肺结节患者治疗决策困境的潜在剖面分析

Latent class analysis of treatment decision-making dilemma in patients with pulmonary nodules

目的探究肺结节患者治疗决策困境的潜在类别,并分析其影响因素。方法采用便利抽样法,选取2023年3-6月就诊于天津市某三级甲等医院的253例肺结节患者作为研究对象。采用一般资料调查表、决策冲突量表、医院焦虑抑郁量表及领悟社会支持量表进行调查。对肺结节患者的决策困境特征进行潜在剖面分析,并通过单因素分析及logistic回归分析考察其潜在类别的影响因素。结果肺结节患者治疗决策困境分为2个类别,即低决策困境组(53.0%)和高决策困境组(47.0%)。二元logistic回归分析显示,对疾病的了解程度(OR=1.592,P<0.05)以及社会支持水平(OR=0.961,P<0.01)是肺结节患者治疗决策困境潜在类别的影响因素。结论肺结节患者的治疗决策困境具有明显的分类特征,对疾病认知水平低、社会支持水平低的患者归为“高决策困境组”的概率较大,提示医护人员应根据不同类别特征开展有针对性的干预措施,以期降低患者的决策困境。

Objective To explore the latent categories of treatment decision-making dilemma in patients with pulmonary nodules,and to analyze its influencing factors.Methods A total of 253 pulmonary nodules patients treated in a tertiary grade-A hospital in Tianjin were selected as the research objects by convenience sampling method,and were surveyed by using a general information questionnaire,the decision conflict scale(DCS),the hospital anxiety and depression scale(HADS),and the perceived social support scale(PSSS).Latent class analysis was used to explore the latent categories of decision-making dilemma among patients with pulmonary nodules,and single factor analysis and logistic regression analysis were used to understand the influence factors of the latent categories.Results Decision-making dilemma of patients with pulmonary nodules was divided into 2 latent categories,namely low decision-making dilemma group(53.0%)and high decision-making dilemma group(47.0%).The results of binary logistic regression analysis revealed that the degree of understanding of the disease(OR=1.592,P<0.05)and the level of social support(OR=0.961,P<0.01)were the influencing factors of the latent categories of treatment decision-making dilemma in patients with pulmonary nodules.Conclusion The patients with pulmonary nodules have obvious classification characteristics of treatment decision-making dilemma,and patients with low disease cognition level and low social support level are more likely to be classified as the"high decision-making dilemma group",suggesting that medical staff should carry out targeted intervention measures according to different category characteristics,so as to reduce the decision-making dilemma of patients.