妇科肿瘤患者经济毒性潜在剖面分析及其影响因素 [中文引用][英文引用]

目的  探讨妇科肿瘤患者经济毒性的潜在剖面及医疗成本应对行为和电子健康素养等因素对经济毒性的影响，为减轻患者经济毒性提供理论依据。方法  采用横断面研究方法，通过便利抽样法于 2024 年 1 月至 4 月选取陕西省某三级甲等肿瘤专科医院收治的 450 例妇科肿瘤患者作为调查对象。采用一般资料调查表、经济毒性综合评分量表（comprehensivescore for financial toxicity- based on the patient-reported outcome measures，COST-PROM）、医疗成本应对行为（medical-related costcoping behaviors）、电子健康素养量表（eHealth literacy scale，eHEALS）进行调查。对患者经济毒性进行潜在剖面分析（latentprofile analysis，LPA），利用多分类 Logistic 回归分析不同类别的影响因素。结果  378 例妇科肿瘤患者完成研究。发生经济毒性的有 358 例（94.7%）；患者分为高经济毒性组 57 例（15.1%），低担忧中经济毒性组 261 例（69.0%）和低经济毒性组 60 例（15.9%）3 种经济毒性类型。Logistic 回归分析结果显示，年龄、居住地、医疗成本应对行为和电子健康素养是患者经济毒性的影响因素（均 P<0.05）。结论  妇科肿瘤患者经济毒性发生率较高，且存在异质性，护理工作者应重点关注高经济毒性和低担忧中经济毒性患者，并根据不同类别的特征及影响因素为其制定个性化的治疗和支持方案，以改善其经济毒性水平。

Objective To explore the latent profiles of financial toxicity in gynaecological patients with cancer and analyse the associated factors such as medical cost-coping behaviours and eHealth literacy，providing a theoretical basis for mitigating financial toxicity in the population. Methods A cross-sectional study was conducted using convenience sampling. From January to April 2024， 450 gynaecological patients with cancer were selected as study subjects from the Grade-A tertiary specialized hospital for oncology in Shaanxi Province. The investigation utilised a general information questionnaire，a comprehensive score for financial toxicity（COSTPROM），a medical-related cost-coping behaviours scale，and the eHealth literacy scale（eHEALS）. Latent profile analysis（LPA）was used to identify profiles of financial toxicity，and multinomial logistic regression was employed to analyse the influential factors of different categories. Results A total of 378 patients completed the study. Financial toxicity occurred in 358 patients（94.7%）. Patients were categorised into three latent profiles：a“high financial toxicity group”（n=57，15.1%），a“low-worry moderate financial toxicity group” （n=261，69.0%）and a“low financial toxicity group”（n=60，15.9%）. Logistic regression analysis indicated that age，place of residence， medical cost-coping behaviours，and eHealth literacy were significant factors that associate with the financial toxicity（all P<0.05）. Conclusion The incidence of financial toxicity among gynaecologic patients with cancer is relatively high and heterogeneous. Nursing professionals should focus on the patients with“high financial toxicity”and“low-worry moderate financial toxicity”. Individualised treatment plans and support interventions should be developed based on the characteristics and influential factors as per category to alleviate the level of financial toxicity.