肺癌患者自我管理行为的潜在剖面分析

doi:10.3761/j.issn.0254-1769.2024.20.008

摘要/Abstract

摘要：

目的基于潜在剖面分析探讨肺癌患者自我管理行为的潜在类别特征，并分析肺癌患者自我管理行为不同类别的特征差异及影响因素。方法采用便利抽样法，选取2022年7月—2023年5月在浙江省某三级甲等综合医院已完成主要治疗方案且即将进入随访期的260例肺癌患者作为调查对象。使用一般资料调查表、肺癌生存者自我管理行为评估量表、癌症自我管理效能感量表、医院焦虑抑郁量表和社会支持评定量表进行调查。运用潜在剖面分析探讨肺癌患者自我管理行为的潜在类别，并分析其影响因素。结果最终纳入患者252例。潜在剖面分析结果显示，肺癌患者自我管理行为可分为低自我管理行为-低情绪管理组（11.90%）、中自我管理行为-低资源管理组（45.24%）、高自我管理行为-低希望管理组（42.86%）3个潜在类别。多元Logistic回归分析结果显示，文化程度、曾接受手术、肿瘤分期、焦虑水平、抑郁水平、自我效能感水平和社会支持水平是肺癌患者自我管理行为的影响因素（P<0.05）。结论肺癌患者自我管理行为处于中等水平，且存在明显异质性，建议医护人员根据各类别患者自我管理行为特征实施个性化干预措施，从而提高肺癌患者自我管理行为水平。

关键词: 肺癌, 自我管理行为, 潜在剖面分析, 影响因素, 肿瘤护理

Abstract:

Objective To explore the potential category characteristics of self-management behavior in patients with lung cancer based on potential profile analysis，and to analyze the characteristic differences and influencing factors of self-management behavior in patients with different categories of lung cancer. Methods A total of 260 patients with lung cancer who had completed the main treatment program and were about to enter the follow-up period in a tertiary A general hospital in Zhejiang Province from July 2022 to May 2023 were selected by convenience sampling method as the investigation subjects. General Information Questionnaire，Lung Cancer Survivor Self-management Behavior Assessment Scale，Strategies Used by People to Promote Health，Hospital Anxiety and Depression Scale and Social Support Rating Scale were used for investigation. Potential profile analysis was used to explore the potential categories of self-management behavior in lung cancer patients and analyze its influencing factors. Results 252 patients were finally included. The results of potential profile analysis showed that lung cancer patients’ self-management behavior could be divided into 3 potential categories，namely low self-management behavior - low emotion management group（11.90%），medium self-management behavior-low resource management group（45.24%），and high self-management behavior-low hope management group（42.86%）. Logistic regression analysis showed that education level，previous surgery，tumor stage，anxiety level，depression level，self-efficacy level and social support level were the influencing factors of lung cancer patients’ self-management behavior（P<0.05）. Conclusion The self-management behavior of lung cancer patients is at a moderate level，and there are obvious classification characteristics. It is suggested that medical staff should carry out personalized intervention measures according to the characteristics of self-management behavior of patients of various categories，so as to improve the level of self-management behavior of lung cancer survivors.

Key words: Lung Cancer, Self-Management Behavior, Latent Profile Analysis, Influencing Factors, Cancer Nursing

徐梅, 林雯雯, 宁丽, 王莉, 汤阿毛, 夏云, 朱艳丽, 檀亚玲. 肺癌患者自我管理行为的潜在剖面分析[J]. 中华护理杂志, 2024, 59(20): 2487-2494.

XU Mei, LIN Wenwen, NING Li, WANG Li, TANG Amao, XIA Yun, ZHU Yanli, TAN Yaling. Potential profiling of self-management behavior in lung cancer patients[J]. Chinese Journal of Nursing, 2024, 59(20): 2487-2494.

图/表 6

表1 调查对象的一般资料和自我管理行为3个潜在剖面的单因素分析

Table 1 Univariate analysis of 3 potential profiles of respondents’ general information and self-management behavior

表2 肺癌患者自我管理行为在潜在剖面模型的拟合指标（n=252）

Table 2 Potential categories of self-management behavior among lung cancer patients（n=252）

图1 肺癌患者自我管理行为3个潜在类别的特征分布

Figure 1 Characteristic distribution of 3 potential categories of self-management behavior in lung cancer patients

表3 不同潜在类别肺癌患者自我管理行为得分情况（分，$\bar{x}\pm s$）

Table 3 Self-management behavior scores of patients with different potential categories of lung cancer（scores，$\bar{x}\pm s$）

表4 自变量赋值方式

Table 4 Assignment methods of argument variables

表5 肺癌患者自我管理行为潜在类别的多元Logistic回归分析（n=252）

Table 5 Multiple Logistic regression analysis of potential categories of self-management behaviors in lung cancer patients（n=252）

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