Latent profile analysis of postoperative pain and fear kinesiophobia on the quality of life in patients after lumbar spinal stenosis surgery

doi:10.11958/20253285

Abstract

Abstract:

Objective To explore the latent class characteristics of pain catastrophizing, kinesiophobia and quality of life (QOL) in patients after lumbar spinal stenosis (LSS) surgery, and to analyze the factors influencing class membership. Methods A convenience sampling method was used to recruit patients who underwent LSS surgery in the Department of Spinal Surgery, Tianjin Union Medical Center, from March 2023 to March 2024. Data were collected using a general information questionnaire, the Pain Catastrophizing Scale (PCS), the Tampa Scale for Kinesiophobia (TSK-17) and the 12-Item Short-Form Health Survey (SF-12). Latent profile analysis (LPA) was performed to identify heterogeneous subgroups. Univariate analysis and multinomial Logistic regression analysis were used to explore the factors influencing class membership. Results A total of 184 patients were included, consisting of 95 males (51.63%) and 89 females (48.37%). Three latent classes of psychobehavioral responses were identified: the high QOL class (96 cases, 52.17%), the high pain catastrophizing-high kinesiophobia class (30 cases, 16.30%) and the low QOL class (58 cases, 31.52%). Univariate analysis showed that there were significant differences in gender, age, educational level, marital status, living arrangement, monthly income and level of disease-related knowledge between patients with different potential categories (all P < 0.05). Multinomial Logistic regression analysis revealed that male gender, middle educational level (senior high school or technical secondary school), a higher level of disease-related knowledge and a monthly income of 5 001-8 000 yuan were independent protective factors for belonging to the high QOL class. Female gender was an independent risk factor for belonging to the high pain catastrophizing-high kinesiophobia class. Conclusion There is significant heterogeneity in pain catastrophizing, kinesiophobia and quality of life in patients after lumbar spinal stenosis surgery. These findings may inform precise assessment and stratified intervention in clinical practice to improve patient outcomes.

Key words: spinal stenosis, lumbar vertebrae, catastrophization, quality of life, kinesiophobia, potential profile analysis

CLC Number:

R681.5

Figures/Tables 4

References 25

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模型	LL			AIC		BIC
1	-2 899.641			5 815.282		5 841.001
2	-2 854.478			5 734.956		5 776.750
3	-2 854.478			5 707.134		5 765.002
4	-2 826.254			5 698.508		5 772.451
模型	aBIC	熵	LMRT		类别概率
1	5 815.663	—
2	5 736.567	0.814	<0.001		0.62/0.38
3	5 707.992	0.895	0.001 6		0.52/0.16/0.32
4	5 699.605	0.884	0.183 9		0.25/0.38/0.21/0.16

模型	LL			AIC		BIC
1	-2 899.641			5 815.282		5 841.001
2	-2 854.478			5 734.956		5 776.750
3	-2 854.478			5 707.134		5 765.002
4	-2 826.254			5 698.508		5 772.451
模型	aBIC	熵	LMRT		类别概率
1	5 815.663	—
2	5 736.567	0.814	<0.001		0.62/0.38
3	5 707.992	0.895	0.001 6		0.52/0.16/0.32
4	5 699.605	0.884	0.183 9		0.25/0.38/0.21/0.16

组别	n		年龄/岁	性别（男/女）		文化程度（初中及以下/高中或中专/大专及以上）		婚姻状况（未婚/已婚/ 其他）
类别1	96		57.71±11.83	47/49		46/23/27		4/90/2
类别2	30		61.67±14.37^a	11/19		9/7/14		2/22/6
类别3	58		64.28±12.57^ab	37/21		31/19/8		2/44/12
F或χ²			5.168^＊	6.400^＊		10.473^＊		18.434^＊
组别		居住状况（独居/仅与配偶/仅与子女/与子女及配偶）			月收入（≤3 000元/3 001~5 000元/ 5 001~8 000元/> 8 000元）		对疾病的了解程度/分
类别1		11/50/7/28			24/48/18/6		3.83±1.13
类别2		3/16/4/7			5/4/16/5		3.38±1.14^ab
类别3		13/30/11/4			3/5/6/44		3.33±1.11^ab
F或χ²		17.017^＊			104.476^＊		3.799^＊

组别	n		年龄/岁	性别（男/女）		文化程度（初中及以下/高中或中专/大专及以上）		婚姻状况（未婚/已婚/ 其他）
类别1	96		57.71±11.83	47/49		46/23/27		4/90/2
类别2	30		61.67±14.37^a	11/19		9/7/14		2/22/6
类别3	58		64.28±12.57^ab	37/21		31/19/8		2/44/12
F或χ²			5.168^＊	6.400^＊		10.473^＊		18.434^＊
组别		居住状况（独居/仅与配偶/仅与子女/与子女及配偶）			月收入（≤3 000元/3 001~5 000元/ 5 001~8 000元/> 8 000元）		对疾病的了解程度/分
类别1		11/50/7/28			24/48/18/6		3.83±1.13
类别2		3/16/4/7			5/4/16/5		3.38±1.14^ab
类别3		13/30/11/4			3/5/6/44		3.33±1.11^ab
F或χ²		17.017^＊			104.476^＊		3.799^＊

