Abstract:

Objective To explore the subtypes and dynamic changes of social support among patients with lung cancer before and after chemotherapy，and to examine their effects on physical activity，thereby providing evidence for the development of individualized clinical interventions. Methods A total of 245 patients with lung cancer who received chemotherapy for the first time in 2 tertiary hospitals in Nanning from October 2024 to June 2025 were selected by convenience sampling method. The perceived social support scale and the International Physical Activity Questionnaire-long form were used to investigate before chemotherapy and after chemotherapy. Results A total of 232 valid questionnaires were finally collected. The social support score of lung cancer patients before chemotherapy was（60.64±11.34） points，and it was（59.90±11.94） points after chemotherapy. The physical activity level before chemotherapy was 1 600.50（1040.00，2 345.25） MET-min/w，and it was 1 065.50（621.00，1 650.00） METS after chemotherapy. Before and after chemotherapy，3 subtypes of a family-led low out-of-family support group，a family-led medium out-of-family support group and a family-friend-other collaborative high support group were identified. The results of latent transition analysis showed that each group had a 50% probability of remaining stable in the original group. The results of generalized estimation equation showed that the physical activity level of lung cancer patients with different social support subtypes decreased significantly after chemotherapy，but the physical activity level of patients in the collaborative high support group was higher than that in the family-led low out-of-family support group and the high out-of-family support group（P<0.05）. Conclusion Social support among lung cancer patients exhibits heterogeneity and dynamic changes before and after chemotherapy，with high-level social support promoting physical activity. Healthcare providers should identify changes in social support among lung cancer patients at an early stage and implement individualized interventions to improve patients’ overall support and physical activity levels，thereby enhancing their quality of life.

Key words: Lung Cancer, Social Support, Physical Activity, Latent Profile Analysis, Latent Transition Analysis, Chronic Disease Care

摘要：

目的 探究肺癌患者化疗前后社会支持亚型及动态变化，并分析其对身体活动的影响，为临床开展个性化干预提供依据。 方法 采用便利抽样法，选取2024年10月—2025年6月于南宁市2所三级甲等医院首次接受化疗的245例肺癌患者为调查对象，分别于化疗前和化疗后采用领悟社会支持量表和国际体力活动问卷-长卷进行调查。 结果 最后共回收有效问卷232份。肺癌患者化疗前社会支持得分为（60.64±11.34）分，化疗后为（59.90±11.94）分；化疗前身体活动水平为1 600.50（1 040.00，2 345.25）梅脱-分钟/周，化疗后为1 065.50（621.00，1 650.00）梅脱-分钟/周。化疗前后识别出家庭主导-低家庭外支持组、家庭主导-中家庭外支持组和家庭-朋友-他人协同高支持组3种亚型。潜在转变分析结果显示，各组均有约50%的概率稳定在原组。广义估计方程结果显示，化疗前后，不同社会支持亚型肺癌患者的身体活动水平呈下降趋势，但家庭-朋友-他人协同高支持组患者身体活动水平均高于家庭主导-低家庭外支持组和家庭外高支持组（P<0.05）。 结论 肺癌患者化疗前后的社会支持呈异质性及动态变化，高水平社会支持可促进身体活动。医护人员应早期识别肺癌患者的社会支持变化，通过个性化干预改善患者整体支持与身体活动水平，提高其生活质量。

关键词: 肺癌, 社会支持, 身体活动, 潜在剖面分析, 潜在转变分析, 慢性病护理