Departments of Public Health and Health Service, University of Washington, Seattle, Washington.
Biobehavioral Cancer Prevention and Control Training Program, Fred Hutchinson Cancer Research Center, Seattle, Washington.
Res Nurs Health. 2019 Oct;42(5):382-391. doi: 10.1002/nur.21974. Epub 2019 Aug 8.
A large amount of interindividual variability exists in symptom experiences of persons with irritable bowel syndrome (IBS). Thus, consideration of multiple symptoms to identify distinct symptom subgroups may be useful in directing personalized health strategies for symptom management. We aimed to identify latent classes (i.e., subgroups) of persons with IBS who share similar patterns of symptoms using symptom-related variables (six groups of daily diary symptoms, cognitive beliefs about IBS, and IBS quality of life [QOL]); and to examine how subgroups differed in patient characteristics. Data were derived from a baseline assessment of men and women enrolled in two cognitively-focused intervention trials (N = 332). Using latent class analysis, four latent classes were identified: Class 1 (low symptoms and good QOL, n = 153), Class 2 (low symptoms and moderate QOL, n = 106), Class 3 (high symptoms with diarrhea and poor QOL, n = 38), and Class 4 (high symptoms with low diarrhea and moderate QOL, n = 35). Diarrhea, being female, less formal education, unemployment, and previous history of major depressive disorder were associated with membership in Class 3. Using these distinct symptom profiles, the next step is to explore underlying mechanisms accounting for symptom burden with the goal of designing tailored interventions to reduce that burden.
存在大量个体间的变异性,即患有肠易激综合征(IBS)的人在症状体验方面存在差异。因此,考虑多种症状以识别不同的症状亚组,可能有助于为症状管理制定个性化的健康策略。我们的目的是使用与症状相关的变量(六组日常日记症状、对 IBS 的认知信念和 IBS 生活质量[QOL]),确定具有相似症状模式的 IBS 患者的潜在类别(即亚组);并研究亚组在患者特征方面的差异。这些数据来自两项以认知为重点的干预试验中纳入的男性和女性的基线评估(N=332)。使用潜在类别分析,确定了四个潜在类别:第 1 类(症状低且 QOL 良好,n=153)、第 2 类(症状低且 QOL 中等,n=106)、第 3 类(腹泻症状高且 QOL 差,n=38)和第 4 类(腹泻症状低且 QOL 中等,n=35)。腹泻、女性、受教育程度较低、失业和先前患有重度抑郁症与第 3 类的成员身份相关。使用这些不同的症状特征,下一步是探索导致症状负担的潜在机制,目标是设计有针对性的干预措施来减轻这种负担。