项目	β	SE	Wald χ²	P	OR（95%CI）
类别2与类别1^a
年龄	0.045	0.030	2.178	0.140	1.046（0.985~1.110）
对疾病的了解程度	-0.867	0.647	1.794	0.180	0.420（0.118~1.494）
男性	-1.445	0.622	5.402	0.020	0.236（0.070~0.797）
文化程度			3.892	0.143
高中或中专	-1.898	1.126	2.840	0.092	0.150（0.016~1.362）
大专及以上	-0.605	2.138	0.080	0.777	0.546（0.008~36.015）
居住状况			2.236	0.525
仅与配偶	-2.067	1.735	1.419	0.234	0.127（0.004~3.797）
仅与子女	-3.033	2.108	2.071	0.150	0.048（0.001~2.999）
与子女及配偶	-0.251	3.127	0.006	0.936	0.778（0.002~357.112）
婚姻状况			1.987	0.370
已婚	1.896	1.445	1.722	0.189	6.660（0.392~113.086）
其他	-1.225	2.067	0.351	0.553	0.294（0.005~16.885）
月收入			12.456	0.006
3 001~5 000元	1.775	1.155	2.360	0.124	5.900（0.613~56.782）
5 001~8 000元	-3.203	1.022	9.819	0.002	0.041（0.005~0.301）
>8 000元	-1.675	0.983	2.905	0.088	0.187（0.027~1.285）
常数项	-1.488	7.578	1.428	0.232	0.226（0.000~2.150）
类别3与类别1^a
年龄	0.053	0.033	2.503	0.114	1.054（0.987~1.126）
对疾病的了解程度	-1.525	0.694	4.828	0.028	0.218（0.056~0.848）
男性	0.030	0.612	0.002	0.961	1.030（0.310~3.420）
文化程度			8.376	0.015
高中或中专	-3.427	1.193	8.256	0.004	0.032（0.003~0.336）
大专及以上	-0.733	2.113	0.120	0.729	0.481（0.008~30.245）
居住状况			0.712	0.870
仅与配偶	-0.643	1.593	0.163	0.687	0.526（0.023~11.933）
仅与子女	-1.687	1.999	0.712	0.399	0.185（0.004~9.314）
与子女及配偶	-0.756	3.060	0.061	0.805	0.470（0.001~189.092）
婚姻状况			1.516	0.468
已婚	2.426	1.971	1.516	0.218	11.315（0.238~538.479）
其他	-1.056	2.486	0.181	0.671	0.348（0.003~45.431）
月收入			23.994	<0.001
3 001~5 000元	0.133	1.368	0.009	0.923	1.142（0.078~16.690）
5 001~8 000元	-3.252	1.166	7.778	0.005	0.039（0.004~0.380）
>8 000元	-5.758	1.175	23.994	<0.001	0.003（0.000~0.032）
常数项	2.002	8.223	2.900	0.089	7.400（0.000~1.45E+8）
类别2与类别3^b
年龄	-0.008	0.036	0.051	0.821	0.992（0.925~1.064）
对疾病的了解程度	0.658	0.742	0.787	0.375	1.931（0.451~8.261）
男性	-1.475	0.688	4.599	0.032	0.229（0.059~0.881）
文化程度			2.036	0.338
高中或中专	1.530	1.072	2.036	0.154	4.616（0.565~37.745）
大专及以上	0.127	1.837	0.005	0.945	1.136（0.031~41.568）
居住状况			0.614	0.896
仅与配偶	-1.425	1.818	0.614	0.433	0.241（0.007~8.491）
仅与子女	-1.346	2.172	0.384	0.536	0.260（0.004~18.390）
与子女及配偶	0.505	3.099	0.027	0.871	1.657（0.004~720.275）
月收入			12.744	0.005
3 001~5 000元	1.642	1.280	1.646	0.199	5.166（0.420~63.468）
5 001~8 000元	0.049	1.087	0.002	0.964	1.050（0.125~8.831）
>8 000元	4.083	1.144	12.744	<0.001	59.312（6.304~558.043）
婚姻状况			0.071	0.965
已婚	-0.530	2.056	0.066	0.797	0.589（0.010~33.125）
其他	-0.169	2.457	0.005	0.945	0.844（0.007~104.299）
常数项	-2.148	8.848	0.313	0.576	0.117（0.000~2 380 000）