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Article(id=1322168839652102525, tenantId=1146029695717560320, journalId=1220038315760373764, issueId=1322168387082502716, articleNumber=null, orderNo=null, doi=10.12102/j.issn.1009-6493.2026.06.004, pmid=null, cstr=null, oa=null, hot=null, price=null, onlineType=0, articleFormat=0, articleType=null, articleTypeStr=null, receivedDate=1745337600000, receivedDateStr=2025-04-23, revisedDate=1770566400000, revisedDateStr=2026-02-09, acceptedDate=null, acceptedDateStr=null, onlineDate=1793159216082, onlineDateStr=2026-10-28, pubDate=1774368000000, pubDateStr=2026-03-25, doiRegisterDate=null, doiRegisterDateStr=null, onlineIssueDate=1793159216082, onlineIssueDateStr=2026-10-28, onlineJustAcceptDate=null, onlineJustAcceptDateStr=null, onlineFirstDate=null, onlineFirstDateStr=null, sourceXml=null, magXml=null, createTime=1793159216082, creator=13701087609, updateTime=1793159216082, updator=13701087609, issue=Issue{id=1322168387082502716, tenantId=1146029695717560320, journalId=1220038315760373764, year='2026', volume='40', issue='6', pageStart='881', pageEnd='1056', issueExtLink='null', onlineDate='null', pubDate='1774368000000', pubDateStr='2026-03-25', beforeIssueId=null, nextIssueId=null, price=null, status=1, issueComplete=1, articleOrder=1, issueType=-1, specialIssue=null, createTime=1793159108180, creator='13701087609', updateTime=1793159108180, updator='13701087609', preIssue=null, nextIssue=null, articleTotal=null, ext=null, issueFiles=null, downloadFileDto=null}, startPage=916, endPage=922, ext={EN=ArticleExt(id=1322168841459847551, articleId=1322168839652102525, tenantId=1146029695717560320, journalId=1220038315760373764, language=EN, title=Latent profile analysis and influencing factors of anxiety of the existential meaninglessness in elderly patients with chronic diseases, columnId=1220689484526572183, journalTitle=Chinese Nursing Research, columnName=Original Articles, runingTitle=null, highlight=null, articleAbstract=
Objective

To analyze the categories and influencing factors of anxiety of the existential meaninglessness in elderly patients with chronic diseases.

Methods

A total of 493 elderly patients with chronic diseases from six tertiary grade A hospitals in Hunan province were selected as research subjects by convenience sampling from July to September 2024.A questionnaire survey was conducted using the General Information Questionnaire,Anxiety Measure of the Existential Meaninglessness Scale,Chinese Self-Transcendence Scale,and Health empowerment scale for elderly patients with chronic disease.Latent profile analysis and multinomial Logistic regression were used to explore the categories and influencing factors of anxiety of the existential meaninglessness in elderly patients with chronic diseases.

Results

Anxiety of the existential meaninglessness in elderly patients with chronic diseases could be divided into three categories,namely low existential meaninglessness anxiety group(48.48%),moderate existential meaninglessness anxiety mixed group(43.41%),and high existential meaninglessness anxiety group(8.11%).Logistic regression analysis showed that economic resources,monthly family income,attitude towards life,type of medical insurance,and health empowerment were influencing factors for the categories of anxiety of the existential meaninglessness in elderly patients with chronic diseases(all P<0.05).

Conclusions

Anxiety of the existential meaninglessness in elderly patients with chronic diseases exhibits group heterogeneity.Targeted interventions based on different categories could be implemented in clinical nursing to reduce the anxiety of existential meaninglessness in elderly patients with chronic diseases.

, authors=Wenxi ZHU, Manfang SU, Xiaoya PENG, Yuan LI, Xiaolang CAO, authorsList=Wenxi ZHU, Manfang SU, Xiaoya PENG, Yuan LI, Xiaolang CAO, authorCompany=null, correspAuthors=Xiaolang CAO, authorNote=null, correspAuthorsNote=
CAO Xiaolang, E-mail:
, copyrightStatement=null, copyrightOwner=null, extLink=null, articleAbsUrl=null, sourceXml=null, magXml=null, pdfUrl=null, pdf=null, pdfFileSize=null, pdfExtLink=null, richHtmlUrl=null, mobilePdfUrl=null, reviewReport=null, pdfFirstPage=null, abstractGraph=null, abstractGraphContent=null, abstractVideo=null, citation=null, cebUrl=null, magXmlContent=null, mapNumber=null, fund=null), CN=ArticleExt(id=1322168841967358338, articleId=1322168839652102525, tenantId=1146029695717560320, journalId=1220038315760373764, language=CN, title=老年慢性病病人存在无意义焦虑的潜在类别及其影响因素, columnId=1220689484681761433, journalTitle=护理研究, columnName=科研论著, runingTitle=null, highlight=null, articleAbstract=
目的

