Symptom-based latent classes of persons with irritable bowel syndrome
Symptom-based latent classes of persons with irritable bowel syndrome
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DOI：
10.1002/nur.21974
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发表时间：
2019-08-08
影响因子：
2
通讯作者：
Heitkemper, Margaret M.
中科院分区：
文献类型：
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作者：
Han, Claire J.;Pike, Ken;Heitkemper, Margaret M.
肠易激综合征（IBS）患者的症状经历存在很大的个体差异。因此，考虑多种症状来识别不同的症状亚组可能有助于指导症状管理的个性化健康策略。我们的目的是使用症状相关变量（六组日常日记症状、对 IBS 的认知信念和 IBS 生活质量 [QOL]）来识别具有相似症状模式的 IBS 患者的潜在类别（即亚组）；并检查亚组患者特征的差异。数据来自对参加两项以认知为重点的干预试验的男性和女性的基线评估（N = 332）。使用潜在类别分析，确定了四个潜在类别：1 类（低症状和良好的生活质量，n = 153）、2 类（低症状和中等生活质量，n = 106）、3 类（高症状伴腹泻和不良生活质量，n = 38）和 4 类（高症状伴低腹泻和中等生活质量，n = 35）。腹泻、女性、受教育程度较低、失业和既往有重度抑郁症史均与第 3 类成员资格有关。利用这些独特的症状特征，下一步是探索导致症状负担的潜在机制，目标是设计量身定制的干预措施来减轻这种负担。
A large amount of interindividual variability exists in symptom experiences of persons with irritable bowel syndrome (IBS). Thus, consideration of multiple symptoms to identify distinct symptom subgroups may be useful in directing personalized health strategies for symptom management. We aimed to identify latent classes (i.e., subgroups) of persons with IBS who share similar patterns of symptoms using symptom-related variables (six groups of daily diary symptoms, cognitive beliefs about IBS, and IBS quality of life [QOL]); and to examine how subgroups differed in patient characteristics. Data were derived from a baseline assessment of men and women enrolled in two cognitively-focused intervention trials (N = 332). Using latent class analysis, four latent classes were identified: Class 1 (low symptoms and good QOL, n = 153), Class 2 (low symptoms and moderate QOL, n = 106), Class 3 (high symptoms with diarrhea and poor QOL, n = 38), and Class 4 (high symptoms with low diarrhea and moderate QOL, n = 35). Diarrhea, being female, less formal education, unemployment, and previous history of major depressive disorder were associated with membership in Class 3. Using these distinct symptom profiles, the next step is to explore underlying mechanisms accounting for symptom burden with the goal of designing tailored interventions to reduce that burden.