Abstract:

Objective To explore the development trajectory and root cause of kinesiophobia in patients with diabetic peripheral neuropathy. Methods By the convenience sampling method，240 diabetic peripheral neuropathy patients who were hospitalized in the Department of Endocrinology of a tertiary A hospital in Jiangsu Province from May 2022 to November 2022 were selected. The baseline data of the patients are collected using a general questionnaire，the Tampa Scale for Kinesiophobia，the Chinese version of the Multidimensional Fatigue Inventory-20，the Pittsburgh Sleep Quality Index，the Social Support Rate Scale，and the Numerical Rating Scale for Pain. At the time of discharge，and at 3，6，and 12 months post-discharge，the level of kinesiophobia in the patients is assessed. The growth mixture model was used to classify the trajectory of kinesiophobia and analyze its root causes. Results Ultimately，227 patients in this study completed the survey. The trajectories of kinesiophobia in patients with diabetic peripheral neuropathy were divided into 3 latent classes：persistent high kinesiophobia group（22.5%），moderate kinesiophobia decline group（44.9%） and persistent low kinesiophobia group（32.6%）. The results of multivariate Logistic regression analysis showed that age，frequency of hypoglycemia，complications，sleep quality，fall history within a year，pain and fatigue score were influencing factors of the latent classes of kinesiophobia trajectories in patients with DPN（P<0.05）. Conclusion Within 12 months after discharge，the kinesiophobia of patients with diabetic peripheral neuropathy shows population heterogeneity. Medical staff should give targeted interventions according to the developmental trajectories of kinesiophobia and root cause analysis.

Key words: Diabetic Peripheral Neuropathy, Kinesiophobia, Latent Classes, Root Cause Analysis, Nursing Care

摘要：

目的 探讨糖尿病周围神经病变（diabetic peripheral neuropathy，DPN）患者运动恐惧的发展轨迹及影响因素。 方法 采用便利抽样法，选取2022年5月—11月于江苏省某三级甲等综合医院内分泌科住院的240例DPN患者作为调查对象。采用一般资料调查表、恐动症Tampa评分表、多维度疲乏症状量表、匹兹堡睡眠质量指数、社会支持评定量表以及疼痛数字评分表收集患者的基线资料，于出院时，出院后第3、6、12个月评估患者运动恐惧水平，采用潜变量增长混合模型对运动恐惧轨迹进行分类并分析其影响因素。 结果 最终227例患者完成调查。DPN患者运动恐惧轨迹分为3个潜在类别：持续高运动恐惧组（22.5%）、中运动恐惧-下降组（44.9%）、持续低运动恐惧组（32.6%）。多元Logistic回归分析结果显示，年龄、每个月低血糖发生次数、合并症、睡眠质量、1年内跌倒史、疼痛及疲劳是DPN患者运动恐惧轨迹潜在类别的影响因素（P<0.05）。结论 DPN患者出院后12个月内的运动恐惧轨迹存在群体异质性，医护人员应根据运动恐惧发展轨迹及其影响因素，给予针对性的宣教和护理。

关键词: 糖尿病周围神经病变, 运动恐惧, 潜在类别, 影响因素分析, 护理