老年下肢静脉溃疡患者自我管理的潜在剖面分析及护理启示

doi:10.3761/j.issn.0254-1769.2024.12.003

摘要/Abstract

摘要：

目的探讨老年下肢静脉溃疡患者自我管理的现状及潜在剖面，分析不同剖面患者的差异及影响因素，为临床护理提供参考。方法采用便利抽样法，选取2022年10月—2023年5月在上海市3所三级甲等医院血管外科、脉管科门诊随访的330例老年下肢静脉溃疡患者作为调查对象。采用一般资料调查表、慢性伤口患者自我管理行为调查量表、慢性病病人健康素养调查量表、简易疾病感知问卷、社会支持评定量表、慢性疾病自我效能感量表和简易老年抑郁量表进行调查。借助Mplus 8.3软件进行潜在剖面分析，SPSS 25.0软件进行单因素分析和多元Logistic回归分析。结果最终回收有效问卷316份，按老年下肢静脉溃疡患者的自我管理水平分为低管理-应对伤口低效型、中管理-医嘱依从高效型和高管理-应对伤口高效型3个潜在类别，占比依次为25.63%、46.84%、27.53%。多元Logistic回归分析显示，患病时长、是否抑郁、健康素养、自我效能感和疾病感知是不同类别老年下肢静脉溃疡患者自我管理的影响因素。结论老年下肢静脉溃疡患者的自我管理水平处于中等水平且具有明显的分类特征，临床护理人员可以根据患者不同类别特征，采取针对性的护理措施，以提高患者的自我管理能力。

关键词: 下肢静脉溃疡, 老年人, 自我管理, 潜在剖面分析, 护理

Abstract:

Objective To explore the status quo and potential profile of self-management in elderly patients with venous leg ulcers，analyse the differences and influencing factors in different profiles，and provide references for clinical nursing. Methods Convenient sampling method was used to select patients who were followed up in the department of vascular surgery and vascular department of 3 tertiary A hospitals in Shanghai from October 2022 to May 2023 as the study subjects. General data questionnaire，Chronic Wound Patient Self-management Behavior Questionnaire，Health Literacy Management Scale，Brief Illness Perception Questionnaire，Social Support Rating Scale，Chronic Disease Self-Efficacy Scale and Geriatric Depression Scale-15 were used for investigation. Mplus 8.3 was used for potential profile analysis，and SPSS 25.0 was used for univariate analysis and multiple Logistic regression analysis. Results A total of 316 valid questionnaires were collected，and the patients were divided into 3 potential profiles according to their self-management level：low management-inefficient wound response，middle management-highly effective compliance and high management-efficient wound response，accounting for 25.63%，46.84%and 27.53% respectively. Multiple Logistic regression analysis showed that duration of illness，depression，health literacy，self-efficacy and illness perception were factors influencing the potential profile of self-management in elderly patients with venous leg ulcers. Conclusion The self-management level of elderly patients with venous leg ulcers is at a medium level and has obvious classification characteristics. Clinical nurses can take targeted nursing measures according to different characteristics of patients to improve their self-management ability.

Key words: Venous Leg Ulcers, Elderly, Self-Management, Latent Profile Analysis, Nursing Care

王安子, 穆文方, 顾飞, 王娴, 王燕, 许志玮, 周盼盼. 老年下肢静脉溃疡患者自我管理的潜在剖面分析及护理启示[J]. 中华护理杂志, 2024, 59(12): 1429-1435.

WANG Anzi, MU Wenfang, GU Fei, WANG Xian, WANG Yan, XU Zhiwei, ZHOU Panpan. Potential profile analysis and nursing implications of self-management in elderly patients with venous leg ulcers[J]. Chinese Journal of Nursing, 2024, 59(12): 1429-1435.

图/表 5

表1 老年下肢静脉溃疡患者的一般资料及自我管理潜在剖面的单因素分析

Table 1 Univariate analysis of potential profiles of self-management in elderly VLU patients

表2 老年下肢静脉溃疡患者自我管理潜在剖面模型的适配指标

Table 2 Fit indicators of potential profile model for self-management in elderly VLU patients

图1 老年下肢静脉溃疡患者自我管理3个潜在剖面的特征分布

Figure 1 Characteristic distribution of 3 potential profiles of self-management in elderly VLU patients

表3 自变量赋值

Table 3 Multiple Logistic regression analysis assignment table

表4 老年下肢静脉溃疡患者自我管理潜在剖面的多因素分析

Table 4 Multifactor analysis of potential profiles of self-management in elderly VLU patients

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