急性脊髓损伤患者精神心理症状群潜在剖面分析及影响因素研究 [中文引用][英文引用]

目的  识别急性脊髓损伤患者精神心理症状群的潜在类别特征及影响因素。方法  采用便利抽样法，于 2024 年7 月— 2025 年 7 月选取合肥市 3 所三级甲等综合医院 279 例急性脊髓损伤患者作为研究对象。采用一般资料调查表、匹兹堡睡眠质量问卷（Pittsburgh sleep quality index，PSQI）、简易疲劳量表（brief fatigue inventory，BFI）、广泛性焦虑量表简版（2-itemgeneralized anxiety disorder scale，GAD-2）、患者健康问卷简版（2-item patient health questionnaire，PHQ-2）、简易应对方式问卷（simplified coping style questionnaire，SCSQ）和领悟社会支持量表（perceived social support scale，PSSS）进行调查。采用潜在剖面分析对精神心理症状群进行分类，并通过多分类 Logistic 回归分析其影响因素。结果  279 例患者完成研究。急性脊髓损伤患者精神心理症状群分为 3 个潜在类别，包括低症状稳定组（38.7%）、中度症状均衡组（45.5%）和高症状情绪突出组（15.8%）。婚姻状况、美国脊柱损伤协会（American Spinal Injury Association，ASIA）分级、应对方式和社会支持是症状群潜在类别的影响因素，差异具有统计学意义（均 P<0.05）。结论  急性脊髓损伤患者精神心理症状群存在群体异质性，医护人员需重点关注不同亚组的影响因素，实施个性化干预策略以改善患者的精神心理状态。

Objective To determine the potential categorical characteristics and influencing factors of psychiatric-related symptom clusters in patients with acute spinal cord injury. Methods A total of 279 acute spinal cord injury patients from three comprehensive tertiary hospitals in Hefei City，Anhui Province，were chosen as study participants between July 2024 and July 2025 using convenience sampling. The general information form，pittsburgh sleep quality index（PSQI），brief fatigue inventory（BFI），2-item generalized anxiety disorder scale（GAD-2），2-item patient health questionnaire（PHQ-2），simplified coping style questionnaire（SCSQ）， and perceived social support scale（PSSS）were used in a cross-sectional survey. Latent profile analysis was used to investigate the potential categories of the psychiatric-related symptom clusters，and multinomial Logistic regression analysis was applied to analyze the influencing factors. Results Toally 279 patients finished the study. The psychiatric-related symptom clusters in patients with acute spinal cord injury can be classified into three potential categories：low symptom stability group（38.7%），moderate symptom equilibrium group（45.5%），and high symptom emotional prominence group（15.8%）. Marital status，ASIA（American Spinal Injury Association） grade，coping style and level of social support influenced the classification of latent categories within this symptom cluster（all P<0.05）. Conclusion Patients with acute spinal cord injury exhibit significant group heterogeneity in the psychiatric-related symptom clusters. Clinical professionals should concentrate on identifying influencing factors across different subgroups and implement tailored intervention strategies to improve patients’mental and psychological status.