低视力患者一般自我效能感LPA及其与生存质量的关系研究

Latent Profile Analysis of General Self-Efficacy and Its Relationship with Quality of Life in Low Vision Patients

目的探究低视力患者一般自我效能感潜在类别,探讨不同潜在类别与生存质量的关系及生存质量的影响因素。方法采用横断面临床研究设计,纳入2021年5月—2022年4月在首都医科大学附属北京同仁医院就诊的低视力患者234例(289只眼),采用一般自我效能感量表(GSES)和中文版低视力生存质量量表(CLVQOL)进行调查,使用Mplus8.0和SPSS 26.0统计学软件分析一般自我效能感潜在类别及与生存质量的关系,采用多重线性回归法分析生存质量的影响因素。结果(1)剖面分析结果:当一般自我效能感潜在剖面数为3时,艾凯克信息准则(AIC)、贝叶斯信息准则(BIC)、调整贝叶斯信息准则(aBIC)值最大,entropy更接近1,剖面3为最佳模型。(2)类别特点及命名:本研究中的低视力患者分为3个潜在类别,类别1(23.9%)一般自我效能感水平最高,命名为高效能感型;类别2(54.7%)位于整体得分的中间水平,命名为中效能感型;类别3(21.4%)一般自我效能感得分最低,命名为低效能感型。(3)类别的基本特征:一般自我效能感不同潜在类别的低视力患者基本特征比较显示,年龄(χ^(2)=16.727,P=0.033)、文化程度(χ^(2)=11.389,P=0.023)、医疗费用来源(χ^(2)=27.914,P=0.000)、户籍类型(χ^(2)=16.503,P=0.002)、视力损伤时长(χ^(2)=36.607,P=0.000)、职业类型(χ^(2)=11.207,P=0.004)、视力(χ^(2)=19.433,P=0.001)和既往眼部手术史(χ^(2)=8.293,P=0.016)在3个不同潜在类别间的差异均有统计学意义,其他社会人口学特征差异均无统计学意义(P>0.05)。(4)类别与生存质量的关系:不同自我效能感潜在类别的低视力患者生存质量总分比较,差异有统计学意义(F=8.187,P=0.000),生存质量各维度比较显示,远视力、移动、光感(F=6.057,P=0.003)、阅读和精细工作(F=9.648,P=0.000)、调节能力(F=5.214,P=0.007)、日常生活能力(F=8.164,P=0.000),差异均有统计学意义。(5)生存质量影响因素的多因素分析:视力(t=-6.582,P=0.000)、一般自我效能感不同潜在类别(t=-2.092,P=0.039)为生存质量的独立影响因素,差异均有统计学意义。结论低视力患者的一般自我效能感存在异质性,应重点关注低效能感型和视力受损严重的低视力患者,探索一般自我效能感干预策略,提高其生存质量水平。

OBJECTIVE To explore the latent categories of general self-efficacy among low vision patients,investigate the relationship between different latent categories and quality of life,and identify factors influencing quality of life.METHODS A cross-sectional clinical study design was employed,involving 234 low vision patients(289 eyes)who were treated at Beijing Tongren Hospital,Capital Medical University,from May 2021 to April 2022.The General Self-Efficacy Scale(GSS)and the Chinese version of the Low Vision Quality of Life Scale(CLVQOL)were used for investigation.Mplus 8.0 and SPSS 26.0 statistical software were utilized to analyze the latent categories of general self-efficacy and their relationship with quality of life.Multiple linear regression was employed to analyze the factors influencing quality of life.RESULTS(1)Profile analysis results:When the number of latent profiles of general self-efficacy was three,the Akaike information criterion(AIC),Bayesian information criterion(BIC),and ajust Bayesian information criterion(aBIC)values were the highest,and entropy was closer to one,indicating that Profile three was the best model.(2)Category characteristics and naming:Low vision patients in this study were classified into three latent categories.Category one(23.9%)had the highest level of general self-efficacy and was named the High Efficacy Type.Category two(54.7%)scored at the intermediate level overall and was named the Moderate Efficacy Type.Category three(21.4%)had the lowest general self-efficacy scores and was named the Low Efficacy Type.(3)Basic characteristics of categories:Comparison of basic characteristics of low vision patients in different latent categories of general self-efficacy showed statistically significant differences in age(χ^(2)=16.727,P=0.033),education level(χ^(2)=11.389,P=0.023),source of medical expenses(χ^(2)=27.914,P=0.000),household registration type(χ^(2)=16.503,P=0.002),visual impairment Duration(χ^(2)=36.607,P=0.000),occupation type(χ^(2)=11.207,P=0.004),visual acuity(χ^(2)=19.433,P=0.001)and previous eye surgery(χ^(2)=8.293,P=0.016),while other demographic differences were not statistically significant(P>0.05).(4)Relationship between categories and quality of life:The total scores of quality of life for low vision patients in different latent categories of general self-efficacy showed statistically significant differences(F=8.187,P=0.000).The comparison of quality of life dimensions showed statistically significant differences in far vision,mobility,light sensitivity(F=6.057,P=0.003),reading and fine work(F=9.648,P=0.000),adjustment ability(F=5.214,P=0.007),and daily life ability(F=8.164,P=0.000).(5)Multifactor analysis of factors influencing quality of life:Vision(t=-6.582,P=0.000),different latent categories of general self-efficacy(t=-2.092,P=0.039)showed statistically significant differences.CONCLUSIONS General self-efficacy among low vision patients exhibits heterogeneity.Special attention should be given to low efficacy individuals and patients with severe visual impairment,and strategies for general self-efficacy intervention should be explored to improve their quality of life.