神经内分泌肿瘤患者术后习得性无助感变化轨迹核心影响因素研究

Study on the core influencing factors of the postoperative trajectory of learned helplessness in patients with neuroendocrine tumor

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摘要目的了解神经内分泌肿瘤患者术前到术后6个月的习得性无助感变化轨迹,分析不同习得性无助感变化轨迹亚型的影响因素。方法选择160例神经内分泌肿瘤患者为研究对象,采用一般资料调查表、习得性无助感量表分别于手术前、手术结束时、手术结束后3个月、6个月进行调查,采用潜类别模型识别习得性无助感变化轨迹亚型,并通过决策树模型分析影响习得性无助感变化轨迹亚型的核心影响因素。结果神经内分泌肿瘤患者不同时段的习得性无助感随着术后时间延长呈逐渐升高趋势。通过模型拟合分析识别出“低习得性无助感-缓慢上升组”和“中习得性无助感-快速上升组”共两条无助感变化轨迹类别。决策树模型显示,预测变量重要性依次为恐惧疾病进展、年龄、文化程度、家庭人均月收入。结论神经内分泌肿瘤患者术后习得性无助感分为“低习得性无助感-缓慢上升”和“中习得性无助感-快速上升”两条轨迹。医护人员可通过辨别“中习得性无助感-快速上升”患者并给予以文化程度为核心的干预方案,以降低其习得性无助感水平。 Objective To investigate the trajectory of learned helplessness in patients with neuroendocrine tumors from preoperative to 6 months after surgery,and to analyze the influencing factors of different subtypes of learned helplessness trajectory.Methods A total of 160 patients with neuroendocrine tumors were selected as subjects.General information questionnaire form and Learned Helplessness Scale were used to investigate the level of learned helplessness at preoperative the end of surgery,3 months after surgery and 6 months after surgery.The latent class growth model was used to identify the subtypes of learned helplessness change trajectories,and the decision tree model was used to analyze the core influencing factors affecting the subtypes of learned helplessness change trajectories.Results The level of learned helplessness in patients with neuroendocrine tumors at different times showed an overall upward trend.Through model fitting analysis,two categories of helplessness change trajectories were identified:"low learned helplessness-slow rise group"and"medium learned helplessness-rapid rise group".The decision tree model showed that the importance of predictive variables fear of progression questionnaire,age,educational level,and per capita monthly household income.Conclusion Postoperative learned helplessness in patients with neuroendocrine tumors is divided into two trajectories:"low learned helplessness-slow rise group"and"medium learned helplessness-rapid rise group".Educational level is an influencing factor of the learned helplessness trajectory category.Medical staff can identify patients with"medium learned helplessness-rapid rise group"and provide intervention programs centered on educational level to reduce the level of learned helplessness.

作者祝子惠朱玲韩倩倩潘思颖徐伈秦鲜桑妮邱伟伟管文静汤琪云 ZHU Zihui;ZHU Ling;HAN Qianqian;PAN Siying;XU Xin;QIN Xian;SANG Ni;QIU Weiwei;GUAN Wenjing;TANG Qiyun(Department of Geriatric Neurodigestive Medicine,Jiangsu Provincial People's Hospital,Nanjing 210038,China)

机构地区江苏省人民医院老年神经消化科

出处《护理管理杂志》 2025年第5期392-396,403,共6页 Journal of Nursing Administration

基金国家自然科学基金(82373180)。

关键词神经内分泌肿瘤患者术后护理习得性无助感疾病恐惧自我感受负担变化轨迹 neuroendocrine tumor patient postoperative nursing learned helplessness fear of disease self-perceived burden change trajectory