慢性肾脏病患者健康素养的潜在剖面分析及其对生命质量的影响

Latent profile analysis of health literacy in patients with chronic kidney disease and its impact on quality of life

目的探究慢性肾脏病(chronic kidney disease,CKD)患者健康素养的潜在类别,并分析其对患者生命质量的影响。方法2023年4月至9月,采用便利抽样法,选取南充市某三级甲等医院肾病内科住院部的CKD患者为研究对象,使用一般资料调查表、CKD健康信息素养问卷、慢性肾衰竭患者生命质量测定量表对其进行调查。采用Mplus 8.0软件进行健康素养潜在剖面分析,采用Logistic回归分析CKD患者生命质量的影响因素。结果共纳入348例CKD患者,健康素养平均得分为(72.44±16.98)分,生命质量平均得分为(67.46±11.09)分,潜在剖面分析结果显示,健康素养可分为“高获取—高储备”(9.19%)、“整体中等”(37.36%)、“整体低下”(34.48%)、“高获取—高整合”(18.97%)4个潜在类别。多因素分析结果显示,男性、年龄<60岁、收入≥3000元、肾脏病分期较低、合并疾病≤1种是生命质量的保护因素,且“高获取—高储备”[OR=5.453,95%CI(1.728,17.212),P=0.004]类别的生命质量得分亦更高。结论CKD患者的健康素养和生命质量处于中下水平,健康素养存在明显的分类特征,医护人员可根据不同类别进行针对性干预,促进患者的知识储备,以提高患者的生命质量。

Objective To explore the potential categories of health literacy in patients with chronic kidney disease(CKD)and to analyze their impact on patients'quality of life.Methods From April to September 2023,patients with CKD in the inpatient nephrology department of a tertiary-level hospital in Nanchong City were selected by convenience sampling method and surveyed using general information questionnaire,CKD health information literacy questionnaire,and chronic renal failure patients'quality of life measurement scale.Mplus 8.0 software was used to analyze the potential profiles of health literacy,and Logistic regression was used to analyze the influencing factors of quality of life.Results A total of 348 CKD patients were included.The average score for health literacy was(72.44±16.98),and the score for quality of life was(67.46±11.09).The results of the latent profile analysis showed that health literacy could be categorized into“high access-high reserve”(9.19%),“overall moderate”(37.36%),“overall low”(34.48%),and“high access-high integration”(18.97%)categories.The results of multivariate analysis showed that male,age<60 years old,month income≥3000 yuan,lower stage of kidney disease,number of complication≤1 were protective factors of the quality of life,and the quality of life score was also higher in the category of“high access-high reserve”[OR=5.453,95%CI(1.728,17.212),P=0.004].Conclusion The health literacy and quality of life of patients with CKD are at a middle to low level,and there are obvious classification characteristics in health literacy.Medical staff can provide targeted interventions according to different categories to promote patients'knowledge reserves and improve their quality of life.