中国血液净化

中国血液净化 ›› 2026, Vol. 25 ›› Issue (02): 110-114.doi: 10.3969/j.issn.1671-4091.2026.02.005

• 临床研究 • 上一篇    下一篇

中青年维持性血液透析患者家庭抗逆力的潜在剖面分析及其影响因素研究

黄梅丽   何 进   陈 妮   肖海艳   李丽珍   

  1. 410000 长沙, 1湖南省人民医院(湖南师范大学附属第一医院)血液净化中心二部
  • 收稿日期:2025-04-27 修回日期:2025-11-03 出版日期:2026-02-12 发布日期:2026-02-02
  • 通讯作者: 李丽珍 E-mail:lilz2023@hunnu.edu.cn

Latent class analysis of family resilience and its influencing factors in young and middle-aged maintenance hemodialysis patients

HUANG Mei-li, HE Jin, CHEN Ni, XIAO Hai- yan, LI Li- zhen   

  1. The Second Hemodialysis Center, Hunan Provincial People's Hospital (The First Affiliated Hospital of Hunan Normal University), Changsha 410000, China
  • Received:2025-04-27 Revised:2025-11-03 Online:2026-02-12 Published:2026-02-02
  • Contact: 410000 长沙，1湖南省人民医院(湖南师范大学附属第一医院)血液净化中心二部 E-mail:lilz2023@hunnu.edu.cn

摘要： 目的 分析中青年(18～59岁)维持性血液透析(maintenance hemodialysis,MHD)患者家庭抗逆力的潜在类别及其影响因素。 方法 选取2024年10月—2025年3月湖南省人民医院(湖南师范大学附属第一医院)血液净化一部和二部、长沙市第一医院和郴州市第二人民医院血液透析室收治的符合纳入标准的412例中青年MHD患者为研究对象，采用一般资料调查表、中文版家庭抗逆力评定量表(Chinese version of the family resilience assessment scale,C-FRAS)进行调查研究。利用潜在类别分析中青年MHD患者家庭抗逆力的不同类别，采用多元Logistic回归分析影响因素。 结果 中青年MHD 患者家庭抗逆力可分为 3 个潜在类别：家庭抗逆力低下(208 例，50.5%)、家庭抗逆力中等(178 例，43.2%)和家庭抗逆力良好(26例，6.3%)。多因素Logistic回归分析表明(以家庭抗逆力良好为参照)：文化程度高(大专及以上为参照，初中及以下：中等比良好OR=1.132，95% CI：1.019～1.825，P=0.026；低下比良好OR=1.587，95% CI：1.120～8.195，P=0.023)、经济负担轻(无负担为参照，负担较轻：中等比良好OR =4.392，95% CI：2.364～6.825，P=0.035)、职工医保(居民医保为参照，中等比良好OR =3.654，95% CI：1.165～7.521，P=0.012；低下比良好OR=3.654，95% CI：1.123～4.574，P＜0.001)、外向性格(内向性格为参照，中等比良好OR=0.245，95% CI：0.321～0.936，P=0.039)、透析龄短(＜1年为参照，1～3年：中等比良 好 OR =3.245，95% CI：2.962～4.954，P=0.015；低 下 比 良 好 OR =1.326，95% CI：1.121～7.829，P＜0.001)是家庭抗逆力的保护因素；经济负担重(无负担为参照，负担较重：低下比良好OR =0.126，95% CI：0.012～0.687，P=0.049)是家庭抗逆力的危险因素。 结论 中青年MHD患者家庭抗逆力存在3个潜在类别，临床医务工作者应关注患者的家庭抗逆力情况，针对性实施干预方案，提高患者治疗依从性。

关键词: 中青年, 维持性血液透析, 家庭抗逆力, 潜在剖面分析, 影响因素

Abstract: Objective To analyze the latent classes of family resilience among young and middle-aged (18-59 years) patients on maintenance hemodialysis (MHD) and to explore their influencing factors. Methods This cross-sectional study recruited 412 eligible young and middle-aged MHD patients from multiple centers, including the First and Second Departments of Blood Purification at Hunan Provincial People's Hospital, the Hemodialysis Unit of Changsha First Hospital, and the Chenzhou Second People's Hospital, between October 2024 and March 2025. A general information questionnaire and the Chinese version of the Family Resilience Assessment Scale (C-FRAS) were used for the survey. Latent class analysis was applied to identify different categories of family resilience among the young and middle-aged MHD patients, and multivariate logistic regression was employed to analyze the influencing factors. Results Family resilience in this population could be classified into three latent classes: low resilience (208 cases, 50.5% ), moderate resilience (178 cases, 43.2%), and good resilience (26 cases, 6.3%). Using the good resilience group as the reference, multivariate logistic regression identified several protective factors: a higher education level (using college or above as reference; junior high school or below: moderate vs. high OR=1.132, 95% CI: 1.019～1.825, P=0.026; low vs. high OR=1.587, 95% CI: 1.120～8.195, P=0.023), lighter economic burden (using no burden as reference; lighter burden: moderate vs. high OR=4.392, 95% CI: 2.364～6.825, P=0.035), enrollment in employee medical insurance (using resident medical insurance as reference; moderate vs. high OR=3.654, 95% CI: 1.165～7.521, P=0.012; low vs. high OR=3.654, 95% CI: 1.123～4.574, P＜0.001), extroverted personality (using introverted as reference; moderate vs. high OR=0.245, 95% CI: 0.321～0.936, P=0.039), and shorter dialysis vintage (using ＜1 year as reference; 1～3 years: moderate vs. high OR=3.245, 95% CI: 2.962～4.954, P= 0.015; low vs. high OR=1.326, 95% CI: 1.121～7.829, P＜0.001). Conversely, a heavy economic burden (using no burden as reference; heavier burden: low vs. high OR=0.126, 95% CI: 0.012～0.687, P=0.049) was identified as a risk factor. Conclusion Family resilience among young and middle-aged MHD patients can be categorized into three latent classes. Clinical healthcare professionals should pay attention to the family resilience status of these patients and implement targeted intervention strategies to enhance their treatment adherence.

Key words: Young and middle-aged, Maintenance hemodialysis, Family resilience, Latent class analysis, Influencing factor

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