肺癌病人术后运动参与行为轨迹及其影响因素  

Trajectories and influencing factors of postoperative exercise participation behavior of patients with lung cancer

作　　者：戴琪 李方[1] 张筱童 朱媛 DAI Qi;LI Fang;ZHANG Xiaotong;ZHU Yuan(The First Affiliated Hospital of Nanjing Medical University,Jiangsu 210029 China)

机构地区：[1]南京医科大学第一附属医院,江苏210029

出　　处：《护理研究》2025年第6期902-909,共8页Chinese Nursing Research

基　　金：2022年江苏省人民医院“临床能力提升工程”项目,编号:JSPH-NB-2022-4。

摘　　要：目的:探讨肺癌病人术后运动参与行为的变化轨迹,并基于信息-动机-行为技巧模型分析其影响因素。方法:采用便利抽样法,选取2023年2月—5月在江苏省某三级甲等医院住院的209例肺癌病人作为研究对象,采用运动参与程度评测问卷调查病人出院时及术后1、3、6个月的运动参与行为。以潜在类别增长分析拟合肺癌病人术后运动参与行为的潜在类别轨迹,采用Logistic回归分析肺癌病人术后运动参与行为轨迹类别的影响因素,并构建决策树模型。结果:共识别3条肺癌病人术后运动参与行为的潜在轨迹,其中,整体上升组62例(29.7%)病人,缓慢下降组106例(50.7%)病人,快速下降组41例(19.6%)病人。Logistic回归分析结果显示,与快速下降组比较,肺癌术后运动知识、疾病获益感、社会支持及自我效能水平较高,居住在城镇的肺癌病人更可能归为整体上升组;肺癌术后运动知识和自我效能水平较高的肺癌病人更可能归为缓慢下降组(P<0.05)。决策树模型显示,自我效能、肺癌术后运动知识、居住地、疾病获益感为预测肺癌病人术后运动参与行为的轨迹亚型的重要变量。结论:肺癌病人术后运动参与行为呈现不同的变化轨迹,应根据影响因素早期识别术后运动参与行为下降病人,构建以自我效能为核心的干预方案,以提高肺癌病人术后运动参与行为的程度。Objective:To explore the trajectories of postoperative exercise participation behavior of patients with lung cancer,and analyze the influencing factors based on information-motivation-behavioral skills model.Methods:A total of 209 patients with lung cancer hospitalized in a tertiary grade A hospital in Jiangsu province from February to May 2023 were selected as the study subjects using convenience sampling method.Subsequently the exercise participation questionnaire was used to investigate the exercise participation behaviors of the patients at discharge,1 month,3 months and 6 months after surgery.The potential trajectories of postoperative exercise participation behavior of patients with lung cancer was fittted by latent class growth analysis Logistic regression was used to analyze the influencing factors of trajectories of postoperative exercise participation behavior of patients with hung cancer,and the decision tree model was constructed.Results:3 potential trajectories of postoperative exercise participation behavior were identified,and there were 62 patients(29.7%)in the overall increase group,106 patients(50.7%)in the slow decline group,and 41 patients(19.6%)in the rapid decline group.Logistic analysis showed that compared with the rapid decline group,the patients with lung cancer were more likely to be classified into the overall increase group whose levels of exercise knowledge after lung cancer surgery,disease benefit-finding,social support and self-efficacy were higher,and living in urban areas.Compared with the rapid decline group,the patients with lung cancer were more likely to be classified into the slow decline group whose levels of exercise knowledge after lung cancer surgery and self-efficacy were higher(P<0.05).The decision tree model showed that self-efficacy,exercise knowledge after lung cancer surgery,residence and disease benefit-finding were important variables for predicting the trajectories of postoperative exercise participation behavior of patients with lung cancer.Conclusions:The post

关 键 词：肺癌 运动参与行为 轨迹变化 IMB模型 影响因素 护理 

分 类 号：R473.73[医药卫生—护理学]