分析老年慢性病病人存在无意义焦虑类别及其影响因素。

方法

采用方便抽样法于2024年7月—9月选取湖南省6所三级甲等医院的493例老年慢性病病人为研究对象。采用一般资料问卷、存在无意义焦虑量表、中文版自我超越量表、老年慢性病患者健康赋权量表进行问卷调查，采用潜在剖面分析和无序多分类Logistic回归模型探索老年慢性病病人存在无意义焦虑类别及其影响因素。

结果

老年慢性病病人的存在无意义焦虑可分为3个类别，即低无意义焦虑组（48.48%）、中等无意义焦虑混合组（43.41%）、高无意义焦虑组（8.11%）。Logistic回归分析结果显示，经济来源、家庭月收入、对待生活的态度、医保类型、健康赋权是老年慢性病病人存在无意义焦虑类别的影响因素（均P<0.05）。

结论

老年慢性病病人存在无意义焦虑存在群体异质性，临床护理中可根据不同类别采取针对性干预，降低老年慢性病病人的存在无意义焦虑。

, authors=朱文希, 苏曼芳, 彭晓雅, 李圆, 曹晓浪*, *, authorsList=朱文希, 苏曼芳, 彭晓雅, 李圆, 曹晓浪, authorCompany=null, correspAuthors=曹晓浪, authorNote=

朱文希，本科

, correspAuthorsNote=
曹晓浪，E-mail:
CAO Xiaolang, E-mail:
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unstructuredReference=陈俊杰,刘文慧,陈洁红,等.共病病人治疗负担现状及影响因素的研究进展[J].全科护理,2024,22(19):3588-3592., articleTitle=共病病人治疗负担现状及影响因素的研究进展, refAbstract=null), Reference(id=1322530597080252778, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322168839652102525, doi=null, pmid=null, pmcid=null, year=2019, volume=33, issue=2, pageStart=214, pageEnd=218, url=null, language=null, rfNumber=32, rfOrder=31, authorNames=杨阳, 曾铁英, journalName=护理研究, refType=null, unstructuredReference=杨阳,曾铁英.老年慢性病病人健康赋权水平及其影响因素[J].护理研究,2019,33(2):214-218., articleTitle=老年慢性病病人健康赋权水平及其影响因素, refAbstract=null)], funds=null, companyList=[AuthorCompany(id=1322530583033528595, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322168839652102525, xref=1, ext=[AuthorCompanyExt(id=1322530583046111508, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322168839652102525, companyId=1322530583033528595, language=EN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=1Changsha Medical University, Hunan 410219 China), AuthorCompanyExt(id=1322530583062888725, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322168839652102525, companyId=1322530583033528595, language=CN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=1长沙医学院，湖南 410219)])], figs=[ArticleFig(id=1322530591229198653, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322168839652102525, language=EN, label=Figure 1, caption=Characteristic distribution of the three latent categories of anxiety of the existential meaninglessness in elderly patients with chronic diseases, figureFileSmall=/e0v1EZWvex4HCFKLXJ4Rg==, figureFileBig=i28gQ8YHmBK3Hq/e5yGTrg==, tableContent=null), ArticleFig(id=1322530591375999294, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322168839652102525, language=CN, label=图1, caption=老年慢性病病人存在无意义焦虑3个潜在类别的特征分布, figureFileSmall=/e0v1EZWvex4HCFKLXJ4Rg==, figureFileBig=i28gQ8YHmBK3Hq/e5yGTrg==, tableContent=null), ArticleFig(id=1322530591472468287, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322168839652102525, language=EN, label=Table 1, caption=

Fit indices of the latent profile model for anxiety of the existential meaninglessness in elderly patients with chronic diseases

, figureFileSmall=null, figureFileBig=null, tableContent=
模型AICBICaBICEntropyP类别概率（%）
BLRTLMRT
123 036.94023 188.15923 073.894100.00
221 459.47521 690.50321 515.9330.864<0.0010.02965.11/34.89
320 972.92321 283.76121 048.8850.897<0.0010.04148.48/43.41/8.11
420 739.52421 130.17220 834.9890.890<0.0010.50843.41/36.51/12.37/7.71
520 544.51521 014.97220 659.4840.881<0.0010.28137.93/33.27/9.33/16.84/2.64
), ArticleFig(id=1322530591560548672, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322168839652102525, language=CN, label=表1, caption=

老年慢性病病人存在无意义焦虑潜在剖面模型的拟合参数

, figureFileSmall=null, figureFileBig=null, tableContent=
模型AICBICaBICEntropyP类别概率（%）
BLRTLMRT
123 036.94023 188.15923 073.894100.00
221 459.47521 690.50321 515.9330.864<0.0010.02965.11/34.89
320 972.92321 283.76121 048.8850.897<0.0010.04148.48/43.41/8.11
420 739.52421 130.17220 834.9890.890<0.0010.50843.41/36.51/12.37/7.71
520 544.51521 014.97220 659.4840.881<0.0010.28137.93/33.27/9.33/16.84/2.64
), ArticleFig(id=1322530591627657537, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322168839652102525, language=EN, label=Table 2, caption=

