基于潜在剖面分析的儿童肝移植受者术后心理行为适应特征的异质性研究  

Heterogeneity of psychological and behavioral adaptation characteristics of pediatric recipients after liver transplantation based on latent profile analysis

作　　者：王贝贝 王艳[1] 黄明珠[1] 陆伊娜 唐诗 Wang Beibei;Wang Yan;Huang Mingzhu;Lu Yi’na;Tang Shi(Department of Nursing,Renji Hospital Affiliated to Shanghai Jiao Tong University School of Medicine,Shanghai 200127,China;不详)

机构地区：[1]上海交通大学医学院附属仁济医院护理部,上海200127 [2]上海交通大学医学院附属仁济医院肝脏外科,上海200127

出　　处：《器官移植》2023年第6期838-846,共9页Organ Transplantation

基　　金：上海市自然科学基金(23ZR1438600);2023年度上海交通大学医学院护理科研重中之重项目(Jyhz2302)。

摘　　要：目的探索儿童肝移植受者心理行为适应特征的异质性亚型及不同类别儿童肝移植受者的特征差异。方法选取741例接受活体肝移植手术儿童受者,由其照护者填写自制一般资料调查表、世界卫生组织5项身心健康指标(WHO-5)中文版量表及长处与困难问卷(SDQ)(家长版),进行调查。以SDQ 5个维度得分为模型的外显变量,采用潜在剖面分析构建儿童肝移植受者心理行为适应特征分类模型,分析儿童肝移植受者心理行为适应特征的潜在类别,并采用单因素分析和logistic回归分析潜在类别的影响因素。结果儿童肝移植受者心理行为适应特征存在3个潜在类别,分别为同伴交往问题组(302例)、心理行为适应组(145例)及心理行为调节困难组(294例)。将前两组合并为心理行为健康组(447例),与心理行为调节困难组(294例)在长处与困难问卷的5个维度得分及困难总分比较差异均有统计学意义(均为P<0.001)。logistic回归分析显示,年龄≤5岁、原发病为非胆汁淤积性肝病、主干家庭类型为儿童肝移植受者心理行为调节困难的危险因素,性别为女、父母教育水平高、照护者WHO-5得分高为儿童肝移植受者术后心理行为调节困难的保护因素(均为P<0.05)。结论儿童肝移植受者的心理行为适应特征存在异质性,医护人员应关注不同心理行为适应类别的儿童肝移植受者的不同特征,采取针对性的筛查和干预策略,以改善儿童肝移植受者的心理行为适应结局。Objective To explore heterogeneous subtypes of psychological and behavioral adaptation characteristics of pediatric recipients after liver transplantation and the characteristics differences of different types of children after liver transplantation.Methods Seven hundred and forty-one children who underwent living-related liver transplantation were enrolled.The self-designed general information questionnaire,Chinese version of 5-Item World Health Organization Well-Being Index(WHO-5)and the parent-report version of the Strengths and Difficulties Questionnaire(SDQ)were filled out by their guardians.The scores of five dimensions of SDQ were used as the manifest variables of the model.The classification model of psychological and behavioral adaptation characteristics of pediatric recipients after liver transplantation was constructed by latent profile analysis.The latent categories of psychological and behavioral adaptation characteristics of pediatric recipients after liver transplantation were analyzed.The influencing factors of latent categories were analyzed by univariate analysis and logistic regression model.Results There were three latent categories of psychological and behavioral adaptation characteristics of pediatric recipients after liver transplantation,including peer communication problem group(n=302),psychological and behavioral adaptation group(n=145)and psychological and behavioral adjustment difficulty group(n=294).The first two groups were merged into the psychological and behavioral health group(n=447),which had significant differences in the five dimensions and the total score of difficulties of SDQ compared with the psychological and behavioral adjustment difficulty group(n=294)(all P<0.001).Logistic regression analysis showed that age≤5 years old,primary disease of non-cholestatic liver disease,stem family were the risk factors for psychological and behavioral adjustment difficulties in pediatric recipients after liver transplantation.Female gender,high education levels of parents and high WHO

关 键 词：肝移植 儿童受者 心理健康 行为 异质性 照护者 潜在剖面分析 长处和困难问卷 

分 类 号：R617[医药卫生—外科学] R395.1[医药卫生—临床医学]