肺癌患者VATS术后运动恐惧与疼痛应对策略的潜在剖面分析-现代医学

肺癌患者VATS术后运动恐惧与疼痛应对策略的潜在剖面分析

单位：安徽医科大学护理学院, 安徽合肥 230032

分类号：R473.73

出版年·卷·期（页码）：2025·53·第八期（1239-1247）

摘要：

目的：探讨肺癌患者视频辅助胸腔镜手术(VATS)术后运动恐惧与疼痛应对策略的潜在类别，并分析不同类别间的特征差异。方法: 采用便利抽样法，选取2024年1月至2024年7月于安徽省某三甲医院行手术治疗的327例肺癌患者为研究对象。采用一般资料调查表、恐动症评估简表、术后疼痛应对策略问卷、简明疲乏量表、肺癌患者运动自我效能量表、领悟社会支持量表进行调查。结果：最终回收311份问卷，潜在剖面分析结果显示，肺癌患者胸腔镜术后运动恐惧与疼痛应对策略可分为3组：高恐动-消极应对组(40.8%)；中恐动-一般应对组(29.6%)；低恐动-积极应对组(29.6%)。Logistic回归分析显示，其影响因素包括领悟社会支持、肺癌患者运动自我效能、疲乏、病理侵袭性、合并并发症。结论：VATS术后运动恐惧与疼痛应对策略水平具有显著分类特征，临床护理人员可以根据患者不同类别特征及影响因素，采用针对性的护理措施，以降低患者胸腔镜手术后运动恐惧水平，改善预后。

Objective: To explore potential categories of kinesiophobia and pain coping strategies in lung cancer patients after video-assisted thoracoscopic surgery(VATS) and to analyze differences in characteristics between the categories. Methods: The convenience sampling method was used to select 327 postoperative lung cancer patients in a tertiary hospital in Anhui Province from January 2024 to July 2024， and general information questionnaire， short form for assessing kinesiophobia， questionnaire on postoperative pain coping strategies， brief fatigue scale， self-efficacy scale for exercise in patients with lung cancer， and scale for Perceived Social Support were used to conduct the survey. Results: 311 questionnaires were collected and the results of latent profile analysis showed that the coping strategies of lung cancer patients with exercise fear and pain after thoracoscopic surgery could be divided into 3 groups， i.e.， high fear of movement-negative coping group(40.8%)， medium fear of movement-general coping group(29.6%)， and low fear of movement-positive coping group(29.6%). Logistic regression analysis showed that the influencing factors included perceived social support， lung cancer patients' exercise self-efficacy， fatigue， pathological aggressiveness， and comorbidities. Conclusion: There is significant heterogeneity in the level of kinesiophobia and pain coping strategies after lung cancer surgery， and clinical caregivers can take targeted care measures to reduce the level of fear after VATS and improve the prognosis of the patients.

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