慢性化脓性中耳炎成年患者术后生活质量轨迹及影响因素分析OA
Analysis of Postoperative Quality of Life Trajectories and Their Influencing Factors in Adults with Chronic Suppurative Otitis Media
目的 探讨慢性化脓性中耳炎成年患者术后生活质量发展轨迹的潜在类别,并分析影响类别差异的相关因素,旨在为早期识别高风险人群、实施精准护理干预提供实证依据.方法 2022年2月至2024年9月,采用便利抽样法选取至香港大学深圳医院接受中耳相关手术的慢性化脓性中耳炎术后患者200例作为研究对象.分别于术后第1天(T1)、术后1个月(T2)、术后3个月(T3)、术后6个月(T4)采用慢性化脓性中耳炎生活质量量表(CSOM-QOL)、疾病不确定感量表(MUIS)、心理弹性量表(CD-RISC)及社会支持量表(SSRS)对患者进行问卷调查.采用潜类别增长模型,通过拟合不同增长曲线,识别患者术后生活质量变化轨迹的潜在类别.采用单因素及多因素logistic回归分析潜在类别间的独立影响因素.结果 200例患者术后生活质量发展可分为3类:快速恢复组(95例,47.50%)、平稳渐进组(66例,33.00%)、缓慢波动组(39例,19.50%).logistic回归分析结果显示,年龄、术后伴有耳鸣、累及耳别、术后并发症、中耳炎类型、MUIS评分、CD-RISC评分及SSRS评分均是不同生活质量发展轨迹的影响因素(均P<0.05).结论 慢性化脓性中耳炎成年患者术后生活质量存在3种不同的发展轨迹,具有群体异质性.临床工作中应关注高龄、术后伴有耳鸣及并发症的患者,并通过针对性干预措施提高其心理弹性水平、减轻疾病不确定感,从而改善患者生活质量.
Objective To explore the latent classes of postoperative quality of life trajectories in adults with chronic suppurative otitis media and to identify factors influencing different classes,aiming to provide empirical evidence for early identification of high-risk populations and the implementation of precise nursing interventions.Methods From February 2022 to September 2024,200 patients who underwent middle ear surgery for chronic suppurative otitis media at the University of Hong Kong-Shenzhen Hospital were selected by convenience sampling.They were investigated using the Chronic Suppurative Otitis Media Quality of Life(CSOM-QOL),Mishel-Uncertainty of Illness Scale(MUIS),Connor-Davidson Resilience Scale(CD-RISC)and Social Support Rating Scale(SSRS)on postoperative Day 1(T1),at postoperative Month 1(T2),at postoperative Month 3(T3)and at postoperative Month 6(T4).A latent class growth model was employed to fit different growth curves and identify latent classes of postoperative quality of life trajectories.Univariate and multivariate logistic regression analyses were conducted to identify independent factors influencing latent classes.Results Postoperative quality of life trajectories in the 200 patients were categorized into three classes:rapid recovery(95 subjects,47.50%),steady improvement(66 subjects,33.00%),and slow fluctuation(39 subjects,19.50%).Logistic regression analysis revealed that age,postoperative tinnitus,affected ear side,postoperative complications,type of otitis media,MUIS score,CD-RISC score and SSRS score were all significant factors influencing quality of life trajectories(P<0.05 for all).Conclusion There are three distinct postoperative quality of life trajectories in adults with chronic suppurative otitis media,demonstrating group heterogeneity.In clinical practice,attention should be given to elderly patients with postoperative tinnitus and complications.Targeted interventions should be implemented to enhance psychological resilience and reduce uncertainty in illness,thereby improving patients'quality of life.
江婷;徐银铃;杨孟凤;张贝
香港大学深圳医院,广东 深圳 518053香港大学深圳医院,广东 深圳 518053香港大学深圳医院,广东 深圳 518053香港大学深圳医院,广东 深圳 518053
医药卫生
慢性化脓性中耳炎手术治疗生活质量发展轨迹影响因素
Chronic suppurative otitis mediaSurgical treatmentQuality of lifeTrajectoryInfluencing factor
《上海护理》 2026 (6)
39-45,7
深圳市耳鼻咽喉疾病临床医学研究中心(20220819120540004-007).
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