肺癌首次化疗患者恐惧疾病进展变化轨迹及预测因素的纵向研究

Longitudinal study on progressive trajectory and predictive factors of fear disease among patients receiving first chemotherapy due to lung cancer

目的探讨肺癌首次化疗患者恐惧疾病进展的轨迹并分析影响因素。方法采用便利抽样法于2023年8—12月选择河南省某三级甲等医院呼吸内科肺癌首次化疗患者作为调查对象。采用一般资料调查表、中文版癌症患者恐惧疾病进展简化量表进行调查,在化疗前1 d、首次化疗后1 d、化疗1周后1~3 d、化疗结束后1~3 d、下次来院复查时,利用潜类别增长模型(Latent Class Growth Model,LCGM)、单因素分析及多元Logistic回归分析数据。结果本研究共纳入222例患者,恐惧疾病进展轨迹可分为“低水平下降组(13.5%)”、“中水平稳定组(35.1%)”、“高水平下降组(34.2%)”、“高水平先升后降组(17.1%)”4个潜在类别。多元logistic回归分析结果显示,领悟社会支持(P=0.001,OR=0.835,95%CI:0.753~0.926)、应对方式(面对(P=0.01,OR=0.009,95%CI:0.001~0.317)、幻想(P=0.028,OR=0.039,95%CI:0.002~0.701))、年龄(P=0.003,OR=0.831,95%CI:0.735~0.939)、性别(P=0.019,OR=0.190,95%CI:0.047~0.759)、文化水平(P=0.002,OR=18.989,95%CI:3.076~117.207)、宗教信仰(P=0.017,OR=7.107,95%CI:1.412~35.777)、肿瘤分级(P=0.007,OR=0.024,95%CI:0.002~0.369)是恐惧疾病进展轨迹的预测因素。结论肺癌首次化疗患者恐惧疾病进展可分为5种变化轨迹,领悟社会支持、应对方式、年龄、性别、文化水平、宗教信仰、肿瘤分级是影响恐惧疾病进展轨迹的主要因素。

Objective To investigate the progression of trajectory fear disease among patients receiving their first chemotherapy due to lung cancer and analyze the influencing factors.Methods From August 2023 to December 2023,patients with lung cancer undergoing chemotherapy for the first time in the respiratory department of a Grade A hospital in Henan Province were selected as the investigation objects by convenient sampling method.The general data questionnaire and the Chinese version of the Simplified Fear of Disease Progression Scale for cancer patients were used to investigate.The Latent Class Growth Model(LCGM),single factor analysis and multiple Logistic regression analysis were used for data analysis at 1 day before chemotherapy,1 day after the first chemotherapy,1 to 3 days after 1 week of chemotherapy,1 to 3 days after the end of chemotherapy,and the next review at the hospital.Results A total of 222 patients were included in this study,and the progressive trajectory of fear disease could be divided into four potential categories:“the low level decline group(13.5%)”,“the medium level stable group(35.1%)”,“the high level decline group(34.2%)”and“the high level rise first and then decline group(17.1%)”.Multiple logistic regression analysis showed that understanding social support(P=0.001,OR=0.835,95%CI:0.753~0.926),coping style(face(P=0.01,OR=0.009,95%CI:0.001~0.317),fantasy(P=0.028,OR=0.039,95%CI:0.002-0.701),age(P=0.003,OR=0.831,95%CI:0.735~0.939),sex(P=0.019,OR=0.190,95%CI:0.047~0.759),education level(P=0.002,OR=18.989,95%CI:3.076~117.207),religious belief(P=0.017,OR=7.107,95%CI:1.412~35.777),tumor grade(P=0.007,OR=0.024,95%CI:0.002~0.369)were predictors of the progressive trajectory of fear disease.Conclusions The progression of fear disease in patients receiving their first chemotherapy for lung cancer can be divided into 5 different trajectories.Understanding social support,coping style,age,gender,educational level,religious belief and tumor grade are the main factors affecting the progression of fear disease.