癌症患者复发恐惧的潜在剖面分析

doi:10.3761/j.issn.0254-1769.2023.06.003

摘要/Abstract

摘要：

目的探讨癌症患者复发恐惧的潜在类别特征，并分析不同类别癌症患者的特征差异。方法采用按比例分配连续性抽样的方法，选取2021年2月—10月在沈阳市某三级甲等医院住院治疗的肺癌、胃肠道癌、乳腺癌及妇科肿瘤的癌症患者作为调查对象。采用一般资料调查表、疾病不确定感量表、医院焦虑抑郁量表、领悟社会支持量表及癌症复发恐惧量表简版进行调查。结果最终共调查390例癌症患者，其中76.7%存在癌症复发恐惧；癌症复发恐惧表现为3种不同潜在类别，分别命名为“低复发恐惧-外向型”“中复发恐惧-常规型”和“高复发恐惧-神经质型”，占比依次为19.5%、59.7%、20.8%。相较于“低复发恐惧-外向型”，焦虑水平越高的癌症患者归属于“中复发恐惧-常规型”和“高复发恐惧-神经质型”的概率越大（OR=1.282，P=0.016；OR=1.378，P=0.010）；而社会支持水平越低的癌症患者归属于“中复发恐惧-常规型”和“高复发恐惧-神经质型”的概率越大（OR=0.948，P=0.010；OR=0.900，P<0.001）；疾病不确定感水平越高的癌症患者归属于“高复发恐惧-神经质型”的概率越大（OR=1.078，P=0.012）。结论癌症患者复发恐惧发生率处于较高水平并且具有明显的分类特征。医护人员可根据不同类别癌症患者采取针对性的护理干预措施以减轻癌症复发恐惧。

关键词: 癌症患者, 癌症复发恐惧, 潜在剖面分析, 影响因素分析, 肿瘤护理

Abstract:

Objective To explore potential classes characteristics of cancer patients’ fear of recurrence，and to analyze differences in characteristics of cancer patients across classes. Methods A cross-sectional study design with proportional allocation continuous sampling was used to select cancer patients of lung cancer，gastrointestinal cancer，breast cancer and gynecologic tumors who were hospitalized and treated in a tertiary hospital in Shenyang from February 2021 to October 2021 as the survey population. The study instruments included the General Information Questionnaire，the Illness Uncertainty Scale，the Hospital Anxiety and Depression Scale，the Perceived Social Support Scale and the short version of the Fear of Cancer Recurrence Scale. Results A total of 390 cancer patients were investigated，and 76.7% of them had fear of recurrence. Fear of recurrence was demonstrated in 3 different potential classes，named as “low fear of recurrence-extroverted”，“medium fear of recurrence-regular”，and “high fear of recurrence-neurotic”.The percentages were 19.5%，59.7%，and 20.8%，respectively.Compared with the type of “low fear of recurrence-extroverted”，cancer patients with higher anxiety levels were more likely to be classified as “medium fear of recurrence-regular” and “high fear of recurrence-neurotic”（OR=1.282，P=0.016；OR=1.378，P=0.010）. Cancer patients with lower levels of social support were more likely to be classified as “medium fear of recurrence-regular” and “high fear of recurrence-neurotic” （OR=0.948，P=0.010；OR=0.900，P<0.001）. Cancer patients with higher levels of illness uncertainty were more likely to be classified as “high fear of recurrence-neurotic”（OR=1.078，P=0.012）. Conclusion The incidence of fear of recurrence in cancer patients is at a high level with distinct characteristics of classification. It is suggested that health care professionals can adopt targeted nursing interventions according to the personality characteristics of different classes of cancer patients to avoid fear of recurrence.

Key words: Cancer Patients, Fear of Cancer Recurrence, Latent Profile Analysis, Root Cause Analysis, Oncologic Nursing Care

张旭, 孙迪, 李小寒, 李娇娇, 秦楠, 李贺吉. 癌症患者复发恐惧的潜在剖面分析[J]. 中华护理杂志, 2023, 58(6): 662-669.

ZHANG Xu, SUN Di, LI Xiaohan, LI Jiaojiao, QIN Nan, LI Heji. Fear of recurrence in cancer patients：a latent profile analysis[J]. Chinese Journal of Nursing, 2023, 58(6): 662-669.

图/表 4

表1 不同潜在剖面模型拟合参数指标的比较（n=390）

Table 1 Comparison of fit parameter indices of different latent profile models（n=390）

图1 癌症患者复发恐惧3个潜在类别的特征分布

Figure 1 Distribution of 3 latent categories of characteristics of cancer survivors’ fear of recurrence

表2 癌症患者复发恐惧潜在类别的单因素分析

Table 2 Univariate analysis of potential categories of recurrent fear in cancer survivors

表3 癌症患者复发恐惧潜在类别的多因素分析

Table 3 Multivariate analysis of potential categories of recurrent fear in cancer survivors

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