老年冠心病患者社会疏离的潜在剖面及影响因素

Latent profile analysis and influencing factors of social isolation in elderly patients with coronary heart disease

目的:探究老年冠心病患者社会疏离的潜在类别及影响因素。方法:采用一般资料调查表、一般疏离感量表、医学应对方式问卷及慢性病资源利用调查量表对湖南省3所三甲医院的322例老年冠心病患者进行调查,运用潜在剖面分析探究其社会疏离的类别及特征,并通过单因素分析和多元logistic回归分析不同类别的影响因素。结果:老年冠心病患者社会疏离可被分为低度社会疏离组(31.9%)、中度社会疏离-无意义感组(26.5%)和高度社会疏离组(41.6%)3个潜在类别。多元logistic回归分析显示,在高度社会疏离组中受教育程度为小学及以下(OR=3.46,P<0.01)、家庭人均月收入<3000元(OR=5.75,P<0.01)以及独居(OR=4.30,P<0.01)的患者比例最大,年住院次数≤1次(OR=0.33,P<0.05)的患者比例最小;相较于低度社会疏离组,患者的面对应对每升高一个单位,其属于中度社会疏离-无意义感组的发生比会降低7%(OR=0.93,P<0.05),属于高度社会疏离组的发生比会降低11%(OR=0.89,P<0.01),患者的屈服应对每升高一个单位,其属于中度社会疏离-无意义感组的发生比会增加19%(OR=1.19,P<0.01),患者的慢性病资源利用每升高一个单位,其属于高度社会疏离组的发生比会降低6%(OR=0.94,P<0.01)。结论:老年冠心病患者社会疏离存在3种潜在类别,且不同类别的患者在医学应对方式、慢性病资源利用、受教育程度、居住方式等方面存在差异,未来应根据不同类别患者的特征和影响因素制定针对性干预策略,以有效改善其社会疏离。

Objective:To investigate the potential categories and influencing factors of latent profiles of social isolation among elderly patients with coronary heart disease(CHD).Methods:A total of 322 elderly patients with CHD who were hospitalized in three tertiary-level general hospitals in Hunan Province were surveyed by the General Information questionnaire,the General Alienation Scale,the Medical Coping Modes Questionnaire andthe Chronic Illness Resource Survey Scale.The latent profile analysis was used to identify the latent class of their social isolation and the univariate analysis and multiple logistic regression were used to explore the influencing factors of social isolation of patients.Results:Social isolation in elderly patients with CHD could be divided into three latent profiles,including low social isolation group(31.9%),medium social isolation-sense of meaninglessness group(26.5%)and high social isolation group(41.6%).Multiple logistic regression analyses showed that the proportion of patients with education level of elementary school and below(OR=3.46,P<0.01),per capita monthly family income<3000 RMB(OR=5.75,P<0.01),and living alone(OR=4.30,P<0.01)was the highest in the high social isolation group,and the proportion of patients with≤1 hospitalization per year(OR=0.33,P<0.05)was the lowest in the high social isolation group.Compared with low social isolation group,when the confrontation coping of patients increased by one unit,the incidence rate of medium social isolation-sense of meaninglessness groupwould decreased by 7%(OR=0.93,P<0.05),the incidence rate of high social isolation groupwould decreased by 11%(OR=0.89,P<0.01),and when the submission copingof patients increased by one unit,the incidence rate of medium social isolation-sense of meaninglessness groupwould increase by 19%(OR=1.19,P<0.01),and when the chronic illness resources utilization of patients increased by one unit,the incidence rate of high social isolation groupwould decrease by 6%(OR=0.94,P<0.01).Conclusion:There are three potential categories of social isolation of elderly patients with CHD.Targeted intervention strategies should be developed according to the characteristics and influencing factors of different categories of patients in order to effectively alleviate their social isolation.