慢性阻塞性肺疾病患者疲劳轨迹的潜在类别及影响因素分析的纵向研究

Potential Categories and Influencing Factors of Fatigue Trajectory in Patients with COPD:A Longitudinal Study

目的 探讨慢性阻塞性肺疾病(chronic obstructive pulmonary disease, COPD)患者疲劳轨迹的潜在类别及其影响因素。方法 2021年9月至2022年4月采用便利抽样法选取湖州市某三甲医院呼吸内科住院的COPD患者为研究对象。采用COPD疲劳量表在患者出院时、出院后1个月、4个月、6个月时评估其疲劳程度,采用潜变量增长模型对疲劳轨迹进行分类并探讨其影响因素。结果 识别出COPD患者疲劳轨迹分为3个潜在类别:显著下降组(22.2%)、缓慢下降组(43.0%)、疲劳升高组(34.8%)。Logistics回归结果显示,运动恐惧、改良版呼吸困难问卷得分、年龄、病程、体质量指数、睡眠状况是COPD患者疲劳轨迹潜在类别的影响因素(均P<0.05)。结论 COPD患者疲劳被分为3种变化轨迹,疲劳轨迹存在群体异质性,护士应根据疲劳变化轨迹给予患者阶段性及个体化的护理干预。

Objective To explore the potential categories and influencing factors of fatigue trajectory in patients with COPD.Methods By convenience sampling method, COPD patients hospitalized in the respiratory department of a tertiary hospital in Huzhou from September 2021 to April 2022 were selected.The COPD fatigue scale was used to evaluate the fatigue degree of patients at discharge, 1 month, 4 months and 6 months after discharge.The latent variable growth model was used to classify the fatigue trajectories and to explore its influencing factors.Results The fatigue trajectories of COPD patients were divided into three potential categories, significant decline group(22.2%),slow decline group(43.0%) and fatigue rise group(34.8%).The results of Logistics regression showed that fear of exercise, the score of modified medical research council dyspneascale(mMRC),age, course of disease, BMI and sleep status were influencing factors of fatigue trajectory in patients with COPD(all P<0.05).Conclusions The fatigue in COPD patients was divided into three change trajectories, with population heterogeneity in fatigue trajectories.According to the fatigue trajectory, nurses should provide staged and individual nursing interventions for patients.