老年髋部骨折患者出院准备度的潜在剖面分析及护理对策

doi:10.3761/j.issn.0254-1769.2025.24.002

摘要/Abstract

摘要：

目的探究老年髋部骨折患者出院准备度的潜在剖面并分析其影响因素，为临床实施精准化出院准备护理干预提供依据。方法采用便利抽样法，选取2024年9月—2025年2月北京市5所三级甲等医院收治的老年髋部骨折患者作为调查对象，通过一般资料调查表、社会支持评定量表、出院指导质量量表、出院准备度量表对其进行问卷调查。采用潜在剖面分析和多元Logistic回归分析进行数据分析。结果回收有效问卷215份，有效问卷回收率为93.48%。老年髋部骨折患者出院准备度得分为6.17（5.42，6.75）分，处于中等偏低水平。出院准备度可被分为3个分型：低准备-全面薄弱型（21.86%）、高准备-适应引领型（39.07%）、中准备-支持优势型（39.07%）。家庭年收入水平、出院时日常生活活动能力、社会支持水平是老年髋部骨折患者出院准备度潜在剖面的影响因素（均P<0.05）。结论老年髋部骨折患者出院准备度处于中等偏低水平且存在明显异质性，建议对低准备-全面薄弱型患者实施基础需求优先-系统支持强化策略，对高准备-适应引领型患者强化院内支持、优化延续护理，对中准备-支持优势型患者实施支持-效能转化干预。

关键词: 髋部骨折, 出院准备, 潜在剖面分析, 影响因素分析, 护理

Abstract:

Objective To explore the potential profiles of discharge readiness among older patients with hip fractures and analyze the influencing factors，providing support for the implementation of precise discharge readiness nursing interventions in clinical practice. Methods Convenience sampling was used to select older patients with hip fractures admitted to 5 tertiary A hospitals in Beijing from September 2024 to February 2025 as the survey subjects. Data was collected using the patient’s general information questionnaire，Social Support Rating Scale，Quality of Discharge Teaching Scale，and Readiness for Hospital Discharge Scale. Latent profile analysis and multivariate Logistic regression analysis were employed to analyze the data. Results A total of 215 valid questionnaires were collected in this study，and 93.48% of the valid questionnaires were included. The score of discharge readiness was 6.17（5.42，6.75），which was at a moderately low level. Discharge readiness could be divided into 3 latent profiles，namely “low readiness-overall weakness type”（21.86%），“high readiness-adaptation leadership type”（39.07%），and “medium readiness-support advantage type”（39.07%）. Family annual income level，activities of daily living ability at discharge，and social support level were independent predictors of the latent profiles of discharge readiness among older patients with hip fractures（all P<0.05）. Among them，social support level had a significant positive impact on patients with medium and high discharge readiness. Conclusion The discharge readiness among older patients with hip fractures is at a moderately low level with significant heterogeneity. It is recommended to implement a basic needs priority-system support strengthening strategy for low readiness patients，enhance in-hospital support and optimize continuous care for high readiness patients，and carry out support-efficacy transformation interventions for medium readiness patients.

Key words: Hip Fractures, Discharge Preparation, Latent Profile Analysis, Root Cause Analysis, Nursing Care

徐雅萍, 贾云洋, 易祖玲, 许蕊凤, 佟冰度, 鲁雪梅. 老年髋部骨折患者出院准备度的潜在剖面分析及护理对策[J]. 中华护理杂志, 2025, 60(24): 2956-2963.

XU Yaping, JIA Yunyang, YI Zuling, XU Ruifeng, TONG Bingdu, LU Xuemei. Latent profile analysis and influencing factors of discharge readiness among older patients with hip fractures and nursing strategies[J]. Chinese Journal of Nursing, 2025, 60(24): 2956-2963.

图/表 5

表1 老年髋部骨折患者的一般资料及出院准备度潜在剖面的单因素分析

Table 1 General information and univariate analysis of potential profiles of discharge readiness among older patients with hip fractures

表2 老年髋部骨折患者出院准备度潜在剖面模型的拟合指标（n=215）

Table 2 Model fitting results of potential profile analysis model for discharge readiness among older patients with hip fractures（n=215）

图1 老年髋部骨折患者出院准备度3个潜在剖面的特征分布

Figure 1 The characteristic distribution of 3 potential profiles of discharge readiness among older patients with hip fractures

表3 自变量赋值

Table 3 Multiple Logistic regression analysis assignment table

表4 老年髋部骨折患者出院准备度潜在剖面的多因素分析（n=215）

Table 4 Multifactor analysis of potential profiles of discharge readiness among older patients with hip fractures（n=215）

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