effective response rate of 97.74%. According to the results of latent profile analysis，we classified the respondents into 3 categories by the fear of progression，namely “low risk fear of disease adaptation group”（n=127，41.91%），“medium risk fear of illness distress group”（n=139，45.88%），“high risk fear of dysfunction group”（n=37，12.21%）. 3 groups showed statistically significant differences in permanent address，self-rated financial pressure，current disease status and self-efficacy（P<0.05）. Conclusion Patients with IBD had obvious differences in characteristics on the fear of progression. Nursing personnel should formulate personalized intervention strategies based on the classification characteristics of the fear of progression of IBD patients. Moreover，nurses should focus on improving patients’ self-efficacy and promoting patients to treat medical care，stress and emotion management correctly.

Key words: Inflammatory Bowel Diseases, Fear of Progression, Latent Profile Analysis, Root Cause Analysis, Nursing Care

王清玉, 林征, 雷阳, 周美景, 王咪, 孙彩云, 顾珺怡, 朱展慧, 唐李晨, 卞秋桂. 炎症性肠病患者恐惧疾病进展潜在类别的影响因素分析及护理启示[J]. 中华护理杂志, 2024, 59(3): 308-316.

WANG Qingyu, LIN Zheng, LEI Yang, ZHOU Meijing, WANG Mi, SUN Caiyun, GU Junyi, ZHU Zhanhui, TANG Lichen, BIAN Qiugui. Influencing factors and nursing enlightenment of the fear of progression in patients with inflammatory bowel disease：a latent profile analysis[J]. Chinese Journal of Nursing, 2024, 59(3): 308-316.

图/表 5

表1 炎症性肠病患者的一般资料及恐惧疾病进展潜在类别的单因素分析结果 [例（百分比，%）]

Table 1 General data and univariate analysis of potential categories of fear of progression among inflammatory bowel disease patients [cases（percentages，%）]

表2 炎症性肠病患者恐惧疾病进展潜在类别模型拟合指标

Table 2 Potential categories of fear of progression among inflammatory bowel disease patients

图1 炎症性肠病患者恐惧疾病进展3个潜在类别的特征分布

Figure 1 The characteristic distribution of 3 potential categories of the fear of progression among patients with inflammatory bowel disease

表3 炎症性肠病患者的中文版炎症性肠病自我效能量表、社会支持评定量表得分在不同潜在类别间的比较（n=303，分，$ \bar{x} \pm s$）

Table 3 Classification of latent profiles of the scores of the IBD-SES and SSRS（n=303，scores，$ \bar{x} \pm s$）

表4 炎症性肠病患者恐惧疾病进展潜在类别影响因素的多元Logistic回归分析

Table 4 Multivariate Logistic analysis results on influencing factors of latent profiles of fear of progression in inflammatory bowel disease patients

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