老年结直肠癌患者造口适应能力潜在剖面 及影响因素研究

Study on Potential Profiles and Influencing Factors of Ostomy Adaptation Ability in Elderly Colorectal Cancer Patients

摘要: 目的：探索老年结直肠癌患者造口适应能力的潜在剖面，并分析其影响因素。方法：采用便利抽样法，选取2023年7月~2025年6月在西安市两所三级甲等医院造口门诊就诊的240例老年结直肠癌造口患者作为研究对象。采用一般资料调查表、中文版造口患者社会心理适应量表(Ostomy Adjustment Inventory-20, OAI-20)、中文版一般自我效能感量表(General Self-Efficacy Scale, GSES)及家庭关怀指数量表(Family APGAR Index)进行评估。采用Mplus 8.3软件进行潜在剖面分析确定造口适应能力的潜在类别；使用SPSS 26.0软件进行单因素分析和多元Logistic回归分析影响因素。结果：造口适应能力可划分为三种潜在类型：低造口适应能力组(39.6%)、中造口适应能力组(36.3%)和高造口适应能力组(24.1%)。多因素分析结果显示，自我效能感、家庭关怀指数、婚姻状况是影响造口适应能力潜在类别的显著因素(P < 0.05)。结论：老年结直肠癌造口患者的造口适应能力存在群体异质性，临床工作者应关注患者自我效能感与社会支持水平，结合婚姻状况制定个性化护理干预策略，提升其造口适应能力与生活质量。

Abstract: Objective: To explore the potential profiles of ostomy adaptability in elderly patients with colorectal cancer and analyze its influencing factors. Methods: Using convenience sampling, 240 elderly patients with colorectal cancer stoma who visited the ostomy clinics of two tertiary hospitals in Xi’an from July 2023 to June 2025 were selected as the research subjects. The evaluation was conducted using a general information survey form, the Chinese version of the Ostomy Adjustment Inventory-20 (OAI-20), the Chinese version of the General Self Efficacy Scale (GSES), and the Family APGAR Index. Mplus 8.3 software was used for latent profile analysis to identify potential categories of stoma adaptability; SPSS 26.0 software was used for univariate analysis and multivariate logistic regression analysis of influencing factors. Results: Ostomy adaptability can be divided into three potential types: low adaptability group (39.6%), medium adaptability group (36.3%), and high adaptability group (24.1%). Multivariate analysis results showed that self-efficacy, family care index, marital status were significant factors affecting the potential categories of stoma adaptability (P < 0.05). Conclusion: There is group heterogeneity in the stoma adaptability of elderly patients with colorectal cancer. Clinical workers should pay attention to patients’ self-efficacy and social support levels, and combine marital status to develop personalized nursing intervention strategies to improve their stoma adaptability and quality of life.