晚期癌症患者安宁疗护态度潜在类别及影响因素分析  

The latent categories and their influencing factors of palliative care attitudes in patients with advanced cancer

作　　者：张梅 罗艳艳[1] 郭华[2,4] 张桂凌 刘凯莉[1] 姚桂英 Zhang Mei;Luo Yanyan;Guo Hua;Zhang Guiling;Liu Kaili;Yao Guiying(School of Nursing,Xinxiang Medical University,Xinxiang 453003,China)

机构地区：[1]新乡医学院护理学院,河南新乡453003 [2]新乡市中心医院肿瘤内科二 [3]新乡市中心医院科教科 [4]新乡市安宁疗护临床实践技能重点实验室

出　　处：《护理学杂志》2024年第6期94-99,共6页Journal of Nursing Science

基　　金：河南省高等学校重点科研项目(21A310013)。

摘　　要：目的 探讨晚期癌症患者安宁疗护态度的潜在类别特征及影响因素。方法 采用便利抽样法选取晚期癌症患者462例,使用一般资料调查表、安宁疗护态度量表和死亡焦虑量表进行调查,利用潜在剖面分析识别晚期癌症患者安宁疗护态度的潜在类别;采用无序多元logistic回归分析死亡焦虑和一般人口学变量对安宁疗护态度潜在类别的影响。结果 晚期癌症患者安宁疗护态度分为4个潜在类别:低认知低行为组(10.8%)、高压力组(18.4%)、低情绪负担组(51.1%)和态度积极组(19.7%)。回归分析显示:死亡焦虑是晚期癌症患者高压力组的预测因素(OR=0.764);农民相对其他职业更容易出现在低认知低行为组(OR=1.332)、事业单位/公务员相对其他职业更容易出现高压力状态(OR=1.427)、月收入<5 000元(OR=2.412~5.687)和接受过癌症手术(OR=0.764)是低情绪负担组的预测因素(均P<0.05)。结论 晚期癌症患者对安宁疗护的态度存在群体异质性,死亡焦虑处于高水平状态;死亡焦虑对安宁疗护态度高压力组具有特异性的影响。Objective To explore the latent categorical characteristics of palliative care attitudes in patients with advanced cancer and the influencing factors.Methods A total of 462 patients with advanced cancer were selected using convenience sampling method and surveyed by the general data questionnaire,Palliative Care Attitudes Scale,and Templer′Death Anxiety Scale.Latent profile ana-lysis was used to identify the potential categories of palliative care attitudesin patients with advanced cancer.Disordered multiple logistic regression was employed to analyze the impact of death anxiety and general demographic variables on latent categories of palliative care attitudes.Results Palliative care attitudes in patients with advanced cancer were classified into four latent categories:low cognition and low behavior group(10.8%),high stress group(18.4%),low emotional burden group(51.1%),and positive attitude group(19.7%).Regression analysis revealed that death anxiety was a predictive factor for the high stress group in patients with advanced cancer(OR=0.764).Farmers were more likely to be in the low cognition and low behavior group compared to other occupations(OR=1.332),while individuals working in government agencies/civil service were more likely to experience high stress compared to other occupations(OR=1.427).Monthly income<5,000(OR=2.412-5.687)and having undergone cancer surgery(OR=0.764)were predictive factors for the low emotional burden group(all P<0.05).Conclusion Patients with advanced cancer exhibit heterogeneity in their attitudes towards palliative care,and death anxiety is at a high level.Death anxiety has a specific impact on the high stress group in terms of palliative care attitudes.

关 键 词：晚期癌症 安宁疗护态度 死亡焦虑 压力 认知 行为 情绪负担 潜在剖面分析 

分 类 号：R473.73[医药卫生—护理学]