基于潜在剖面分析的乳腺癌术后化疗患者应对方式分型及其影响因素分析

张艳芳; 丁京; 于园园; 蒋楠楠; 赵龙; 杨秀木

doi:10.16766/j.cnki.issn.1674-4152.003395

基于潜在剖面分析的乳腺癌术后化疗患者应对方式分型及其影响因素分析

doi: 10.16766/j.cnki.issn.1674-4152.003395

张艳芳¹,
丁京¹,
于园园²,
蒋楠楠¹,
赵龙¹,
杨秀木^{1, 3, ,}

1.
蚌埠医科大学护理学院，安徽蚌埠 233030
2.
蚌埠医科大学第二附属医院内分泌科，安徽蚌埠 233030
3.
蚌埠医科大学全科医学发展中心，安徽蚌埠 233000

基金项目:

安徽省教育厅人文社科重点项目 SK2019A0193

蚌埠医学院人文社科重点研究项目 2021byzd240sk

蚌埠医学院人文社科重点研究项目 2020byzd214sk

蚌埠医学院大学生创新创业训练计划项目 bydc2023075

详细信息

通讯作者:
杨秀木，E-mail：yxiumu@sohu.com

中图分类号: R737.9
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- 文章访问数: 32
- HTML全文浏览量: 18
- PDF下载量: 4
- 被引次数: 0
出版历程
- 收稿日期: 2023-10-11
- 网络出版日期: 2024-03-27

To analyze the coping style classification and its influencing factors of breast cancer patients undergoing chemotherapy after surgery based on latent profile analysis

1.
School of Nursing, Bengbu Medical University, Bengbu, Anhui 233030, China

摘要

摘要: 目的分析乳腺癌术后化疗患者应对方式的潜在类别，探讨不同潜在类别的乳腺癌术后化疗患者应对方式的影响因素。方法选取2021年6月—2022年5月安徽省三所医院共601例乳腺癌术后化疗患者为研究对象，采用简易应对问卷、知觉压力量表和领悟社会支持量表进行问卷调查。结果乳腺癌术后化疗患者应对方式可以分为“消极组”(C1)、“积极组”(C2)、“高积极-高消极组”(C3)3种潜在类别；不同类别乳腺癌术后化疗患者应对方式在人均月收入和居住地、知觉压力和领悟社会支持得分上差异均有统计学意义(P < 0.05)；相对于“积极组”，领悟社会支持(OR=0.957，P < 0.001)得分水平越高出现在“消极组”的可能性越小，知觉压力(OR=1.069，P < 0.01)得分水平越高出现在“消极组”的可能性越大；相对于“积极组”，居住地为农村(OR=1.510，P < 0.05)出现在“高积极-高消极组”的可能性较大，知觉压力(OR=1.097，P < 0.001)得分水平越高出现在“高积极-高消极组”的可能性越大；相对于“消极组”，领悟社会支持(OR=1.043，P < 0.001)得分水平越高出现在“高积极-高消极组”的可能性越大，人均月收入 < 3 000元(OR=0.431，P < 0.05)出现在“高积极-高消极组”的可能性小。结论本研究识别出乳腺癌术后化疗患者3种应对方式的潜在类别，专业护理人员和健康教育工作者可根据其不同应对方式潜在类别的心理特征实施个性化心理干预。
- 应对方式 /
- 知觉压力 /
- 领悟社会支持 /
- 潜在剖面分析 /
- 乳腺癌
Abstract: Objective To analyze the potential categories of coping styles among breast cancer patients and explore the factors that influence them. Methods A total of 601 breast cancer patients from three hospitals in Anhui Province were selected as research participants between September 2021 and May 2022. Questionnaire investigations were conducted using the simple coping questionnaire, perceived stress scale, and perceived social support scale. Results The coping style of breast cancer patients undergoing postoperative chemotherapy were divided into three categories: the "negative group" (C1), the "positive group" (C2) and the "high positive-high negative group" (C3). Significant differences were observed in the average monthly income, residence, perceived stress, and perceived social support scores among the different categories of breast cancer patients with postoperative chemotherapy (P < 0.05). Compared with the active group, the "negative group" was less likely to have perceived social support (OR=0.957, P < 0.001), and higher levels of perceived stress (OR=1.069, P < 0.01) were associated with a greater likelihood of being in the "negative group". Living in a rural area (OR=1.510, P < 0.05) increased the likelihood of being in the "high positive-high negative group", and higher levels of perceived stress (OR=1.097, P < 0.001) were associated with a higher likelihood of being in the "high positive-high negative group". Compared with the "negative group", higher levels of perceived social support (OR=1.043, P < 0.001) were associated with a higher likelihood of being in the "high positive-high negative group", while a monthly income less than 3 000 yuan (OR=0.431, P < 0.05) decreased the likelihood of being in the high positive-high negative group. Conclusion This study categorizes coping styles in breast cancer patients undergoing chemotherapy into three potential categories. Based on these findings, professional nursing staff and health educators can provide personalized psychological intervention to the specific coping styles of individuals.
- Coping style /
- Perceived pressure /
- Perceived social support /
- Potential profile analysis /
- Breast cancer

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图 1 乳腺癌术后化疗患者应对方式的潜在剖面分析结果

Figure 1. Results of potential profile analysis of patients undergoing postoperative chemotherapy for breast cancer

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表 1 不同类别数的潜在剖面模型拟合指数(n=601)

Table 1. Potential profile model fit index for different numbers of categories (n=601)

