老年慢性肺炎患者疲乏轨迹的潜在类别及影响因素分析  

Latent class growth analysis and factors influencing fatigue trajectories in elderly patients with chronic pneumonia

作　　者：蔡景曦 蔡佳佳 张宗丽 翟翠翠 Cai Jingxi;Cai Jiajia;Zhang Zongli;Zhai Cuicui(No 4 Department of Geriatrics,Zhejiang Provincial Tongde Hospital,Hangzhou 310012,China)

机构地区：[1]浙江省立同德医院老年四科,杭州310012

出　　处：《中华现代护理杂志》2025年第6期803-809,共7页Chinese Journal of Modern Nursing

基　　金：浙江省中医药科技计划临床研究应用项目(2023ZL323)。

摘　　要：目的探讨老年慢性肺炎患者疲乏轨迹的潜在类别及影响因素。方法采用便利抽样法,选取2023年1月—2024年1月浙江省立同德医院老年科收治的188例老年慢性肺炎患者为研究对象,采用一般资料调查表、营养风险筛查2002、阿森斯失眠量表、汉密尔顿焦虑量表、社区承诺量表、疲乏量表进行调查,于就诊时(T0)、就诊后第3个月(T1)和第6个月(T2)对患者疲乏追踪调查,采用潜类别增长分析拟合老年慢性肺炎患者疲乏程度的轨迹变化。结果本研究共发放问卷188份,回收有效问卷165份,问卷有效回收率为87.8%(165/188)。165例患者T0、T1、T2的疲乏量表得分分别为(4.63±1.74)、(5.54±1.90)、(7.82±2.84)分;疲乏轨迹可分为低疲乏-缓升组(74.5%,123/165)、低疲乏-恶化组(10.3%,17/165)、高疲乏-缓升组(15.2%,25/165)3个潜在类别。多分类Logistic回归分析显示,年龄、吸烟指数、慢性病数量、睡眠、焦虑和咳嗽咳痰持续时间是老年慢性肺炎患者疲乏轨迹的影响因素(P<0.05)。结论老年慢性肺炎患者的疲乏轨迹存在群体异质性,医护人员应根据不同轨迹类别制订针对性的护理措施,减轻患者疲乏,提高生活质量。Objective To explore the latent classes of fatigue trajectories and influencing factors in elderly patients with chronic pneumonia.MethodsA convenience sampling method was used to select 188 elderly patients with chronic pneumonia admitted to the Department of Geriatrics at Zhejiang Provincial Tongde Hospital from January 2023 to January 2024.General Data Questionnaires,Nutrition Risk Screening 2002,Athens Insomnia Scale,Hamilton Anxiety Scale,Community Commitment Scale,and Fatigue Scale were used to assess the patients.Patients were followed up for fatigue Scale at the time of consultation(T0),and at the third(T1)and sixth(T2)months after consultation.Latent class growth analysis was used to model the trajectory of fatigue changes in elderly patients with chronic pneumonia.ResultsA total of 188 questionnaires were distributed,with 165 valid responses,yielding an effective response rate of 87.8%(165/188).The Fatigue Scale scores at T0,T1,and T2 were(4.63±1.74),(5.54±1.90),and(7.82±2.84),respectively.The fatigue trajectories could be classified into three latent classes:low fatigue-slow increase group(74.5%,123/165),low fatigue-worsening group(10.3%,17/165),and high fatigue-slow increase group(15.2%,25/165).Multivariate logistic regression analysis showed that age,smoking index,number of chronic diseases,sleep,anxiety,and duration of cough and sputum were significant influencing factors for the fatigue trajectory in elderly patients with chronic pneumonia(P<0.05).ConclusionsFatigue trajectories in elderly patients with chronic pneumonia exhibit group heterogeneity.Healthcare providers should develop targeted nursing measures based on different trajectory classes to alleviate fatigue and improve quality of life.

关 键 词：老年人 慢性肺炎 疲乏 轨迹 影响因素 

分 类 号：R473.5[医药卫生—护理学]