Abstract:

Objective To analyze the influencing factors and action paths of frailty in elderly patients with colorectal cancer，so as to provide a theoretical clinical intervention. Methods A convenience sampling method was adopted. A total of 254 elderly patients with colorectal cancer who were scheduled for elective surgery in a tertiary A hospital in Shanxi Province from March 2023 to September 2024 were selected as the research subjects. General information questionnaires，Fried frailty phenotype，Perceived Ageism Scale，Multidimensional Assessment Scale of Interoceptive Awareness Version 2-Chinese，Cancer Patient Self-Management Assessment Scale，and Anderson Symptom Inventory were used for the investigation，and a structural equation model was constructed. Results The incidence of frailty in elderly colorectal cancer patients before surgery is 38.98%.Anderson Symptom Assessment and Perceived Ageism were positively correlated with frailty（r=0.534，0.568，P<0.01），while interoceptive sensitivity and the self-management level were negatively correlated with frailty（r=-0.444，-0.659，P<0.01）. Self-management behavior had only a direct effect on patients’ frailty（β=-0.349，P<0.001），while Anderson Symptom Assessment，perceived age discrimination and interoceptive sensitivity had both direct and indirect effects on patients’ frailty（direct effects β=0.235，0.287，-0.220；indirect effects β=0.147，0.090，-0.113；all P<0.001）. Conclusion The incidence of frailty in elderly patients with colorectal cancer before surgery is high. Attention should be paid to patients who are elderly，female and have a low level of education. Medical staff can take targeted measures to enhance patients’ interoceptive concentration and stability，so that patients can better monitor and regulate their bodies and emotions，and improve their health-promoting decisions and behaviors. At the same time，attention should also be paid to the problem of age discrimination to create a good medical environment for patients.

Key words: Colorectal Neoplasms, Frailty, Interoceptive Sensitivity, Root Cause Analysis, Nursing Care

摘要：

目的 分析术前老年结直肠癌患者衰弱的影响因素及其作用路径，为临床干预提供理论依据。方法 采取便利抽样法，选取2023年3月—2024年9月在山西省某三级甲等医院普外科拟行择期手术的254例老年结直肠癌患者作为调查对象，采用一般资料调查表、Fried衰弱表型、感知年龄歧视调查表、内感受意识多维评估量表第2版、癌症患者自我管理测评量表、安德森症状评估量表进行调查，并构建结构方程模型。结果 术前老年结直肠癌患者衰弱的发生率为38.98%。安德森症状评估和感知年龄歧视与衰弱呈正相关（r=0.534，0.568，P<0.01），内感受敏感性和自我管理水平与衰弱呈负相关（r=-0.444，-0.659，P<0.01）。自我管理水平对患者衰弱仅存在直接效应（β=-0.349，P<0.001），而安德森症状评估、感知年龄歧视和内感受敏感性对患者衰弱同时存在直接和间接效应（直接效应β=0.235、0.287、-0.220；间接效应β=0.147、0.090、-0.113；均P<0.001）。结论 术前老年结直肠癌患者衰弱发生率高，应重点关注年龄大、女性、文化程度低的患者，且医护人员可采取针对性的措施加强患者内感受的专注力与稳定性，使其拥有对身体、情感更好的监测与调节，改善促进健康的决策和行为。同时，还应注重年龄歧视问题，为患者创造良好医疗环境。

关键词: 结直肠癌, 衰弱, 内感受敏感性, 影响因素分析, 护理