目的 探索肺癌患者根治手术前后营养自我效能潜在类别随时间变化趋势并分析其影响因素。方法 便利抽样法选取南通市第六人民医院于2024年1月至2025年4月收治的肺癌患者作为本研究的调查对象,采用一般资料调查表、营养自我效能量表对入组的调研对象在入院时/术前(T1)、术后/出院前(T2)进行测量,根据营养自我效能量表将患者分为高营养自我效能组和低营养自我效能组,并展开潜在转变分析。结果 178例患者完成调查。低营养自我效能组稳定性强,保持原组的概率0.813,高营养自我效能组肺癌患者随时间发展倾向于向低营养自我效能组转变,转变概率为29.8%。Logistic回归分析结果显示:学历小学及以下(OR=1.219)、营养风险筛查2002≥3分(OR=2.215)、独居(OR=1.826)、社会低支持(OR=1.734)的患者由高营养自我效能组转变为低营养自我效能组的概率增加,而社会高支持(OR=0.522)的患者由高营养自我效能组转变为低营养自我效能组的概率降低。社会高支持(OR=1.550)的患者由低营养自我效能组转变为高营养自我效能组的概率升高,独居(OR=0.347)的患者由低营养自我效能组转变为高营养自我效能组的概率降低。结论 小学及以下学历、存在营养风险、体质指数低于18.5 kg/m2的肺癌患者更容易处于低营养自我效能组。独居和社会低支持的患者倾向于由高营养自我效能向低营养自我效能的转变模式。这提示临床医务人员应重视上述高危人群,应早期强化营养教育及个体化支持,以预防其营养自我效能从高向低转化,并稳定低效能组的营养管理。
Abstract
Objective To explore the changing trend of potential categories of nutritional self-efficacy in lung cancer patients before and after radical surgery over time and analyze its influencing factors. Method Convenience sampling method was used to select lung cancer patients admitted to the Sixth People's Hospital of Nantong from January 2024 to April 2025 as the research objects. The general information questionnaire and Nutritional Self-Efficacy Scale were used to measure the enrolled research objects at admission/before surgery (T1) and after surgery/before discharge (T2) for potential transformation analysis. Result 178 patients completed the investigation. Before and after the operation, it can be divided into two potential categories: the high-nutrition self-efficacy group and the low-nutrition self-efficacy group. The stability of the low-nutrition self-efficacy group was strong, and the probability of maintaining the original group was 0.813. Lung cancer patients in the high-nutrition self-efficacy group tended to transform to the low-nutrition self-efficacy group over time, and the transformation probability was 29.8%. The results of Logistic regression analysis show that: Patients with a primary school education or below (OR=1.219), a nutritional risk score of ≥3 (OR=2.215), living alone (OR=1.826), and low social support (OR=1.734) had an increased probability of changing from the high nutritional self-efficacy group to the low nutritional self-efficacy group. However, the probability of patients with a high social support factor (OR=0.522) changing from the high nutritional self-efficacy group to the low nutritional self-efficacy group decreased. Patients with high social support (OR=1.550) had an increased probability of transitioning from the low-nutrition self-efficacy group to the high-nutrition self-efficacy group, while patients living alone (OR=0.347) had a decreased probability of transitioning from the low-nutrition self-efficacy group to the high-nutrition self-efficacy group. Conclusion Lung cancer patients with an educational background of primary school or below, with nutritional risks and a BMI lower than 18.5 kg/m2 are more likely to be in the low nutritional self-efficacy group. This suggests that clinical medical staff should attach importance to the above-mentioned high-risk groups. They should strengthen nutritional education and individualized support at an early stage to prevent the transformation of their nutritional self-efficacy from high to low and stabilize the nutritional management of the low-efficiency group.
关键词
肺癌 /
手术 /
营养自我效能 /
潜在剖面分析 /
潜在转变分析 /
影响因素
Key words
Lung cancer /
Surgery /
Nutritional self-efficacy /
Potential profile analysis /
Potential transformation analysis /
Risk factors
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