Comparison of EMS-A scores among different categories of elderly patients with chronic diseases（x±s）

, figureFileSmall=null, figureFileBig=null, tableContent=
类别例数EMS-A总分不理解的焦虑无目标的焦虑生命无意义的焦虑
低无意义焦虑组23930.49±3.7111.03±2.2910.73±2.168.73±2.62
中等无意义焦虑混合组21442.73±3.9815.66±2.1514.41±2.4912.66±2.88
高无意义焦虑组4058.38±7.1721.10±3.2319.83±4.1817.45±4.34
F值986.682436.217277.119205.719
P<0.001<0.001<0.001<0.001
), ArticleFig(id=1322530591690572098, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322168839652102525, language=CN, label=表2, caption=

不同类别老年慢性病病人EMS-A得分比较（x±s）

, figureFileSmall=null, figureFileBig=null, tableContent=
类别例数EMS-A总分不理解的焦虑无目标的焦虑生命无意义的焦虑
低无意义焦虑组23930.49±3.7111.03±2.2910.73±2.168.73±2.62
中等无意义焦虑混合组21442.73±3.9815.66±2.1514.41±2.4912.66±2.88
高无意义焦虑组4058.38±7.1721.10±3.2319.83±4.1817.45±4.34
F值986.682436.217277.119205.719
P<0.001<0.001<0.001<0.001
), ArticleFig(id=1322530591757680963, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322168839652102525, language=EN, label=Table 3, caption=

Univariate analysis of influencing factors for anxiety categories of the existential meaninglessness in elderly patients with chronic diseases

, figureFileSmall=null, figureFileBig=null, tableContent=
项目分类例数（%）低无意义焦虑组（n=239）中等无意义焦虑混合组（n=214）高无意义焦虑组（n=40）统计值P
民族[例（%）]汉族480（97.4）234（97.9）210（98.1）36（90.0）χ2=9.2140.027
其他13（2.6）5（2.1）4（1.9）4（10.0）
居住状况[例（%）]与配偶同住229（46.5）89（37.2）120（56.1）20（50.0）
与子女同住165（33.5）98（41.0）56（26.2）11（27.5）χ2=17.6570.001
其他99（20.1）52（21.8）38（17.8）9（22.5）
文化程度[例（%）]小学及以下298（60.4）159（66.5）116（54.2）23（57.5）
初中140（28.4）45（18.8）84（39.3）11（27.5）χ2=26.871<0.001
高中或中专43（8.7）27（11.3）11（5.1）5（12.5）
专科及以上12（2.4）8（3.3）3（1.4）1（2.5）
经济来源[例（%）]退休金113（22.9）54（22.6）51（23.8）8（20.0）
子女供养247（50.1）106（44.4）114（53.3）27（67.5）χ2=12.3610.015
其他133（27.0）79（33.1）49（22.9）5（12.5）
家庭月收入[例（%）]<1 000元184（37.3）100（41.8）75（35.0）9（22.5）
1 000~<2 000元153（31.0）60（25.1）81（37.9）12（30.0）χ2=19.6120.003
2 000~3 000元73（14.8）30（12.6）33（15.4）10（25.0）
>3 000元83（16.8）49（20.5）25（11.7）9（22.5）
对待生活的态度[例（%）]积极430（87.2）213（89.1）189（88.3）28（70.0）χ2=11.6480.004
消极63（12.8）26（10.9）25（11.7）12（30.0）
医保类型[例（%）]城镇职工医保56（11.4）34（14.2）16（7.5）6（15.0）
城镇居民医保343（69.6）144（60.3）175（81.8）24（60.0）χ2=26.859<0.001
其他94（19.1）61（25.5）23（10.7）10（25.0）
自我超越（x±s，分）39.62±6.7037.23±6.5234.95±6.48F=12.690<0.001
健康赋权（x±s，分）54.62±9.3559.38±8.7759.68±10.32F=16.864<0.001
获取支持（x±s，分）11.52±3.0512.57±2.5613.58±2.97F=13.244<0.001
参与治疗（x±s，分）9.92±2.1011.06±1.8510.68±1.80F=19.165<0.001
重建自我（x±s，分）10.08±2.4611.68±2.5011.75±3.22F=24.650<0.001
), ArticleFig(id=1322530591824789828, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322168839652102525, language=CN, label=表3, caption=

