Analysis of latent classes and influencing factors of kinesiophobia trajectories in initial hemodialysis patients
蔡冬青 1戴璐 2万桂芹 1任静 1杨倩倩3
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作者信息
1. 南京医科大学附属淮安第一医院血液净化中心，淮安 223399
2. 南京医科大学附属淮安第一医院护理部，淮安 223399
3. 南京医科大学附属淮安第一医院肾内科，淮安223399
折叠
摘要
目的 探讨初始血液透析患者运动恐惧的轨迹及其影响因素。 方法 采用便利抽样法，选取2023年6—12月南京医科大学附属淮安第一医院血液净化中心首次行血液透析治疗的患者为研究对象。采用一般资料调查表、恐动症评分量表（TSK）、透析患者症状负担量表（DFSSBI）、恐惧疾病进展简化量表（FoP-Q-SF）、多维度疲劳量表（MFI-20）和匹兹堡睡眠质量指数量表（PSQI）进行基线调查，采用TSK调查患者血液透析后1、3、6个月的运动恐惧水平。应用潜变量增长混合模型、单因素分析和多分类Logistic回归分析进行数据分析。 结果 共调查251例初始血液透析患者，最终239例完成随访。识别出初始血液透析患者运动恐惧轨迹的3个潜在类别，分别为持续高运动恐惧组（32.22%，77/239）、中运动恐惧-下降组（28.45%，68/239）和持续低运动恐惧组（39.33%，94/239）。多分类Logistic回归分析结果显示，年龄、有无配偶、是否存在睡眠障碍、既往1年内跌倒史、症状负担、恐惧疾病进展、疲劳是初始血液透析患者运动恐惧轨迹潜在类别的影响因素（P<0.05）。 结论 初始血液透析患者运动恐惧呈现不同的变化轨迹，医护人员应根据运动恐惧轨迹的影响因素进行针对性干预。 Objective To explore the trajectories of kinesiophobia in initial hemodialysis patients and their influencing factors. Methods A convenience sampling method was used to recruit patients undergoing their first hemodialysis treatment at Hemodialysis Center, the Affiliated Huai'an No.1 People's Hospital of Nanjing Medical University from June to December 2023. Baseline data were collected using a general information questionnaire, the Tampa Scale for Kinesiophobia (TSK), the Dialysis Patient Symptom Burden Index (DFSSBI), the Fear of Progression Questionnaire-Short Form (FoP-Q-SF), the Multidimensional Fatigue Inventory (MFI-20), and the Pittsburgh Sleep Quality Index (PSQI). The TSK was used to measure kinesiophobia levels at 1, 3, and 6 months post-dialysis. Data were analyzed using a latent class growth mixture model, univariate analysis, and multinomial Logistic regression. Results A total of 251 patients were surveyed, and 239 completed follow-ups. Three latent classes of kinesiophobia trajectories were identified: persistently high kinesiophobia group (32.22%, 77/239), moderate kinesiophobia-declining group (28.45%, 68/239), and persistently low kinesiophobia group (39.33%, 94/239). Multinomial Logistic regression analysis indicated that age, marital status, presence of sleep disorders, history of falls in the past year, symptom burden, fear of disease progression, and fatigue significantly influenced kinesiophobia trajectory classes (P<0.05) . Conclusions Kinesiophobia in initial hemodialysis patients exhibits distinct trajectories. Healthcare professionals should implement targeted interventions based on the influencing factors of kinesiophobia trajectory development.
Abstract
Objective To explore the trajectories of kinesiophobia in initial hemodialysis patients and their influencing factors. Methods A convenience sampling method was used to recruit patients undergoing their first hemodialysis treatment at Hemodialysis Center, the Affiliated Huai'an No.1 People's Hospital of Nanjing Medical University from June to December 2023. Baseline data were collected using a general information questionnaire, the Tampa Scale for Kinesiophobia (TSK), the Dialysis Patient Symptom Burden Index (DFSSBI), the Fear of Progression Questionnaire-Short Form (FoP-Q-SF), the Multidimensional Fatigue Inventory (MFI-20), and the Pittsburgh Sleep Quality Index (PSQI). The TSK was used to measure kinesiophobia levels at 1, 3, and 6 months post-dialysis. Data were analyzed using a latent class growth mixture model, univariate analysis, and multinomial Logistic regression. Results A total of 251 patients were surveyed, and 239 completed follow-ups. Three latent classes of kinesiophobia trajectories were identified: persistently high kinesiophobia group (32.22%, 77/239), moderate kinesiophobia-declining group (28.45%, 68/239), and persistently low kinesiophobia group (39.33%, 94/239). Multinomial Logistic regression analysis indicated that age, marital status, presence of sleep disorders, history of falls in the past year, symptom burden, fear of disease progression, and fatigue significantly influenced kinesiophobia trajectory classes (P<0.05) . Conclusions Kinesiophobia in initial hemodialysis patients exhibits distinct trajectories. Healthcare professionals should implement targeted interventions based on the influencing factors of kinesiophobia trajectory development.
维普
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