학술논문

Predictors of preparedness for recovery following colorectal cancer surgery: a latent class trajectory analysis.
Document Type
Article
Source
Acta Oncologica. Dec2023, Vol. 62 Issue 12, p1625-1634. 10p.
Subject
*RESEARCH
*COLON tumors
*HOSPITALS
*CONVALESCENCE
*CLASSIFICATION
*MULTIVARIATE analysis
*AGE distribution
*PATIENT-centered care
*HEALTH outcome assessment
*RETROSPECTIVE studies
*PATIENTS
*REGRESSION analysis
*HEALTH status indicators
*RISK assessment
*COLORECTAL cancer
*SEX distribution
*COMMUNICATION
*HEALTH
*INFORMATION resources
*MEDICAL records
*DESCRIPTIVE statistics
*QUESTIONNAIRES
*RESEARCH funding
*MEDICAL practice
*LATENT structure analysis
*COMORBIDITY
*PSYCHOLOGICAL stress
RECTUM tumors
Language
ISSN
0284-186X
Abstract
With an interest in providing knowledge for person-centred care, our overall goal is to contribute a greater understanding of diversity among patients in terms of their preparedness before and up to six months after colorectal cancer surgery. Our aim was to describe and provide a tentative explanation for differences in preparedness trajectory profiles. The study was explorative and used prospective longitudinal data from a previously published intervention study evaluating person-centred information and communication. The project was conducted at three hospitals in Sweden. Patient-reported outcomes measures, including the Longitudinal Preparedness for Colorectal Cancer Surgery Questionnaire, were collected before surgery, at discharge, and four to six weeks, three months, and six months after surgery. Clinical data were retrospectively obtained from patients' medical records. We used latent class growth models (LCGMs) to identify latent classes that distinguish subgroups of patients who represent different preparedness trajectory profiles. To determine the most plausible number of latent classes, we considered statistical information about model fit and clinical practice relevance. We used multivariable regression models to identify variables that explain the latent classes. The sample (N = 488) comprised people with a mean age of 68 years (SD = 11) of which 44% were women. Regarding diagnoses, 60% had colon cancer and 40% rectal cancer. The LCGMs identified six latent classes with different preparedness for surgery and recovery trajectories. The latent classes were predominantly explained by differences in age, sex, physical classification based on comorbidities, treatment hospital, global health status, distress, and sense of coherence (comprehensibility and meaningfulness). Contrary to the received view that emphasizes standardized care practices, our results point to the need for adding person-centred and tailored approaches that consider individual differences in how patients are prepared before and during the recovery period related to colorectal cancer surgery. [ABSTRACT FROM AUTHOR]