老年慢性病病人存在无意义焦虑类别影响因素的单因素分析

, figureFileSmall=null, figureFileBig=null, tableContent=
项目分类例数（%）低无意义焦虑组（n=239）中等无意义焦虑混合组（n=214）高无意义焦虑组（n=40）统计值P
民族[例（%）]汉族480（97.4）234（97.9）210（98.1）36（90.0）χ2=9.2140.027
其他13（2.6）5（2.1）4（1.9）4（10.0）
居住状况[例（%）]与配偶同住229（46.5）89（37.2）120（56.1）20（50.0）
与子女同住165（33.5）98（41.0）56（26.2）11（27.5）χ2=17.6570.001
其他99（20.1）52（21.8）38（17.8）9（22.5）
文化程度[例（%）]小学及以下298（60.4）159（66.5）116（54.2）23（57.5）
初中140（28.4）45（18.8）84（39.3）11（27.5）χ2=26.871<0.001
高中或中专43（8.7）27（11.3）11（5.1）5（12.5）
专科及以上12（2.4）8（3.3）3（1.4）1（2.5）
经济来源[例（%）]退休金113（22.9）54（22.6）51（23.8）8（20.0）
子女供养247（50.1）106（44.4）114（53.3）27（67.5）χ2=12.3610.015
其他133（27.0）79（33.1）49（22.9）5（12.5）
家庭月收入[例（%）]<1 000元184（37.3）100（41.8）75（35.0）9（22.5）
1 000~<2 000元153（31.0）60（25.1）81（37.9）12（30.0）χ2=19.6120.003
2 000~3 000元73（14.8）30（12.6）33（15.4）10（25.0）
>3 000元83（16.8）49（20.5）25（11.7）9（22.5）
对待生活的态度[例（%）]积极430（87.2）213（89.1）189（88.3）28（70.0）χ2=11.6480.004
消极63（12.8）26（10.9）25（11.7）12（30.0）
医保类型[例（%）]城镇职工医保56（11.4）34（14.2）16（7.5）6（15.0）
城镇居民医保343（69.6）144（60.3）175（81.8）24（60.0）χ2=26.859<0.001
其他94（19.1）61（25.5）23（10.7）10（25.0）
自我超越（x±s，分）39.62±6.7037.23±6.5234.95±6.48F=12.690<0.001
健康赋权（x±s，分）54.62±9.3559.38±8.7759.68±10.32F=16.864<0.001
获取支持（x±s，分）11.52±3.0512.57±2.5613.58±2.97F=13.244<0.001
参与治疗（x±s，分）9.92±2.1011.06±1.8510.68±1.80F=19.165<0.001
重建自我（x±s，分）10.08±2.4611.68±2.5011.75±3.22F=24.650<0.001
), ArticleFig(id=1322530591891898693, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322168839652102525, language=EN, label=Table 4, caption=

Assignment of independent variables

, figureFileSmall=null, figureFileBig=null, tableContent=
项目赋值方式
民族汉族=1；其他=2
居住状况其他=（0,0）；与配偶同住=（1,0）；与子女同住=（0,1）
文化程度专科及以上=（0,0,0）；小学及以下=（1,0,0）；初中=（0,1,0）；高中或中专=（0,0,1）
经济来源其他=（0,0）；退休金=（1,0）；子女供养=（0,1）
家庭月收入>3 000元=（0,0,0）；<1 000元=（1,0,0）；1 000~<2 000元=（0,1,0）；2 000~3 000元=（0,0,1）
对待生活的态度积极=1；消极=2
医保类型其他=（0,0）；城镇职工医保=（1,0）；城镇居民医保=（0,1）
自我超越原值代入
健康赋权原值代入
获取支持原值代入
参与治疗原值代入
重建自我原值代入
), ArticleFig(id=1322530591950618950, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322168839652102525, language=CN, label=表4, caption=

自变量赋值方式

, figureFileSmall=null, figureFileBig=null, tableContent=
项目赋值方式
民族汉族=1；其他=2
居住状况其他=（0,0）；与配偶同住=（1,0）；与子女同住=（0,1）
文化程度专科及以上=（0,0,0）；小学及以下=（1,0,0）；初中=（0,1,0）；高中或中专=（0,0,1）
经济来源其他=（0,0）；退休金=（1,0）；子女供养=（0,1）
家庭月收入>3 000元=（0,0,0）；<1 000元=（1,0,0）；1 000~<2 000元=（0,1,0）；2 000~3 000元=（0,0,1）
对待生活的态度积极=1；消极=2
医保类型其他=（0,0）；城镇职工医保=（1,0）；城镇居民医保=（0,1）
自我超越原值代入
健康赋权原值代入
获取支持原值代入
参与治疗原值代入
重建自我原值代入
), ArticleFig(id=1322530592013533511, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322168839652102525, language=EN, label=Table 5, caption=

Multivariate analysis of influencing factors for anxiety categories of the existential meaninglessness in elderly patients with chronic diseases

