HCC患者死亡焦虑和治疗依从性的联合潜在特征
Joint latent profiles of death anxiety and treatment adherence in HCC patients.
摘要(中文译文)
肝细胞癌（HCC）是造成全球癌症负担的主要因素之一，常使患者陷入死亡焦虑显著与治疗依从性欠佳的双重困境。既往研究大多将死亡焦虑与依从性视为相互独立、同质的构念，从而忽视了人群中可能存在的异质性及其共现模式。本研究采用以个体为中心的方法，识别肝细胞癌患者死亡焦虑与治疗依从性的联合潜在剖面，并考察与剖面归属相关的因素。研究采用横断面设计。2025年10月至11月，通过便利抽样从中国深圳、北京和拉萨的五家三级综合医院招募了586例肝细胞癌患者。数据采用死亡焦虑量表（DAS）、通用药物依从性量表（GMAS）、健康素养简表（HLS-SF）和恐惧疾病进展问卷简表（FoP-Q-SF）收集。潜在剖面分析识别出三个性质不同的亚组：低死亡焦虑-高治疗依从性、中等死亡焦虑-中等治疗依从性、高死亡焦虑-低治疗依从性。各剖面间，死亡焦虑与治疗依从性呈现明显的反向共变模式。多项logistic回归表明，健康素养和恐惧疾病进展是区分剖面归属的关键心理社会因素。此外，人口学及疾病相关变量对剖面归属显示出不同的预测效应。高死亡焦虑-低治疗依从性剖面患者可能代表一个具有临床重要意义的高危亚组，适合进行针对性筛查和支持性照护。临床实践在规划分层干预时，应重视对健康素养的评估以及针对特定剖面的心理社会需求。然而，由于采用横断面设计，所观察到的关联不应作因果解释，尚需纵向研究考察剖面间的时间性转变及其对后续治疗结局的影响。
Abstract
Hepatocellular carcinoma (HCC), one of the leading contributors to the global cancer burden, often places patients in a dual predicament of pronounced death anxiety and suboptimal treatment adherence. Prior research has largely treated death anxiety and adherence as independent, homogeneous constructs, thereby overlooking potential within-population heterogeneity and their co-occurring patterns. This study adopted a person-centered approach to identify joint latent profiles of death anxiety and treatment adherence among patients with HCC and to examine factors associated with profile membership. A cross-sectional design was employed. From October to November 2025, 586 patients with HCC were recruited via convenience sampling from five tertiary general hospitals in Shenzhen, Beijing and Lhasa, China. Data were collected using the Death Anxiety Scale (DAS), General Medication Adherence Scale (GMAS), Health Literacy Scale Short-Form (HLS-SF), and Fear of Progression Questionnaire-Short Form (FoP-Q-SF). Latent profile analysis identified three qualitatively distinct subgroups: low death anxiety-high treatment adherence, moderate death anxiety-moderate treatment adherence, and high death anxiety-low treatment adherence. Across profiles, death anxiety and treatment adherence exhibited a clear inverse co-variation pattern. Multinomial logistic regression indicated that health literacy and fear of disease progression were key psychosocial factors differentiating profile membership. In addition, demographic and disease-related variables showed varying predictive effects on profile assignment. Patients in the high death anxiety-low treatment adherence profile may represent a clinically important high-risk subgroup for targeted screening and supportive care. Clinical practice should emphasize assessment of health literacy and profile-specific psychosocial needs when planning stratified interventions. However, because of the cross-sectional design, the observed associations should not be interpreted causally, and longitudinal studies are needed to examine temporal transitions between profiles and their effects on subsequent treatment outcomes.
如何引用
AMA
Shoupeng Sheng, Lipeng Bai, Zhaxi Yundan, Hongwei Chen, Basang ZhaXi, LuoBu Duoji, et al. Joint latent profiles of death anxiety and treatment adherence in HCC patients.. Frontiers in psychiatry. 2026; doi:10.3389/fpsyt.2026.1792371.
APA
Shoupeng Sheng, Lipeng Bai, Zhaxi Yundan, Hongwei Chen, Basang ZhaXi, LuoBu Duoji, et al (2026). Joint latent profiles of death anxiety and treatment adherence in HCC patients.. Frontiers in psychiatry. https://doi.org/10.3389/fpsyt.2026.1792371
GB/T 7714
Shoupeng Sheng, Lipeng Bai, Zhaxi Yundan, Hongwei Chen, Basang ZhaXi, LuoBu Duoji, et al. Joint latent profiles of death anxiety and treatment adherence in HCC patients.[J]. Frontiers in psychiatry, 2026 doi:10.3389/fpsyt.2026.1792371.
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