School of Nursing, Fujian Medical University, Fuzhou, Fujian, China.
Department of Oncology, Affiliated Hospital of Putian University, Putian, Fujian, China.
Psychooncology. 2024 Mar;33(3):e6312. doi: 10.1002/pon.6312.
Demoralization has garnered increasing attention in recent years as a significant psychological distress. This study aims to identify latent classes of demoralization in lung cancer patients using Latent Class Analysis (LCA) from a person-centered perspective and to explore the factors influencing the latent classes of demoralization.
A cross-sectional study using convenience sampling was conducted among 567 lung cancer patients in three tertiary hospitals in China. LCA was employed to classify heterogeneous classes of demoralization. Multinomial logistic regression analyses were performed to explore the associations between demographic and clinical characteristics, as well as physical symptoms, resilience, family function, and coping strategies, with class membership in the identified heterogeneous subgroups of lung cancer patients.
Three latent classes of demoralization were identified: the high demoralization group (Class 1, 14.8%), the moderate demoralization-distress and helplessness group (Class 2, 37.2%), and the low demoralization group (Class 3, 48.0%). In comparison to Class 3, lung cancer patients with hypertension, higher core symptom burden, poorer resilience, dysfunctional family dynamics, and resignation coping were more likely to belong to Class 1 and Class 2.
The demoralization patterns in lung cancer patients were varied. Targeted intervention should be developed based on the characteristics of each class, and timely attention should be paid to high-risk patients.
近年来，道德低落作为一种严重的心理困扰引起了越来越多的关注。本研究旨在从以人为中心的角度使用潜在类别分析（LCA）来确定肺癌患者的道德低落潜在类别，并探讨影响道德低落潜在类别的因素。
采用便利抽样方法，在中国三家三级医院对 567 名肺癌患者进行横断面研究。采用潜在类别分析对异质的道德低落类别进行分类。采用多项逻辑回归分析探讨人口统计学和临床特征以及身体症状、韧性、家庭功能和应对策略与识别的肺癌患者异质亚组中的类别归属之间的关联。
确定了三种道德低落的潜在类别：高道德低落组（第 1 类，14.8%）、中度道德低落-痛苦和无助组（第 2 类，37.2%）和低道德低落组（第 3 类，48.0%）。与第 3 类相比，患有高血压、核心症状负担较高、韧性较差、家庭动态功能失调和听天由命应对方式的肺癌患者更有可能属于第 1 类和第 2 类。
肺癌患者的道德低落模式各不相同。应根据每个类别的特点制定针对性的干预措施，并及时关注高危患者。
