基于潜类别增长模型的胃癌患者围术期症状群轨迹分型纵向研究OA

Objective To explore the trajectory of symptom clusters in gastric cancer patients during the perioperative period based on the latent class growth model(LCGM),and analyze the in-fluencing factors of each trajectory.Methods A convenience sampling method was used to select 156 patients with primary gastric cancer who underwent surgical treatment for the first time as the re-search subjects.Surveys were conducted using a general information questionnaire and the Anderson Symptom Assessment Scale-Gastric Cancer Specific Module at 2 to 3 days before surgeiy,2 to 4 days af-ter surgery,14 days after surgery,and 1 month after surgery.Exploratory factor analysis was used to extract symptom clusters.LCGM was employed to identify the trajectory of symptom cluster categories.A multivariate logistic regression model was used to analyze the influencing factors of each symptom cluster trajectory category.Results Exploratory factor analysis showed that the symptom clusters in gastric cancer patients during the perioperative period could be classified into 5 types.Among them,the gastrointestinal symptom cluster and the psychological symptom cluster persisted at all four survey time points.The LCGM identification results indicated that the gastrointestinal symptom cluster had 4 subtype categories(group with an initial decrease followed by an increase,low-level group with an initial increase followed by a decrease,flat group,and high-level group with an initial increase fol-lowed bya decrease),and the psychological symptom cluster had 2 subtype categories(high-level group with an initial increase followed by a decrease,and low-level group with an initial increase fol-lowed by a decrease).Age and gender were influencing factors for the trajectory of the gastrointesti-nal symptom cluster(P＜0.05);gender,educational level,and payment method were influencing factors for the trajectory of the psychological symptom cluster(P＜0.05).Conclusion The traj-ectories of symptom clusters in gastric cancer patients during the perioperative period exhibit differ-ent characteristics.The gastrointestinal symptom cluster shows relatively significant heterogeneity,while the trajectories of each subgroup in the psychological symptom cluster are relatively stable,with an overall gradual relief trend aftersurgery.The period of 2 to 4 days after surgery is a critical intervention period.There are differences in the influencing factors of different symptom clusters.Healthcare professionals should conduct targeted nursing assessments and interventions and imple-ment precision nursing to improve patient prognosis.