, figureFileSmall=null, figureFileBig=null, tableContent=
类别项目回归系数标准误Wald χ2值POR值95%CI
中等无意义焦虑混合组①医保类型（城镇居民医保）-0.9740.3557.5400.0060.378[0.188,0.757]
参与治疗0.1520.0665.2900.0211.164[1.023,1.326]
重建自我0.1920.05611.988<0.0011.212[1.087,1.352]
高无意义焦虑组①家庭月收入（<1 000元）-1.3400.6654.0600.0440.262[0.071,0.964]
经济来源（子女供养）-1.1810.5714.2800.0390.307[0.100,0.940]
获取支持0.3410.09113.975<0.0011.406[1.176,1.681]
中等无意义焦虑混合组②家庭月收入（<1 000元）1.4340.6724.5630.0334.198[1.126,15.653]
对待生活的态度1.1550.5184.9680.0263.173[1.149,8.758]
医保类型（城镇居民医保）-1.7380.5898.7110.0030.176[0.055,0.558]
获取支持-0.3430.09114.225<0.0010.710[0.594,0.848]
), ArticleFig(id=1322530592084836680, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322168839652102525, language=CN, label=表5, caption=

老年慢性病病人存在无意义焦虑类别影响因素的多因素分析

, figureFileSmall=null, figureFileBig=null, tableContent=
类别项目回归系数标准误Wald χ2值POR值95%CI
中等无意义焦虑混合组①医保类型（城镇居民医保）-0.9740.3557.5400.0060.378[0.188,0.757]
参与治疗0.1520.0665.2900.0211.164[1.023,1.326]
重建自我0.1920.05611.988<0.0011.212[1.087,1.352]
高无意义焦虑组①家庭月收入（<1 000元）-1.3400.6654.0600.0440.262[0.071,0.964]
经济来源（子女供养）-1.1810.5714.2800.0390.307[0.100,0.940]
获取支持0.3410.09113.975<0.0011.406[1.176,1.681]
中等无意义焦虑混合组②家庭月收入（<1 000元）1.4340.6724.5630.0334.198[1.126,15.653]
对待生活的态度1.1550.5184.9680.0263.173[1.149,8.758]
医保类型（城镇居民医保）-1.7380.5898.7110.0030.176[0.055,0.558]
获取支持-0.3430.09114.225<0.0010.710[0.594,0.848]
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老年慢性病病人存在无意义焦虑的潜在类别及其影响因素
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朱文希 , 苏曼芳 , 彭晓雅 , 李圆 , 曹晓浪 *, *
护理研究 | 科研论著 2026,40(6): 916-922
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护理研究 |科研论著 2026 , 40 (6) : 916 -922
老年慢性病病人存在无意义焦虑的潜在类别及其影响因素
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朱文希, 苏曼芳, 彭晓雅, 李圆, 曹晓浪*, *
作者信息
  • 1长沙医学院，湖南 410219
通讯作者:
曹晓浪，E-mail:
CAO Xiaolang, E-mail:
作者简介:

朱文希，本科

Latent profile analysis and influencing factors of anxiety of the existential meaninglessness in elderly patients with chronic diseases
Wenxi ZHU, Manfang SU, Xiaoya PENG, Yuan LI, Xiaolang CAO
Affiliations
  • 1Changsha Medical University, Hunan 410219 China
    • Corresponding Author:
    CAO Xiaolang, E-mail:
出版时间: 2026-03-25 doi: 10.12102/j.issn.1009-6493.2026.06.004
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摘要
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目的

分析老年慢性病病人存在无意义焦虑类别及其影响因素。

方法

采用方便抽样法于2024年7月—9月选取湖南省6所三级甲等医院的493例老年慢性病病人为研究对象。采用一般资料问卷、存在无意义焦虑量表、中文版自我超越量表、老年慢性病患者健康赋权量表进行问卷调查，采用潜在剖面分析和无序多分类Logistic回归模型探索老年慢性病病人存在无意义焦虑类别及其影响因素。

结果

老年慢性病病人的存在无意义焦虑可分为3个类别，即低无意义焦虑组（48.48%）、中等无意义焦虑混合组（43.41%）、高无意义焦虑组（8.11%）。Logistic回归分析结果显示，经济来源、家庭月收入、对待生活的态度、医保类型、健康赋权是老年慢性病病人存在无意义焦虑类别的影响因素（均P<0.05）。

结论

老年慢性病病人存在无意义焦虑存在群体异质性，临床护理中可根据不同类别采取针对性干预，降低老年慢性病病人的存在无意义焦虑。

老年人  /  慢性病  /  存在无意义焦虑  /  潜在剖面分析  /  影响因素  /  健康赋权
Objective

To analyze the categories and influencing factors of anxiety of the existential meaninglessness in elderly patients with chronic diseases.

Methods

A total of 493 elderly patients with chronic diseases from six tertiary grade A hospitals in Hunan province were selected as research subjects by convenience sampling from July to September 2024.A questionnaire survey was conducted using the General Information Questionnaire,Anxiety Measure of the Existential Meaninglessness Scale,Chinese Self-Transcendence Scale,and Health empowerment scale for elderly patients with chronic disease.Latent profile analysis and multinomial Logistic regression were used to explore the categories and influencing factors of anxiety of the existential meaninglessness in elderly patients with chronic diseases.

