结直肠癌患者社会疏离的潜在剖面分析及护理启示

doi:10.3761/j.issn.0254-1769.2025.20.010

摘要/Abstract

摘要：

目的分析结直肠癌患者社会疏离的潜在类别，并探讨不同类别的影响因素及风险因素的累积效应，以期为实施个体化干预提供参考。方法采用便利抽样法，选取2023年1—6月在山东省3所三级甲等医院胃肠外科、肿瘤科住院的结直肠癌患者作为调查对象。使用一般资料调查表、社交回避量表、社交焦虑量表、加利福尼亚洛杉矶分校孤独感量表、心理一致感量表、家庭亲密度量表、社会支持评定量表进行问卷调查。采用潜在剖面分析、多元Logistic回归分析进行分析。结果发放问卷292份，回收有效问卷270份，有效问卷回收率为92.47%。结直肠癌患者社会疏离可分为3个潜在类别：低疏离组（42.59%）、高疏离-高社交回避组（14.08%）、中等疏离-高社交焦虑组（43.33%）。Logistic回归分析结果显示，工作状况、造口情况、是否转移、心理一致感、家庭亲密度、社会支持是不同潜在类别的影响因素，且心理一致感、家庭亲密度和社会支持对不同类别的影响存在累积效应（P<0.05）。结论结直肠癌患者社会疏离存在群体异质性，医护人员应识别不同患者的特征差异，重点关注存在多个风险因素的患者，以制订针对性的干预措施，帮助其更好地融入社会。

关键词: 结直肠癌患者, 社会疏离, 潜在剖面分析, 累积效应, 影响因素分析, 护理

Abstract:

Objective To analyze the latent classes of social alienation in colorectal cancer patients and further explore the influencing factors and cumulative effects of risk factors across different classes，thereby providing a reference for individualized interventions. Methods Convenience sampling was used to select colorectal cancer patients hospitalized in the gastrointestinal surgery and oncology departments of 3 tertiary-level hospitals in Shandong Province from January to June 2023 as the study subjects. A questionnaire survey was conducted using the General Information Questionnaire，Social Avoidance Scale，Social Anxiety Scale，UCLA Loneliness Scale，Sense of Coherence Scale，Family Cohesion Scale，and Social Support Rating Scale. Data analysis was performed using latent profile analysis and multivariate logistic regression analysis. Results A total of 292 questionnaires were distributed，with 270 valid responses collected，yielding a response rate of 92.47%. The results of the latent profile analysis indicated that social alienation among colorectal cancer patients could be categorized into 3 latent groups：the “low alienation group”（42.59%），the“high alienation-high social avoidance group”（14.08%），and the “moderate alienation-high social anxiety group”（43.33%）. Results of logistic regression analysis revealed that employment status，stoma status，metastasis，sense of coherence，family cohesion，and social support were influencing factors across different categories. Moreover，a cumulative effect of sense of coherence，family cohesion，and social support on distinct categories was observed（P<0.05）. Conclusion Social alienation among colorectal cancer patients exhibits group heterogeneity. Healthcare professionals should identify the characteristic differences among patients，prioritise those with multiple risk factors，and develop targeted intervention measures to help them better integrate into society.

Key words: Colorectal Cancer Patients, Social Alienation, Latent Profile Analysis, Cumulative Effect, Root Cause Analysis, Nursing Care

杨晓霞, 于子夫, 王芳, 侯亚丽, 朱礼敬, 吕利明. 结直肠癌患者社会疏离的潜在剖面分析及护理启示[J]. 中华护理杂志, 2025, 60(20): 2499-2506.

YANG Xiaoxia, YU Zifu, WANG Fang, HOU Yali, ZHU Lijing, LÜ Liming. Latent profile analysis and nursing implications of social alienation in colorectal cancer patients[J]. Chinese Journal of Nursing, 2025, 60(20): 2499-2506.

图/表 7

表1 调查对象的一般资料及社会疏离潜在类别的单因素分析

Table 1 General information on respondents and univariate analysis of potential categories of social alienation

表2 结直肠癌患者社会疏离潜在类别模型拟合指标（n=270）

Table 2 Indicators of model fit for potential categories of social alienation in colorectal cancer patients（n=270）

图1 结直肠癌患者社会疏离的潜在剖面

Figure 1 Potential profiles of social alienation in colorectal cancer patients

表3 结直肠癌患者社会疏离潜在类别的多元Logistic回归分析（n=270）

Table 3 Multiple Logistic regression analysis of potential categories of social alienation in patients with colorectal cancer（n=270）

表4 社会疏离潜在类别累积风险的多元Logistic回归分析（n=270）

Table 4 Multiple Logistic regression analyses of cumulative risk of potential categories of social alienation（n=270）

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