类别	AIC	BIC	aBIC	Entropy	LRT	BLRT	类别概率
1	28 918.066	29 094.010	28 967.020
2	27 764.329	28 032.643	27 838.985	0.916	< 0.001	< 0.001	0.206/0.794
3	27 190.500	27 551.185	27 290.857	0.854	< 0.001	< 0.001	0.175/0.481/0.344
4	26 944.509	27 397.565	27 070.567	0.881	0.337	< 0.001	0.121/0.343/0.067/0.469

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表 2 不同潜在类别的乳腺癌术后化疗患者社会人口学特征比较[例(%)]

Table 2. Comparison of sociodemographic characteristics and scores of patients undergoing postoperative chemotherapy for breast cancer with different potential categories[cases (%)]

项目	类别	总样本(n=601)	C1(n=105)	C2(n=289)	C3(n=207)	统计量	P值
年龄(岁)	< 30	52(8.7)	8(7.6)	29(10.0)	15(7.2)	3.322^a	0.345
	30~	274(45.6)	51(48.6)	125(43.3)	98(47.3)
	45~	226(37.6)	38(36.2)	111(38.4)	77(37.2)
	>60	49(8.2)	8(7.6)	24(8.3)	17(8.2)
人均月收入(元)	< 3 000	152(25.3)	39(37.1)	69(23.9)	44(21.3)	7.102^a	0.029
	3 000~5 000	356(59.2)	54(51.4)	172(59.5)	130(62.8)
	>5 000	93(15.5)	12(11.4)	48(16.6)	33(15.9)
婚姻状况	有配偶	452(75.2)	82(78.1)	218(75.4)	152(73.4)	0.828^b	0.661
	无配偶	149(24.8)	23(21.9)	71(24.6)	55(26.6)
居住地	农村	379(63.1)	66(62.9)	171(59.2)	142(68.6)	6.190^b	0.045
	城市	222(36.9)	39(37.1)	118(40.8)	65(31.4)
受教育程度	小学及以下	44(7.3)	9(8.6)	19(6.6)	16(7.7)	1.835^a	0.607
	初中	199(33.1)	35(33.3)	104(36.0)	60(29.0)
	高中/中专	228(37.9)	39(37.1)	109(37.7)	80(38.6)
	大专及以上	130(21.6)	22(21.0)	57(19.7)	51(24.6)
报销形式	职工医保	120(20.0)	20(19.0)	51(17.6)	49(23.7)	4.630^b	0.592
	城镇居民医保	225(37.4)	38(36.2)	110(38.1)	77(37.2)
	新型农村合作医疗	244(40.6)	44(41.9)	124(42.9)	76(36.7)
	其他	12(2.0)	3(2.9)	4(1.4)	5(2.4)
注：^a为Z值，^b为χ²值。

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表 3 不同潜在类别乳腺癌术后化疗患者各变量得分比较(x±s)

Table 3. Comparison of scores of each variable in patients undergoing postoperative chemotherapy for breast cancer with different potential categories[cases (%)] (x±s)

项目	总样本(n=601)	C1(n=105)	C2(n=289)	C3(n=207)	F值	P值
积极应对	2.48±0.39	1.83±0.27	2.66±0.24	2.58±0.24	444.953^a	＜0.001
消极应对	1.39±0.56	1.53±0.47	0.98±0.34	1.90±0.35	386.168^b	＜0.001
知觉压力	2.81±0.48	2.96±0.49	2.67±0.43	2.93±0.48	27.083^c	＜0.001
领悟社会支持	5.28±1.02	4.80±0.95	5.49±0.99	5.25±1.00	18.831^d	＜0.001
注：^a表示C2>C3>C1；^b表示C3>C1>C2；^c表示C1≈C3>C2；^d表示C2>C3>C1。

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表 4 乳腺癌术后化疗患者应对方式类别的logistic回归分析结果

Table 4. Results of Logistic regression analysis of patients for breast cancer

变量	B	SE	Waldχ²	P值	OR(95% CI)
C1(相对于C2)
领悟社会支持	-0.043	0.011	15.765	＜0.001	0.957(0.937~0.978)
知觉压力	0.067	0.020	10.069	＜0.001	1.069(1.027~1.113)
人均月收入(元)
< 3 000	0.713	0.395	3.262	0.001	2.041(0.941~4.427)
≥3 000	0.154	0.373	0.171	0.071	1.166(0.562~2.421)
居住地为农村	0.120	0.248	0.235	0.679	1.128(0.694~1.833)
C3(相对于C2)
领悟社会支持	-0.001	0.009	0.015	0.903	0.999(0.982~1.016)
知觉压力	0.092	0.017	30.323	＜0.001	1.097(1.061~1.133)
人均月收入(元)
< 3 000	-0.129	0.310	0.173	0.678	0.879(0.479~1.614)
≥3 000	0.113	0.266	0.181	0.671	1.120(0.665~1.887)
居住地为农村	0.412	0.201	4.242	0.039	1.510(1.020~2.236)
C3(相对于C1)
领悟社会支持	0.042	0.011	14.141	＜0.001	1.043(1.021~1.067)
知觉压力	0.025	0.021	1.492	0.222	1.026(0.985~1.068)
人均月收入(元)
< 3 000	-0.842	0.41	4.229	0.040	0.431(0.193~0.961)
≥3 000	-0.041	0.381	0.011	0.915	0.960(0.455~2.027)
居住地为农村	0.292	0.259	1.274	0.259	1.339(0.806~2.224)
注：人均月收入以>5 000元为参照；居住地以城市为参照。

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