Results

Anxiety of the existential meaninglessness in elderly patients with chronic diseases could be divided into three categories,namely low existential meaninglessness anxiety group(48.48%),moderate existential meaninglessness anxiety mixed group(43.41%),and high existential meaninglessness anxiety group(8.11%).Logistic regression analysis showed that economic resources,monthly family income,attitude towards life,type of medical insurance,and health empowerment were influencing factors for the categories of anxiety of the existential meaninglessness in elderly patients with chronic diseases(all P<0.05).

Conclusions

Anxiety of the existential meaninglessness in elderly patients with chronic diseases exhibits group heterogeneity.Targeted interventions based on different categories could be implemented in clinical nursing to reduce the anxiety of existential meaninglessness in elderly patients with chronic diseases.

the elderly  /  chronic diseases  /  anxiety of the existential meaninglessness  /  latent profile analysis  /  influencing factors  /  health empowerment
朱文希, 苏曼芳, 彭晓雅, 李圆, 曹晓浪. 老年慢性病病人存在无意义焦虑的潜在类别及其影响因素. 护理研究, 2026 , 40 (6) : 916 -922 . DOI: 10.12102/j.issn.1009-6493.2026.06.004
Wenxi ZHU, Manfang SU, Xiaoya PENG, Yuan LI, Xiaolang CAO. Latent profile analysis and influencing factors of anxiety of the existential meaninglessness in elderly patients with chronic diseases[J]. Chinese Nursing Research, 2026 , 40 (6) : 916 -922 . DOI: 10.12102/j.issn.1009-6493.2026.06.004
正文
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随着我国人口老龄化趋势日益显著，老年慢性病病人数量持续增长[1-2]。第7次全国人口普查结果显示，截至2020年，我国60岁及以上老年人口已接近2.6亿人，占全国总人口的18.70%[3]。老年人不仅要应对身体机能衰退和认知功能退化带来的生理困扰，还需面对心理功能老化和适应能力下降引发的各类问题[4]。相关研究表明，长期承受疾病带来的身体不适以及社会价值感降低，可导致老年慢性病病人普遍存在对生命意义的焦虑感[5-6]。从存在主义心理学视角来看，个体具有追寻生命意义的内在需求，当这种需求得不到满足时，就可能产生存在无意义焦虑[7]。老年人是存在无意义焦虑的高发人群[8]。然而，目前针对老年慢性病病人存在无意义焦虑的横断面研究较少，且已有研究多以量表总分评价人群的存在无意义焦虑水平，忽视了个体特异性[9]。基于此，本研究运用潜在剖面分析方法探索老年慢性病病人存在无意义焦虑的类别，并深入分析不同类别的特征差异，以期为制定个性化干预方案提供理论依据。
1　对象与方法
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1.1　研究对象
采用方便抽样法于2024年7月—9月选取湖南省6所三级甲等医院内分泌科、心血管内科、神经内科等科室住院的老年慢性病病人为研究对象。纳入标准：1）年龄≥60岁；2）意识清楚、有认知判断能力；3）可独立填写问卷或虽不能独立填写问卷但可做出判断；4）知情同意，自愿参与并配合研究；5）病程（距首次确诊时间）≥6个月。排除标准：1）精神异常；2）无法自主回答问题。横断面调查研究以研究变量总数的5~10倍确定样本量。本研究总变量为32个，计算需病人160~320例，考虑20%的无效问卷，最初需选取病人192~384例。本研究已通过我院伦理审查委员会批准（编号：X2025030）。
