减重代谢手术后患者治疗依从性现状及影响因素分析

doi:10.3761/j.issn.0254-1769.2026.05.014

摘要/Abstract

摘要：

目的了解减重代谢手术后患者治疗依从性现状并分析其影响因素，为制订个性化干预策略提供参考。方法采用便利抽样法，于2024年2—4月选取重庆市某三级甲等医院减重代谢手术后复查与随访的451例患者为调查对象。使用一般资料调查表及减重手术后患者治疗依从性量表进行调查，采用潜在剖面分析、多元Logistic回归分析进行数据分析。结果回收有效问卷434份，有效问卷回收率为96.23%。减重代谢手术后患者治疗依从性总分为（62.81±17.40）分，其治疗依从性分为4个潜在类别，即高依从组（28.34%）、随访驱动组（26.73%）、自我管理组（21.89%）与低依从组（23.04%）。性别、手术后时间与目前BMI是减重代谢手术后患者治疗依从性潜在剖面分类的影响因素（P<0.05）。结论减重代谢手术后患者治疗依从性处于中等水平且存在异质性，并受多种因素影响。医护人员可根据不同类别特征及影响因素，制订个性化干预方案，以提升患者的治疗依从性并改善减重效果。

关键词: 减重代谢手术, 治疗依从性, 潜在剖面分析, 影响因素分析, 护理

Abstract:

Objective To investigate the status and influencing factors of treatment adherence among patients after bariatric surgery，and to provide a reference for developing individualized intervention strategies. Methods Using convenience sampling，we recruited 451 patients who completed postoperative follow-up after bariatric surgery at a tertiary Grade A hospital in Chongqing，China，between February and April 2024. The general information questionnaire and the Treatment Adherence Scale for Post-Bariatric Surgery Patients were administered. Latent profile analysis and multinomial logistic regression were performed for data analysis. Results A total of 434 valid questionnaires were collected，yielding an effective response rate of 96.23%. The total score for treatment adherence was（62.81±17.40） points. Treatment adherence among patients after bariatric surgery could be categorized into 4 latent profiles：high adherence group（28.34%），follow-up-driven group（26.73%），self-management group（21.89%），and low adherence group（23.04%）. Gender，time since surgery，and current body mass index（BMI） were significant factors associated with latent profile classification of treatment adherence in patients after bariatric metabolic surgery（P<0.05）. Conclusion Treatment adherence after bariatric surgery is suboptimal and heterogeneous，influenced by multiple factors. Healthcare professionals may develop individualized intervention programs based on the characteristics and associated factors of each profile to improve treatment adherence and optimize weight-loss outcomes.

Key words: Bariatric Surgery, Treatment Adherence, Latent Profile Analysis, Root Cause Analysis, Nursing Care

叶惠林, 邬小容, 唐维荣, 殷云睿, 李跃荣. 减重代谢手术后患者治疗依从性现状及影响因素分析[J]. 中华护理杂志, 2026, 61(5): 674-681.

YE Huilin, WU Xiaorong, TANG Weirong, YIN Yunrui, LI Yuerong. The status and influencing factors of treatment adherence among patients after bariatric surgery[J]. Chinese Journal of Nursing, 2026, 61(5): 674-681.

图/表 4

表1 减重代谢手术后患者的一般资料及治疗依从性潜在剖面的单因素分析

Table 1 Univariate analysis of latent profiles of treatment adherence among patients after bariatric surgery

表2 减重代谢手术后患者治疗依从性潜在剖面的拟合指标（n=434）

Table 2 Model fit indices of treatment adherence latent profiles among patients after bariatric surgery（n=434）

图1 减重代谢手术后患者治疗依从性潜在剖面的特征分布

Figure 1 Characteristic profiles of the latent classes for treatment adherence among patients after bariatric surgery

表3 减重代谢手术后患者治疗依从性潜在剖面的Logistic回归分析（n=434）

Table 3 Multinomial Logistic regression analysis of latent profiles for treatment adherence among patients after bariatric surgery（n=434）

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