目的 探索原发性肝癌患者经济毒性的潜在类别,并分析影响不同潜在类别的因素.方法 运用连续纳入的方法,采用患者一般资料调查表、患者报告结局的经济毒性综合评分量表(comprehensive scores for financial toxicity based on the patient-reported outcome measures,COST-PROM)、心理弹性量表(connor davidson resilience scale,CD-RISC)、社会支持量表(social support rating scale,SSRS),于2023年5-8月对上海市某三甲医院肝肿瘤中心的原发性肝癌患者进行调查,使用潜在剖面分析探索肝癌患者经济毒性的潜在类别,采用有序多分类logistic回归分析相关影响因素.结果 共纳入362例肝癌患者,其经济毒性可分为3个类别,分别命名为"高经济毒性-严重型"(n=115,31.77％)、"中经济毒性-平衡型"(n=200,55.25％)、"低经济毒性-轻松型"3个类别(n=47,12.98％);有序多分类logistic回归分析结果显示,年龄、文化水平、退休、家庭人均月收入、自有房(无贷款)、心理弹性和社会支持是肝癌患者经济毒性类别的影响因素,高经济毒性-严重型的患者心理弹性水平较低、社会支持水平较低.结论 肝癌患者经济毒性存在异质性,心理弹性水平、社会支持水平及社会经济因素及是其影响因素,应识别并根据患者所属的经济毒性类别,采取重点关注和针对性的干预措施,以缓解患者的经济毒性.
Latent profile analysis of financial toxicity in patients with primary liver cancer
Objective To explore the potential categories of financial toxicity in patients with primary liver cancer and to analyze the factors affecting different potential categories.Methods Using a continuous inclusion approach with the patient general information questionnaire,the comprehensive scores for financial toxicity based on the pa-tient-reported outcome measures(COST-PROM),the psychological resilience scale(CD-RISC),and the social sup-port rating scale(SSRS),patients with primary liver cancer at the Liver Tumor Center of a tertiary care hospital in Shanghai from May to August 2023 were surveyed,and potential classes of financial toxicity in patients with primary liver cancer were explored using latent profile analysis,and relevant influencing factors were analyzed using ordered multinomial logistic regression to analyze the relevant influencing factors.Results A total of 362 patients with prima-ry liver cancer were included,and financial toxicity was categorized into 3 categories,named as"high financial toxici-ty-severe type"(n=115,31.77％),"moderate financial toxicity-balanced type"(n=200,55.25％),and"low fi-nancial toxicity-easy type"(n=47,12.98％);The results of ordered multinomial logistic regression analysis showed that age,literacy level,retirement,per capita monthly household income,owning a home(no loan),psychological resilience,and social support were the factors influencing financial toxicity of hepatocellular carcinoma patients,pa-tients with high financial toxicity-severe type had lower levels of psychological resilience and social support.Conclu-sion There is heterogeneity of financial toxicity in patients with primary liver cancer,and the level of psychological resilience and social support,and socio-economic factors are its influencing factors.Focused attention and targeted in-terventions should be identified and implemented according to the economic toxicity category to which the patients belong in order to alleviate their economic toxicity.
万方数据
维普
