肝硬化失代偿期病人经济毒性潜在剖面及影响因素的混合研究OA
A mixed study on the potential profile of financial toxicity and its influencing factors in patients with decompensated liver cirrhosis
目的:探讨肝硬化失代偿期病人经济毒性的潜在类别,并分析其影响因素,以期为实施个性化干预提供参考.方法:选取2023年7月—2025年5月东莞市某三级甲等医院消化内科收治的206例肝硬化失代偿期病人为调查对象,使用一般资料调查表、中文版患者报告结局的经济毒性综合评分量表、社会支持评定量表进行调查,并采用Logistic回归分析影响因素;采用目的抽样法选取11例病人进行半结构化访谈,并用解释现象学分析法对访谈资料进行分析.结果:肝硬化失代偿期经济毒性可分为轻经济毒性-轻社会心理反应型(13.1%)、中经济毒性-重社会心理反应型(51.5%)、中经济毒性-中社会心理反应型(29.1%)、重经济毒性-中社会心理反应型(6.3%)4个潜在类别.Logistic回归分析结果显示,性别、婚姻状况、文化程度、家庭经济收入、社会支持是肝硬化失代偿期病人经济毒性的影响因素(P<0.05).质性研究共提炼出理性应对、心理崩塌、消极妥协、心理隔离4个核心主题,医疗费用支付方式、个体医学应对方式、医疗费用不确定感、钝感力、非正式经济支撑、家庭责任感、疾病管理半衰期是肝硬化失代偿期病人经济毒性的影响因素.结论:肝硬化失代偿期病人普遍受经济毒性影响,经济毒性潜在类别存在多元特征,提示社会工作者、医护人员可通过早期识别各类别特征及影响因素,制订个性化干预方案,改善经济毒性体验,弱化其对肝硬化失代偿期病人最佳健康行为决策的负向影响.
Objective:To explore the potential latent class characteristics of financial toxicity in patients with decompensated liver cirrhosis and to analyze the influencing factors of different latent classes,aiming to provide reference basis for implementing personalized interventions.Methods:A total of 206 patients with decompensated liver cirrhosis admitted to the gastroenterology department of a tertiary grade A hospital in Dongguan city from July 2023 to May 2025 were selected as the study subjects.A General Information Questionnaire,the Chinese version of the Comprehensive Score for Financial Toxicity Scale,and the Social Support Rating Scale were used to investigate.Logistic regression analysis was used to identify the influencing factors.A total of 11 patients were purposively sampled for semi-structured interviews by purposive sampling.Interpretive phenomenological analysis was applied to analyze the interview data.Results:Financial toxicity in decompensated liver cirrhosis was classified into four latent classes:mild financial toxicity-mild social psychological reactivity type(13.1%),moderate financial toxicity-severe social psychological reactivity type(51.5%),moderate financial toxicity-moderate social psychological reactivity type(29.1%),and severe financial toxicity-moderate social psychological reactivity type(6.3%).Logistic regression analysis results showed that gender,marital status,education level,household economic income,and social support were identified as influencing factors of financial toxicity in patients with decompensated liver cirrhosis(P<0.05).The qualitative study extracted four core themes:rational coping,psychological collapse,passive compromise,and psychological isolation.Payment methods for medical expenses,individual medical coping strategies,uncertainty of medical expenses,emotional resilience,informal financial support,sense of family responsibility,and disease management half-life were the influencing factors of financial toxicity in patients with decompensated cirrhosis.Conclusion:Patients with decompensated liver cirrhosis are commonly affected by financial toxicity,with the latent classes exhibiting diverse characteristics.It suggests that social workers and healthcare professionals could develop personalized intervention plans by early identification of class-specific characteristics and influencing factors,thereby improving the experience of financial toxicity and mitigating its negative impact on optimal health behavior decision-making in patients with decompensated liver cirrhosis.
高莹;曾芳;田华;刘曦琳;叶丽芳
广东药科大学附属第六医院(东莞市应急医院),广东 523955广东药科大学附属第六医院(东莞市应急医院),广东 523955广东药科大学附属第六医院(东莞市应急医院),广东 523955广东医科大学护理学院广东药科大学附属第六医院(东莞市应急医院),广东 523955
经济毒性肝硬化潜在剖面分析影响因素质性研究混合研究调查研究
financial toxicityliver cirrhosislatent profile analysis,LPAinfluencing factorsqualitative researchmixed researchinvestigation
《护理研究》 2026 (19)
3362-3371,10
2023年度东莞市科学技术局社会发展科技重点项目,编号:20231800936172
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