目的: 探讨喉癌手术患者创伤后成长和疾病感知的变化轨迹及其影响因素。方法: 通过便利抽样法,选取2018年9月—2021年12月在湖南某三级甲等医院治疗的92例喉癌患者为研究对象,采用一般资料调查表、创伤后成长量表、疾病感知量表在术前、出院后1个月、3个月、6个月进行重复测量。选用潜类别增长模型、多类别Logistic回归分析。结果: 根据模型相关指标,喉癌手术患者的创伤后成长发展轨迹可分为高分增长组（16/92,17.4%）、中等增长组（55/92,59.8%）和低稳增长组（21/92,22.8%）3个潜在类别;相对成长低稳增长组,喉部分切除术患者更容易进入成长高分增长组（OR=0.88,P=0.006）。疾病感知发展轨迹划分为快速下降组（26/92,28.3%）、平稳下降组（42/92,45.6%）、缓慢下降组（24/92,26.1%）3个潜在类别。结论: 喉癌患者术前至出院后6个月,创伤后成长和疾病感知均呈现出3种变化轨迹,群体间存在个体差异。医护人员可通过手术方式识别创伤后成长水平低的人群,预测其创伤后成长动态变化。建议临床医护人员应根据喉癌手术患者创伤后成长和疾病感知的发展轨迹类型和影响因素制订针对性的个体化干预方案。
Abstract
Objective To explore the potential categories and influencing factors of post-traumatic growth and disease perception in surgical patients with laryngeal cancer. Method 92 cases with laryngeal cancer treated in a first-class hospital in Hunan province from September 2018 to December 2021 were selected as the research object using convenient sampling method. The general data questionnaire, post-traumatic growth scale, disease awareness scale in preoperative were used for follow-up evaluation before surgery, 1 month after discharge, 3 months after discharge and 6 months after discharge. Latent category growth model and multi-category Logistic regression analysis were used. Results According to the relevant indicators of the model, the development trajectory of laryngeal cancer patients could be divided into three potential categories: high score growth group (16/92, 17.4%), medium growth group (55/92, 59.8%) and low steady growth group (21/92, 22.8%). Compared with the low steady growth group, the patients with partial laryngectomy were more likely to enter the high score growth group (OR=0.88, P=0.006). The development trajectory of disease perception was divided into rapid decline group (26/92, 28.3%), steady decline group (42/92, 45.6%), slow decline group (24/92, 26.1%). Conclusion From preoperative to 6 months after discharge, post-traumatic growth and disease perception of laryngeal cancer patients show three different trajectories, and there are individual differences among groups. Medical staff can identify the population with low post-traumatic growth by surgical methods and predict the dynamic changes of post-traumatic growth. It is suggested that clinical medical staff should formulate targeted individualized intervention programs according to the development trajectory types and influencing factors of disease perception and post-traumatic growth of laryngeal cancer patients.
关键词
喉癌 /
创伤后成长 /
疾病感知 /
潜类别增长模型
Key words
squamous cell carcinoma of head and neck /
post-traumatic growth /
disease perception /
latent category growth model
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基金
湖南省自然科学基金资助项目“基于眼动追踪技术的青年乳腺癌患者抑郁数智个体化干预模式的构建与实证研究”（2024JJ5300）,“基于眼动轨迹特征的育龄期乳腺癌术后患者创伤后应激障碍预测模型的构建及干预研究”（2024JJ9270）; 湖南省中医药科研课题“乳腺癌相关淋巴水肿中医护理技术循证护理方案的构建与实践研究”（B2023125）; 湖南省卫生健康委科研课题“头颈肿瘤患者术后吞咽障碍预警评估体系的构建及实证研究”（202114051914）
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