1.2　方法
1.2.1　调查工具
1.2.1.1　一般资料问卷
阅读文献并自行编制一般资料问卷，内容包括民族、居住状况、文化程度、经济来源、家庭月收入、对待生活的态度、医保类型等。
1.2.1.2　存在无意义焦虑量表（Anxiety Measure of the Existential Meaninglessness Scale，EMS-A）
EMS-A由Li等[10]编制，中文版量表由张艳丽等[11]汉化形成，量表包含不理解的焦虑、无目标的焦虑、生命无意义的焦虑3个维度，共18个条目，每个条目均采用Likert 6级评分法，从“非常不焦虑”到“非常焦虑”依次计1~6分，总分18~108分，得分越高代表存在无意义焦虑感越严重。本研究中该量表的Cronbach's α系数为0.890。
1.2.1.3　中文版自我超越量表（Chinese Self-Transcendence Scale，CSTS）
自我超越量表由Reed[12]编制，由张晶等[13]汉化形成，共15个条目，每个条目均采用Likert 4级评分法，从“一点也不”到“非常”依次计1~4分，总分15~60分，得分越高代表自我超越水平越高，得分>45分提示自我超越水平较高、心理状态良好，≤45分提示自我超越水平较差。本研究中该量表的Cronbach's α系数为0.871。
1.2.1.4　老年慢性病患者健康赋权量表
老年慢性病患者健康赋权量表由杨阳等[14]编制，包含责任信念、获取支持、增长知识、参与治疗和重建自我5个维度，共26个条目，每个条目从“非常不同意”到“非常同意”依次计1~5分，总分26~130分，得分越高代表健康赋权水平越高。本研究中该量表的Cronbach's α系数为0.883。
1.2.2　资料收集与质量控制方法
发放问卷前，由经过统一培训的研究小组成员使用统一的指导语向病人介绍本研究的目的及意义。问卷由研究小组发放，由老年慢性病病人独立填写。对于无法独立填写问卷的老年人，由研究者以面对面问答形式协助其完成。问卷填写完成后当场收回。由2名研究小组成员进行双人录入及核对，检查有无漏项并剔除规律性作答问卷。本研究共发放问卷520份，剔除不合格问卷27份，回收有效问卷493份，问卷有效回收率为94.81%。
1.2.3　统计学方法
采用SPSS 27.0及Mplus 8.3软件进行数据分析。通过潜在剖面分析对老年慢性病病人存在无意义焦虑进行分类,根据潜在剖面分析结果确定老年慢性病病人存在无意义焦虑类别，模型拟合指数包括艾凯克信息准则（Akaike information criterion,AIC）、贝叶斯信息准则（Bayesian information criterion,BIC）、样本校正的贝叶斯信息准则（adjusted BIC,aBIC）、熵（Entropy）、基于Bootstrap的似然比检验（the Bootstrap likelihood ratio test,BLRT）、似然比检验（Lo-Mendell-Rubin test,LMRT），其中，AIC、BIC、aBIC数值越小，熵值（取值0~1）越接近1，表明模型的拟合程度越好[15]；BLRT和LMRT有统计学意义，代表k个类别的模型显著优于k-1个类别的模型[16]，采用判别分析对分类的后验概率进行检验。对老年慢性病病人存在无意义焦虑类别影响因素进行单因素分析，符合正态分布的定量资料以均数±标准差（x±s）表示，组间比较采用方差分析；定性资料以频数及百分比（%）表示，组间比较采用χ2检验；判断数据是否符合平行性假设，不符合平行性假设采用无序多分类Logistic回归分析进行老年慢性病病人存在无意义焦虑类别影响因素的多因素分析。以P<0.05为差异有统计学意义。
2　结果
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2.1　老年慢性病病人存在无意义焦虑的潜在剖面分析
对493例老年慢性病病人的EMS-A得分进行潜在剖面分析，以18个条目为外显指标，共拟合1~5个模型，见表2。类别1~类别5的AIC、BIC、aBIC逐渐减小，类别3的Entropy值最高，且LMRT和BLRT均有统计学意义（P<0.05），因此，选择类别3为最优模型。见表1。
2.2　老年慢性病病人存在无意义焦虑类别特征及命名
基于EMS-A的18个条目得分绘制3个类别的特征分布图，结果显示，类别1共239例（48.48%）病人，其EMS-A总分为（30.49±3.71）分，低于其他类别且该类别EMS-A各条目得分均低于其他类别，因此命名为“低无意义焦虑组”。类别2共214例（43.41%）病人，其EMS-A总分为（42.73±3.98）分，处于其他两个类别之间且EMS-A各条目得分显示出一定的水平波动与不确定性，因此命名为“中等无意义焦虑混合组”。类别3共40例（8.11%）病人，其EMS-A总分为（58.38±7.17）分，高于其他类别且EMS-A各条目得分均高于其他类别，因此命名为“高无意义焦虑组”。见图1。
2.3　不同类别老年慢性病病人EMS-A得分比较（见表2）
2.4　老年慢性病病人存在无意义焦虑类别影响因素的单因素分析（见表3）
