老年维持性血液透析患者习得性无助感潜在剖面及影响因素分析

doi:10.3761/j.issn.0254-1769.2025.23.008

摘要/Abstract

摘要：

目的探讨老年维持性血液透析患者习得性无助感的潜在剖面及影响因素，为临床护理实践提供参考。方法便利选取2024年10月—2025年2月昆山市3所综合医院血液透析中心的440例老年维持性血液透析患者作为调查对象。采用一般资料调查表、习得性无助量表、国际体力活动问卷简表及透析后疲乏量表进行调查，通过潜在剖面分析和Logistic回归分析老年维持性血液透析患者习得性无助感潜在剖面的影响因素。结果回收有效问卷432份，有效问卷回收率为98.18%。432例老年维持性血液透析患者习得性无助得分为（37.34±12.76）分，可分为3个潜在剖面，分别是低无助-低绝望组（59.72%）、高无助-低绝望组（25.92%）、高无助-高绝望组（14.35%）。Logistic回归分析显示，年龄、原发疾病、久坐行为、透析后疲乏是老年维持性血液透析患者习得性无助感潜在剖面的影响因素（P<0.05）。结论老年维持性血液透析患者习得性无助感存在异质性，医护人员可根据不同的潜在剖面影响因素进行个体化干预，以降低其无助感。

关键词: 老年人, 维持性血液透析, 习得性无助, 潜在剖面分析, 护理

Abstract:

Objective To explore the latent profiles of learned helplessness and their influencing factors in elderly patients undergoing maintenance hemodialysis（MHD），so as to provide references for clinical nursing practice. Methods A convenience sample of 440 elderly patients undergoing MHD was selected from 3 hemodialysis centers in Kunshan City between October 2024 and February 2025. Data were collected using a general information questionnaire，the Learned Helplessness Scale，the International Physical Activity Questionnaire Short Form，and the Post-Dialysis Fatigue Scale. Latent profile analysis and logistic regression were used to identify distinct profiles and their influencing factors. Results A total of 432 valid questionnaires were collected，yielding a response rate of 98.18%. The mean score for learned helplessness among the 432 elderly MHD patients was（37.34±12.76）scores. LPA revealed 3 distinct latent profiles：Low Helplessness-Low Hopelessness（59.72%），High Helplessness-Low Hopelessness（25.92%），and High Helplessness-High Hopelessness（14.35%）. Logistic regression analysis indicated that age，primary disease，sedentary behavior，and post-dialysis fatigue were significant influencing factors for profile membership（P<0.05）. Conclusion Learned helplessness exhibits heterogeneity in elderly patients on MHD. Healthcare providers may implement personalized interventions targeting profile-specific influencing factors to reduce helplessness.

Key words: Aged, Maintenance Hemodialysis, Learned Helplessness, Latent Profile Analysis, Nursing Care

陆沁怡, 陆程倩, 聂奕轩, 金学勤. 老年维持性血液透析患者习得性无助感潜在剖面及影响因素分析[J]. 中华护理杂志, 2025, 60(23): 2872-2879.

LU Qinyi, LU Chengqian, NIE Yixuan, JIN Xueqin. Latent profiles of learned helplessness and its influencing factors in elderly patients on maintenance hemodialysis[J]. Chinese Journal of Nursing, 2025, 60(23): 2872-2879.

图/表 6

表1 老年维持性血液透析患者的一般资料及习得性无助感潜在剖面的单因素分析[例（百分比，%）]

Table 1 Univariate analysis of general information and latent profiles of learned helplessness among elderly patients on maintenance hemodialysis[cases（percentage，%）]

表2 老年维持性血液透析患者习得性无助感潜在剖面分析模型拟合结果（n=432）

Table 2 Model fit results of latent profile analysis for learned helplessness in elderly patients on maintenance hemodialysis（n=432）

图1 老年维持性血液透析患者习得性无助感3个潜在剖面的特征分布

Figure 1 Characteristics and distribution of 3 potential profiles of learned helplessness among elderly patients on maintenance hemodialysis

表3 透析后疲乏与习得性无助的阈值效应分析结果（n=432）

Table 3 Threshold effect analysis results of post-dialysis fatigue and learned helplessness（n=432）

表4 自变量赋值方式

Table 4 Assignment of independent variables

表5 老年维持性血液透析患者习得性无助感潜在剖面的多因素Logistic回归分析（n=432）

Table 5 Multivariate logistic regression analysis of latent profiles of learned helplessness in elderly patients undergoing maintenance hemodialysis（n=432）

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