炎症性肠病患者心理韧性的潜在剖面分析及护理对策

L atent profile analysis and nursing decision-making of psychological resilience among patients with inflam-matory bowel disease

目的 探究炎症性肠病患者心理韧性的潜在剖面特征,分析不同潜在剖面在患者一般资料中的差异以及对心理社会适应能力的影响,提出护理对策。方法 采用横断面调查法,便利选取2022年6月-10月在山东省某三级甲等综合医院门诊就诊的230例炎症性肠病患者作为调查对象,采用一般资料调查表、炎症性肠病心理韧性量表及炎症性肠病患者心理社会适应问卷进行调查。以炎症性肠病心理韧性量表的6个维度作为外显指标进行潜在剖面分析,比较不同潜在剖面在患者一般资料中的差异,并通过混合回归模型分析不同心理韧性潜在剖面对患者心理社会适应能力的影响。结果 回收有效问卷222份,有效问卷回收率为96.5%。炎症性肠病患者的心理韧性分为3个潜在剖面,包括“低韧性-困难主动应对低效组”(9.00%)、“中韧性-困难主动应对中效组”(41.90%)、“高韧性-困难主动应对高效组”(49.10%), 3个潜在剖面在居住方式上存在差异,“高韧性-困难主动应对高效组”的炎症性肠病患者心理社会适应问卷得分最高。结论 炎症性肠病患者的心理韧性具有明显的异质性,不同潜在剖面患者心理社会适应能力存在差异。护理人员应根据炎症性肠病患者心理韧性的分类特点,制订个性化的干预策略,以提高其心理社会适应能力。

Objective To explore the characteristics of latent profiles of psychological resilience among patients with inflammatory bowel disease,and to analyze the differences of the latent profiles of psychological resilience in sociodemographic information as well as the impacts of the profiles on patients'psychosocial adaptability,and to propose nursing decisions.Methods From June to October 2022,a total of 230 outpatients with inflammatory bowel disease in a tertiary hospital in Shandong Province were selected as the survey subjects by cross-sectional survey method.The General Information Questionnaire,Resilience Scale for Inflammatory Bowel Disease and Psychosocial Adaptation Questionnaire for Inflammatory Bowel Disease were used for investigation.The latent profile analysis was conducted with the 6 dimensions of psychological resilience in patients with inflammatory bowel disease as the explicit indicators.Univariate analysis was used to explore the differences in potential profiles of psychological resilience,and regression mixture model was used to analyze the impacts of dfferent profiles on psychosocial adaptation of patients.Results 222 valid questionnaires were collected,with the effective recovery rate of 96.5%.The status of psychological resilience of 222 patients with inflammatory bowel disease was divided into 3 profiles,including low resilience and low efficiency in active coping with difficulties group(9.00%),moderate resilience and moderate efficiency in active coping with difficulties group(41.90%),and high resilience and high efficiency in active coping with difficulties group(49.10%).Housing arrangement was the influencing factor of the 3 profiles.The high resilience and high efficiency in active coping with difficulties group had the highest total score of psychosocial adaptation.Conclusion The psychological resilience of patients with inflammatory bowel disease was significantly heterogeneous,and there were significant differences in psychosocial adaptation among the profiles.Nursing personnel should formulate personalized intervention strategies based on the classification characteristics of psychological resilience of inflammatory bowel disease patients to improve their psychosocial adaptation.