探究肺移植受者生活质量潜在剖面及不同生活质量类别受者特征差异及影响因素。

选取2022年1月至12月无锡市人民医院门诊复诊的300例肺移植受者作为调查对象。采用一般资料调查表和肺移植受者特异性生活质量量表(LT-QOL)进行问卷调查。计数资料组间比较采用卡方检验或Fisher确切概率法；计量资料组间比较采用Kruskal-Wallis H检验。使用lavaan包计算各维度因子得分，采用tidyLPA和mclust包进行潜在剖面分析(LPA)。采用nnet包对单因素分析中P<0.10的因素进行logistic回归分析。P<0.05为差异具有统计学意义。

共发放300份调查问卷，剔除无效问卷5份，有效问卷回收率为98.3%(295/300)。基于LT-QOL 11个方面的因子得分进行LPA，295例受者被分为高生活质量—生活质量满意组(n＝181)、中等生活质量—腹泻症状突出组(n＝34)、中等生活质量—性功能问题突出组(n＝40)和低生活质量—综合感知不佳组(n＝40)。单因素分析结果表明，高生活质量—生活质量满意组、中等生活质量—腹泻症状突出组、中等生活质量—性功能问题突出组和低生活质量—综合感知不佳组肺移植受者年龄、血糖和血脂异常方面，差异均有统计学意义(H/χ²＝10.135、15.599和14.527，P均<0.05)。多元logistic回归分析结果示年龄、非计划再入院次数、血糖异常和血脂异常是影响肺移植受者生活质量类别的危险因素，差异均有统计学意义(P均<0.05)。

肺移植受者生活质量具有明显异质性，护理人员可根据其生活质量类别特征制订针对性干预策略，以提高其生活质量和整体健康水平。

To explore the latent profiles of lung transplant recipients′ quality of life, as well as the traits and contributing variables of different quality of life categories.

The study included 300 lung transplant recipients who visited Wuxi People′s Hospital for follow-up outpatient visits between January and December 2022. The lung transplant quality of life survey (LT-QOL) and a general information questionnaire were used in the questionnaire surveys. The Kruskal-Wallis H test was used to compare groups for continuous data, while the chi-square test or Fisher′s exact probability test was used for comparison between groups for categorical data. The factor scores for every dimension were determined using the lavaan package. The mclust and tidyLPA programs were used to conduct latent profile analysis (LPA). The nnet software was used to perform logistic regression on factors with P<0.10 in univariate analysis. The threshold for statistical significance was set at P<0.05.

A total of 300 questionnaires were distributed, with 5 invalid responses excluded, yielding a valid response rate of 98.3% (295/300). LPA was conducted based on factor scores across the LT-QOL′s 11 domains, the 295 recipients were categorised into high quality of life-quality of life satisfaction group (n=181), moderate quality of life-prominent diarrhoea symptoms group (n=34), moderate quality of life-prominent sexual function issues group (n=40), low quality of life-poor overall perception group (n=40). Univariate analysis revealed statistically significant differences in age, pathoglycemia, and dyslipidaemia among recipients in the above four groups (H/χ²=10.135, 15.599 and 14.527 respectively, all P<0.05). Multivariate logistic regression analysis revealed that the age, unplanned readmission frequency, pathoglycemia, and dyslipidaemia were statistically significant factors influencing quality of life categories among lung transplant recipients (all P<0.05).

Quality of life among lung transplant recipients exhibits marked heterogeneity. Nursing staff may develop targeted intervention strategies based on the characteristics of their respective quality of life categories to enhance their quality of life and overall health status.