脊柱肿瘤患者家庭抗逆力与创伤后成长的分型及影响因素

Classification and influencing factors of family resilience and post-traumatic growth in spinal tumor patients based on potential profile analysis

目的探索脊柱肿瘤患者家庭抗逆力与创伤后成长的潜在分型。方法该研究为横断面研究。2021年7月至2022年7月对复旦大学附属肿瘤医院住院治疗的219例脊柱肿瘤患者,采用一般情况问卷、中文版家庭抗逆力量表(C-FRACS)、中文版创伤后成长量表(PTGI)、中文版家庭危机个人评价量表(F-COPES)、社会支持量表(SSRS)进行横断面问卷调查,对家庭抗逆力和创伤后成长各维度进行潜在剖面分析,采用多元logistic回归分析家庭抗逆力和创伤后成长各潜在类别的影响因素。结果219例患者中,原发性脊柱肿瘤患者62例(28.3%)。患者的家庭抗逆力与创伤后成长可分为3种潜在剖面类型:家庭困境-抗拒型(38例,17.4%)、一般抗力-抗争型(99例,45.2%)和家庭适应-成长型(82例,37.4%),3种类型患者的职业状况、是否承担家务、家庭氛围情况比较差异有统计学意义(χ^(2)=10.75,P=0.025;χ^(2)=6.95,P=0.031;χ^(2)=11.37,P=0.017),F-COPES总分和SSRS总分比较差异有统计学意义(F=25.95,P<0.001;F=19.06,P<0.001)。多元logistic回归分析显示,离退休[OR=2.928,95%CI(1.098~7.808)]、家庭应对水平[OR=1.113,95%CI(1.063~1.165)]、社会支持[OR=1.226,95%CI(1.103~1.362)]是脊柱肿瘤患者家庭抗逆力和创伤后成长的影响因素(P<0.05)。结论脊柱肿瘤患者的家庭抗逆力与创伤后成长存在明显的群体异质性,其中一般抗力-抗争组患者占比较大,职业状况、家庭应对水平和社会支持是患者家庭抗逆力与创伤后成长的影响因素。

Objective To explore the classification and influencing factors of family resilience and post-traumatic growth in patients with spinal tumor.Methods A cross-sectional investigation was conducted among 219 inpatients with spinal tumor admitted from July 2021 to July 2022.The General Demographic Information questionnaire,Chinese-Family Resilience Assessment Scale,Posttraumatic Growth Inventory,Family Crisis-Oriented Personal Evaluation Scales(F-COPES),and Social Support Rating Scale(SSRS)were used in the study.The ordinal and multivariate logistic regression analyses was applied to identify the factors associated with the classification of family resilience and post-traumatic growth.Results Of the 219 patients,there were 62 cases of primary spinal tumors(28.3%).According to the results of latent profile analysis,the respondents were classified into three categories by family resilience and post-traumatic growth,namely family difficulty-resistant type(n=38,17.4%),general resilience-struggle type(n=99,45.2%)and family adaptation-growth type(n=82,37.4%).There were significant differences in occupational status,commitment to housework,family atmosphere(χ^(2)=10.75,P=0.025;χ^(2)=6.95,P=0.031;χ^(2)=11.37,P=0.017),and total score of F-COPES and SSRS(F=25.95,P<0.001;F=19.06,P<0.001)among three groups.Ordinal and multivariate logisitc regression analyses showed that retirement(OR=2.928,95%CI:1.098-7.808,P<0.05),family coping(OR=1.113,95%CI:1.063-1.165,P<0.05),and social support(OR=1.226,95%CI:1.103-1.362,P<0.05)were independently associated with family resilience and post-traumatic growth in patients with spinal tumor.Conclusion Patients with spinal tumor have significant differences in characteristics by family resilience and post-traumatic growth.As a result,more targeted interventions should be provided for different categories of spinal tumor patients in the future.