乳腺癌化疗病人需求变化轨迹及影响因素的纵向研究OA
Change trajectories of needs and influencing factors in breast cancer patients undergoing chemotherapy:a longitudinal study
目的:探索乳腺癌化疗病人疾病信息需求、心理需求及社会需求的动态变化轨迹,并明确各轨迹类别的影响因素,为临床制定精准化干预措施提供依据.方法:采用便利抽样法选取146例乳腺癌首次化疗病人,采用乳腺癌病人需求量表、益处发现量表在8个化疗周期(T1～T8)进行纵向随访调查.运用潜类别增长模型分析3类需求的变化轨迹,采用多分类Logistic回归探讨轨迹类别的影响因素.结果:乳腺癌化疗病人3类需求均呈下降趋势且存在群体异质性:1)疾病信息需求识别出2个轨迹类别,即低信息需求下降组(58.2%)、高信息需求下降组(41.8%);2)心理需求识别出3个轨迹类别,即低心理需求组(35.6%)、中心理需求组(41.8%)、高心理需求组(22.6%);3)社会需求识别出2个潜在剖面,即低社会需求组(69.2%)、高社会需求组(30.8%).多因素分析显示,手术、益处发现是疾病信息需求轨迹的影响因素(均P<0.05);合并其他慢性病、益处发现是心理需求轨迹的影响因素(均P<0.05);合并其他慢性病、转移、益处发现是社会需求类别的影响因素(均P<0.05).结论:乳腺癌化疗病人3类需求的变化轨迹具有群体异质性,且受不同因素影响,临床医护人员可结合病人需求轨迹特征及影响因素,实施针对性干预,持续满足病人动态需求.
Objective:To explore the dynamic change trajectories of disease information needs,psychological needs,and social needs in breast cancer patients undergoing chemotherapy,and to identify the influencing factors for each trajectory category,thereby providing a basis for developing precise clinical interventions.Methods:A convenience sampling method was used to select 146 breast cancer patients undergoing their first chemotherapy session.A longitudinal follow-up survey was conducted over eight chemotherapy cycles(T1-T8)using the Breast Cancer Patients Needs Scale and the Benefit Finding Scale.Latent class growth modeling was applied to analyze the change trajectories of the three types of needs,and multinomial logistic regression was used to explore the influencing factors of the trajectory categories.Results:The three types of needs in breast cancer patients undergoing chemotherapy all showed a declining trend with population heterogeneity:1)Two trajectory categories were identified for disease information needs:low information needs declining group(58.2%)and high information needs declining group(41.8%);2)Three trajectory categories were identified for psychological needs:low psychological needs group(35.6%),moderate psychological needs group(41.8%),and high psychological needs group(22.6%);3)Two trajectory categories were identified for social needs:low social needs group(69.2%)and high social needs group(30.8%).Multivariate analysis showed that surgery and benefit finding were influencing factors for the disease information needs trajectory(both P<0.05);comorbidities with other chronic diseases and benefit finding were influencing factors for the psychological needs trajectory(both P<0.05);comorbidities with other chronic diseases,metastasis,and benefit finding were influencing factors for the social needs trajectory(all P<0.05).Conclusions:The change trajectories of the three types of needs in breast cancer patients undergoing chemotherapy exhibit population heterogeneity.And they are influenced by different factors.Clinical staff can combine the characteristics of patients'need trajectories and influencing factors to implement targeted interventions,continuously meeting patients'dynamic needs.
赵映;黄菲;徐滢佳;李明雅;卢燕
湖北医药学院护理学院,湖北 442000||仙桃职业学院湖北医药学院护理学院,湖北 442000乐山市中医医院湖北医药学院护理学院,湖北 442000国药东风总医院
乳腺癌化疗信息需求心理需求社会需求纵向研究影响因素
breast cancerchemotherapyinformation needspsychological needssocial needslongitudinal studyinfluencing factors
《护理研究》 2026 (9)
1467-1480,14
湖北省卫生健康科技项目,编号:WJ2025M175湖北省自然科学基金项目,编号:2024AFB258
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