应用线性结构模型分析农村胃癌患者生活质量的影响因素

背景胃癌患者的生活质量受诸多因素的影响,采用线性结构方程式模型,可以揭示不能通过直接观测得到的潜在因子之间的关系,适合对胃癌患者生活质量的影响因素作分析.目的分析影响长乐县胃癌患者生活质量的因素,为改善农村胃癌患者在生活质量提供科学信息.设计以诊断为依据的回顾性研究.地点和对象423例居住在长乐县且由县级以上医院确诊的胃癌患者,其中男355例,女68例;生存时间0.5～15.6年.方法采用观测性研究方法,每例胃癌患者填写调查表.调查胃癌患者基本情况指标7项,治疗情况25项,生活质量18项.采用因子分析方法对26个变量和18个条目评分进行分析,用线性结构方程式(LISREL)分析潜在外生变量ζ与潜在内生变量η之间的关系.主要观察指标反映胃癌患者生活质量的18个条目的评分及相关因素的量化值.结果从反映胃癌患者生活质量的18个条目的评分提取出2个潜在的内生变量,从与生活质量相关的26个显在变量中提取出11个潜在外生变量,二者之间的线性结构方程的拟合优度指数为0.95.结论胃癌患者的心理状态受到其生理状态的显著影响;影响胃癌患者生活质量的因素有病情、生存时间、年龄、手术情况、性别和营养.

Analysis of the influencing factors on the quality of patients life in rural patients with gastric carcinoma using linear structural equation

BACKGROUND: Since many factors can influence the quality of life (QOL)of the cancer patients, it is important to find out what factors may be related to the quality of life in order to improve the QOL in cancer patients.OBJECTIVE: To analyze the factors that influenee the QOL of gastric carcinoma patients living in Changle Country so as to provide scientific information for the improvernent of QOL of rural patients with gastric carcinoma.DESIGN: A retrospective study based on diagnosis was conducted.SETTING and PARTICIPANTS: Our sample consisted of 423 cases residing in Changle county and those patients were diagnosed by county-level and above hospitals to suffer from gastric carcinoma. Of the 423 patients, 355cases were male, 68 cases were female. The survival time was from half year to 15.6 years,METHODS: All of the patients in our sample were asked to answer a questionnaire reflecting the information of the disease condition, treatment and rehabilitation of the stomach cancer patients and 18 items describing the quality of life of the patients.MAIN OUTCOME MEASURES: The scores of 18 items and the values of the variables in the questionnaire were obtained from the answered questionnaires.RESULTS: Two latent endogenous variables were drawn from 18 items describing the patient's survival quality and 11 latent exogenous variables were drawn from 26 influencing factors on the QOL. The LISREL model fitting the relationship between latent exogenous variables and latent endogenoos variables showed a good effect(Goodness-of-fit index = 0.95).