产褥期妇女身心症状及其人群特征识别的潜在剖面分析  

Identifying subgroups of physical and psychological symptoms in postpartum women and its population characteristics:a latent profile analysis

作　　者：金天 郑朱婷 王婧婷 董小兰 袁长蓉 JIN Tian;ZHENG Zhu-ting;WANG Jing-ting;DONG Xiao-lan;YUAN Chang-rong(School of Nursing,Fudan University,Shanghai 200032,China;Department of Nuring,Obstetrics and Gynecology Hospital,Fudan University,Shanghai 200090,China;School of Nursing,Naval Medical University,Shanghai 200433,China;Department of Nuring Science,Faculty of Medicine,University of Turku,Turku 20014,Finland)

机构地区：[1]复旦大学护理学院,上海200032 [2]复旦大学附属妇产科医院护理部,上海200090 [3]海军军医大学护理系,上海200433 [4]图尔库大学医学院护理系,图尔库20014

出　　处：《复旦学报（医学版）》2024年第6期961-969,共9页Fudan University Journal of Medical Sciences

摘　　要：目的基于潜在剖面分析(latent profile analysis,LPA)识别产妇产褥期身心症状人群亚组及其特征。方法进行横断面研究,采用便利抽样法选取2023年12月至2024年3月在复旦大学附属妇产科医院分娩后1~2周的157名产妇。采用患者报告结局测量信息系统(patient-reported outcomes measurement information system,PROMIS)的焦虑、抑郁、疲乏、睡眠困扰、疼痛简表进行调查,针对产妇产褥期身心症状进行LPA,多元Logistic回归分析探讨不同症状亚组产妇的人群特征。结果产妇产褥期身心症状分为症状重度困扰组(10.2%)、症状中度困扰组(50.3%)和症状困扰不显著组(39.5%)3个类别。这3个类别在产妇年龄、产褥期居住方式、新生儿出生体重、新生儿喂养方式、新生儿就医史、妊娠风险预警评估、分娩方式以及产后并发症上的差异均有统计学意义(P均<0.05)。结论产妇产褥期身心症状可分为3个潜在类别,医护人员可根据不同人群特征预测产妇分组,并制定针对性干预策略,以改善产妇产褥期体验。Objective To identify the latent profile of physical and psychological symptoms in postpartum women and examine the associations of the latent class membership with individual characteristics,based on a latent profile analysis.Methods A cross-sectional survey study was conducted.With convenience sampling,157 postpartum women who had delivered at the Obstetrics and Gynecology Hospital,Fudan University from Dec 2023 to Mar 2024 were selected.The participants were surveyed with patient-reported outcomes measurement information system(PROMIS)Anxiety,Depression,Fatigue,Sleep Disturbance,and Pain interference short forms.LPA and multinomial Logistic regression model were performed to identify subgroups based on physical and psychological symptoms in postpartum women and population heterogeneity.Results LPA results suggested that there existed three distinct classes of postpartum physical and psychological symptoms:severe symptoms distress class(10.2%),moderate symptoms distress class(50.3%),and mild symptoms distress class(39.5%).Postpartum women’s age,living arrangements,newborn’s birthweight,newborn’s feeding method,newborn’s medical background,prenatal pregnancy risk assessment,mode of delivery,and postpartum complications had significant associations with the latent class membership(P<0.05).Conclusion There are 3 latent profiles of postpartum physical and psychological symptoms.Healthcare providers could provide targeted intervention to postpartum women according to the characteristics of different subgroup population characteristics,so as to improve the postpartum experience of women.

关 键 词：产妇 身心症状 患者结局报告测量信息系统(PROMIS) 潜在剖面分析(LPA) 

分 类 号：R714.6[医药卫生—妇产科学]