结直肠癌临时性肠造口患者社交回避及苦恼潜在剖面分析及其影响因素 [中文引用][英文引用]

目的  探讨行临时性肠造口术的结直肠癌患者社交回避及苦恼的潜在剖面及其影响因素，为医护人员提供参考。方法  采用便利抽样法，选取 2023 年 10 月— 2024 年 7 月在湖北省和陕西省 5 所三级甲等综合医院就诊并行临时性肠造口术的 613 例结直肠癌患者作为研究对象。采用一般资料调查表、社交回避及苦恼量表、一般自我效能感量表和社会影响量表进行调查。运用 Mplus8.3 软件进行潜在剖面分析将患者社交回避及苦恼分为不同类别，采用无序多分类 Logistic 回归分析患者社交回避及苦恼潜在类别的影响因素。结果  592 例患者完成研究。患者可分为 3 个潜在剖面，分别为高回避 - 高苦恼组、中回避 - 低苦恼组和低回避 - 低苦恼组。性别、年龄、手术方案知晓情况、造口自理能力、造口门诊就诊、一般自我效能感和病耻感是患者社交回避及苦恼潜在剖面的影响因素。结论  行临时性肠造口术的结直肠癌患者社交回避及苦恼具有异质性，多个因素对其分型有影响，医护人员实施干预时需考虑患者不同类型的差异性。

Objective To identify latent profiles of social avoidance and distress（SAD）among the patients with temporary enterostomy for colorectal cancer and to explore the factors influencing the latent profiles in order to develop intervention strategies. Methods With a convenience sampling method，613 patients who received temporary enterostomy due to colorectal cancer were recruited from 5 Tier-IIIA hospitals in Hubei and Shaanxi provinces of China between October 2023 and July 2024. Data were collected with a general-information questionnaire，social avoidance and distress scale，general self-Efficacy scale and social impact scale. Latent profile analysis（Mplus 8.3）was used to categorise patients according to severity of social avoidance and distress. Multinomial logistic regression was employed to examine the predictors for latent profiles. Results A total of 592 patients completed the survey. Three distinct latent profiles were identified: high avoidance and high distress，moderate avoidance and low distress，and low avoidance and low distress. Multivariate logistic regression analysis confirmed the significant predictors of SAD profiles that included gender，age， preoperative understanding of stoma procedure，stoma self-care ability，visit of stoma clinic，general self-efficacy，and scores of general self-efficacy scale and social impact. Conclusion SAD in patients with a temporary enterostomy for colorectal cancer is heterogeneous and is influenced by multiple factors in profiles. Tailored interventions should be taken into account in the intervention of healthcare workers in order to manage different type of patients.