基于潜在剖面分析的老年癌症患者衰弱水平影响因素研究  

Influencing factors of senile cancer patients'debilitating level based on potential profile analysis

作　　者：孟英涛 王格 尚美美 王雅莉[3] 杨静[4] 张丽[5] 王莉 MENG Yingtao;WANG Ge;SHANG Meimei;WANG Yali;YANG Jing;ZHANG Li;WANG Li(Shandong Cancer Hospital and Institute,Shandong First Medical University and Shandong Academy of Medical Sciences,Jinan,Shangdong 250117,China;Health Management Center of Provincial Hospital Affiliated to Shandong First Medical University,Jinan,Shandong 250021,China)

机构地区：[1]山东省肿瘤防治研究院,山东省肿瘤医院,护理管理部,山东第一医科大学(山东省医学科学院),山东济南250117 [2]山东省肿瘤防治研究院食管外科病区,山东第一医科大学(山东省医学科学院),山东济南250117 [3]山东省肿瘤防治研究院呼吸内科二病区,山东第一医科大学(山东省医学科学院),山东济南250117 [4]山东省肿瘤防治研究院消化内科三病区,山东第一医科大学(山东省医学科学院),山东济南250117 [5]山东省肿瘤防治研究院血液科病区,山东第一医科大学(山东省医学科学院),山东济南250117 [6]山东第一医科大学附属省立医院健康管理中心,山东济南250021

出　　处：《中华肿瘤防治杂志》2024年第20期1252-1258,共7页Chinese Journal of Cancer Prevention and Treatment

基　　金：山东省人文社会科学课题(2022-ZXJK-22);山东医药科技发展计划(202214050797);山东第一医科大学(山东省医学科学院)校级教育教学改革研究面上项目(XM2023085)。

摘　　要：目的识别老年癌症患者衰弱类型,比较不同衰弱类型在人口学和社会支持水平上的差异。方法采用便利抽样的方法选取2021-10-01-2021-11-30山东省肿瘤医院收治的520例老年癌症患者为研究对象,其中男312例,女208例。采用一般资料调查问卷、Tilburg衰弱量表和感知社会支持量表行问卷调查。采用χ^(2)检验或单因素方差分析比较一般人口学资料和社会支持水平差异,采用多元logistic回归分析探讨影响因素。结果老年癌症患者衰弱类型可分为“躯体不适-高衰弱型”“心理失衡-中衰弱型”和“社会满足-低衰弱型”3个类别,其中衰弱量表得分为(9.52±2.13)分,社会支持得分为(62.84±11.99)分。单因素分析结果显示,文化程度(χ^(2)=12.881,P=0.045)、月收入(χ^(2)=18.410,P=0.001)、是否放疗(χ^(2)=9.361,P=0.009)、是否化疗(χ^(2)=6.521,P=0.038)、是否合并慢性病(χ^(2)=6.081,P=0.048)和社会支持得分(F=28.842,P<0.001)在3种衰弱类型上差异有统计学意义。多因素分析结果显示,放疗(OR=1.684,P=0.047,95%CI:1.007~2.814)和社会支持水平(OR=1.062,P<0.001,95%CI:1.039~1.086)是“躯体不适-高衰弱型”老年癌症患者的独立影响因素;放疗(OR=2.355,P=0.019,95%CI:1.153~4.809)和合并慢性病(OR=1.370,P=0.035,95%CI:0.147~2.093)是“心理失衡-中衰弱型”老年癌症患者的独立影响因素;文化程度为初中(OR=0.522,P=0.029,95%CI:0.292~0.935)是“社会满足-低衰弱型”老年癌症患者的独立影响因素。结论老年癌症患者衰弱水平存在异质性,识别出3个衰弱类型。尤其需要关注“躯体不适-高衰弱型”和“心理失衡-中衰弱型”的老年癌症患者,为不同类型的老年癌症患者制定针对性的护理措施,进而改善患者的生存质量。Objective To identify the types of weakness in elderly cancer patients and compare the differences in demographic and social support levels among different types of weakness.Methods Convenience sampling method was used to select 520elderly cancer patients admitted to the Cancer Hospital Affiliated to Shandong First Medical University from October 1to November 30,2021,including 312males and 208females.Questionnaire surveys were conducted by using the General Information Questionnaire,Tilburg Insufficiency Scale and Perceived Social Support Scale.Differences in general demographic data and social support levels were compared usingχ^(2) test or one-way analysis of variance,and influencing factors were explored using multiple logistic regression analysis.Results The types of weakness in elderly cancer patients could be divided into three categories:"physical discomfort-high weakness","psychological imbalance-moderate weakness"and"social satisfaction-low weakness".The score of the weakness scale was(9.52±2.13)points,and the score of social support was(62.84±11.99)points.Single factor analysis showed that education level(χ^(2)=12.881,P=0.045),monthly income(χ^(2)=18.410,P=0.001),whether radiotherapy(χ^(2)=9.361,P=0.009),whether chemotherapy(χ^(2)=6.521,P=0.038),whether concurrent chronic diseases(χ^(2)=6.081,P=0.048),and social support scores(F=28.842,P<0.001)were statistically significant differences in the three types of weakness.Multivariate analysis showed that radiotherapy(OR=1.684,P=0.047,95%CI:1.007-2.814)and level of social support(OR=1.062,P<0.001,95%CI:1.039-1.086)were independent influencing factors in elderly cancer patients with"physical discomforthyperasthenia".Radiotherapy(OR=2.355,P=0.019,95%CI:1.153-4.809)and concurrent chronic diseases(OR=1.370,P=0.035,95%CI:0.147-2.093)were independent influencing factors in elderly cancer patients with"psycholgical imbalance-moderately debilitating".Junior high school education(OR=0.522,P=0.029,95%CI:0.292-0.935)was an independent influencing factor for elde

关 键 词：老年癌症 衰弱 潜在剖面 影响因素 

分 类 号：R473.73[医药卫生—护理学]