Latent profile analysis and network analysis of symptom among acute stroke patients
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摘要:
目的 针对急性期脑卒中患者症状存在群体异质性的临床特征,探索急性期脑卒中患者症状的潜在剖面类别,构建各组症状网络,并揭示各组症状网络核心症状。 方法 便利抽样法选取2024年7月—2025年3月在安徽医科大学第一附属医院神经内科住院的351例急性期脑卒中患者为研究对象,采用一般资料调查问卷、脑卒中症状体验量表进行调查。采用Mplus8.3软件构建潜在剖面模型, R语言构建症状网络并分析中心性指标。 结果 351例患者中男性233例、女性118例;年龄为18~92(66.07±12.48)岁。急性期脑卒中患者症状可分为4个潜在类别:低症状负担组(85例,占24.2%)、中症状负担-低认知障碍组(81例,占23.1%)、中症状负担-高认知障碍组(83例,占23.6%)、高症状负担组(102例,占29.1%)。基于症状网络分析,整体样本的核心症状是肢体活动受限;低症状负担组的核心症状是对周围活动没兴趣;中症状负担-低认知障碍组的核心症状是无法保持身体平衡;中症状负担-高认知障碍组和高症状负担组的核心症状是肢体活动受限。 结论 急性期脑卒中患者的症状困扰明显存在群体异质性,可分为4个类别。医护人员应根据不同的症状类别中的核心症状,制订具有针对性的临床症状管理方案。 Abstract:Objective Aiming at the clinical feature of population heterogeneity in symptoms among patients with acute stroke, thereby exploring the latent profile categories in acute stroke patients, constructing network characteristics, and identifying core symptoms in each group. Methods From July 2024 to March 2025, 351 acute stroke patients hospitalized in the Department of Neurology of the First Affiliated Hospital of Anhui Medical University were selected by convenience sampling method. A general information questionnaire and the stroke symptom experience scale were used for data collection. Mplus 8.3 software was used to construct the latent profile model, and symptom networks were built and centrality indices were analyzed using R programming language. Results A total of 351 patients with complete data were enrolled, including 233 males and 118 females, aged 18-92 years [(66.07±12.48) years]. Symptoms in acute stroke patients could be categorized into four latent categories: low symptom burden group [85 cases (24.2%)], moderate symptom burden-low cognitive impairment group [81 cases (23.1%)], moderate symptom burden-high cognitive impairment group [83 cases (23.6%)], and high symptom burden group [102 cases (29.1%)]. Based on symptom network analysis, the core symptom in the overall sample was limitation of limb movement. The core symptom in the low-symptom burden was lack of interest in surrounding activities. The core symptom in the medium-symptom burden-low cognitive impairment group was the inability to maintain body balance. The core symptom in the medium-symptom burden-high cognitive impairment group and high-symptom burden group was limitation of limb movement. Conclusion Group heterogeneity is evident in symptom distress among acute stroke patients, which can be categorized into 4 categories. Healthcare professionals should develop targeted clinical symptom management strategies based on the core symptoms in different symptom categories. -
Key words:
- Acute stroke /
- Latent profile analysis /
- Network analysis /
- Symptom management
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表 1 急性期脑卒中患者潜在剖面模型拟合信息
Table 1. Latent profile model fitting indicators for acute stroke patients
类别数 AIC BIC aBIC Entropy LMR (P值) BLRT (P值) 类别概率 1 14 866.222 14 982.045 14 886.874 1.000 2 13 909.423 14 087.019 13 941.090 0.863 0.000 5 <0.001 0.558/0.442 3 13 622.305 13 861.674 13 664.987 0.901 0.033 4 <0.001 0.214/0.481/0.305 4 13 287.407 13 588.548 13 341.103 0.922 0.003 7 <0.001 0.242/0.231/0.236/0.291 5 13 156.982 13 519.895 13 221.692 0.918 0.760 0 <0.001 0.202/0.279/0.143/0.211/0.165 -
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