2.5　老年慢性病病人存在无意义焦虑类别影响因素的多因素分析
以潜在剖面分析确定的老年慢性病病人存在无意义焦虑3个类别作为因变量，将单因素分析中有统计学意义的变量（P<0.05）作为自变量，进行无序多分类Logistic回归分析。自变量赋值方式见表4。无序多分类Logistic回归分析结果见表5。
3　讨论
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3.1　老年慢性病病人的存在无意义焦虑现象较严重且具有群体异质性
本研究通过潜在剖面分析发现，老年慢性病病人的存在无意义焦虑可分为低无意义焦虑组、中等无意义焦虑混合组、高无意义焦虑组，提示老年慢性病病人存在无意义焦虑具有群体异质性。1）低无意义焦虑组（48.48%）病人的存在无意义焦虑水平较低，这可能与其具有相对稳定的家庭支持有关。配偶作为主要照料者可能通过情感陪伴和日常生活协助减轻病人孤独感，同时城镇居民医保覆盖可减轻医疗负担，间接缓解焦虑，从而维持病人积极的生活态度，与既往研究强调家庭支持和经济安全对老年人心理健康的保护作用结论一致[17]。2）中等无意义焦虑混合组（43.41%）存在无意义焦虑处于中间水平，子女的经济支持可能部分缓解其心理压力，但低收入可能迫使其减少娱乐或社交支出，进一步降低社会参与度。需要适当的干预缓解焦虑以免进一步发展。3）高无意义焦虑组（8.11%）存在无意义焦虑水平较高，这可能与该类病人文化程度较低有关，已有研究结果显示，低文化程度等因素会对老年慢性病病人的心理状态产生负面影响[18]。低文化程度会在一定程度上限制获取健康知识和心理调节资源的能力，导致病人在面对疾病时更容易产生各种焦虑。对于老年慢性病病人而言，焦虑情绪会很大程度上对疾病的治疗产生不良影响[19]，故应积极干预。
3.2　老年慢性病病人存在无意义焦虑类别的影响因素
3.2.1　经济来源
本研究结果显示，与高无意义焦虑组相比，经济来源为子女供养的病人更易归为低无意义焦虑组（P<0.05)，与Wang等[20]的研究结果一致。子女供养不仅是经济支持，更包含着情感陪伴，可以在一定程度减轻老年慢性病病人的经济负担与心理压力[21]。而缺乏子女供养的病人，需独自承担医疗与生活压力，更易出现焦虑情绪。同时，经济上的不自主会使老年人在治疗和生活方面的决策受限，从而进一步加重焦虑情绪[22]。因此，医护人员应重点关注无子女供养的老年慢性病病人，可协助其申请社区养老服务等社会支持资源以减轻经济压力，此外，还可以为病人提供合适的社交活动或建立兴趣，帮助他们转移注意力，提升自我价值感，从而缓解因经济来源问题导致的存在无意义焦虑。
3.2.2　家庭月收入
本研究结果显示，与高无意义焦虑组相比，家庭月收入较低的病人较易归于低无意义焦虑组和中等无意义焦虑混合组（P<0.05）。李进等[19]研究结果显示，收入与焦虑情绪紧密相关，低收入会使老年慢性病病人在应对医疗费用和日常生活时面临巨大压力，病人会对未来生活感到担忧，在疾病应对过程中面临更多现实压力。但本研究中，低收入病人更易归为低无意义焦虑组和中等无意义焦虑组，原因可能与低收入人群长期形成的适应特点有关。低收入人群生活压力往往较大，心理困扰以现实焦虑为主，对生命意义的追求可能更加朴素，较少陷入抽象的存在性思考，因此存在无意义焦虑程度较低[23]。在临床工作中，医护人员应结合病人实际需求开展个性化评估，积极为他们提供医疗救助和补贴等相关信息，可联合社区为病人提供生活便利，减轻病人的现实压力，通过正向引导等方式帮助病人正视自身价值，降低病人的存在无意义焦虑水平。
3.2.3　对待生活的态度
本研究结果显示，与高无意义焦虑组相比，对待生活态度消极的老年慢性病病人更易归为中等无意义焦虑混合组（P<0.05）。慢性病病程较长，且往往涉及多个系统，较难在短期内完全治愈。已有研究结果显示，当病人感觉实际治疗过程与想象不符甚至出现病情波动时，会产生巨大的心理落差，进而出现情绪低落等负面情绪[24]。但本研究中，消极病人更易归为中等无意义焦虑混合组，这可能与其拥有一定的家庭支持、社会联系或基础心理调适能力有关[25-26]，同时临床医疗和护理干预的早期介入等也会在一定程度上缓解焦虑水平[27]。在临床护理过程中，医护人员应积极对老年慢性病病人生活态度给予关注，及时识别消极情绪，可通过加强沟通、提供情感支持等方式联合家属共同引导病人调整心态，鼓励病人参与力所能及的日常活动，从中获得成就感与价值感，逐步改善消极心态，降低存在无意义焦虑水平。
3.2.4　医保类型
本研究结果显示，与中等无意义焦虑混合组相比，有城镇居民医保的病人更易归为低无意义焦虑组（P<0.05），与Renzaho等[28]研究的医保保障程度影响病人心理状态的结果相似。医保在一定程度上可以减少病人经济压力，从而降低焦虑，但也应注意老年慢性病病人病程较长，医疗费用较高，容易超过医保报销限额[29]，可能对病人及其家庭的经济状况造成影响，这种经济压力会逐渐增加治疗负担，从而导致病人焦虑[30]。医护人员应重视这一问题，加强医保政策宣传，帮助病人了解医保报销的具体过程。建议政府部门进一步完善城镇居民医保政策，扩大报销范围，提高报销比例，优化特殊慢性病报销待遇，切实减轻病人经济压力，降低存在无意义焦虑的发生风险。
3.2.5　健康赋权
本研究结果显示，健康赋权的获取支持、参与治疗、重建自我维度得分较高的病人更易归为中等无意义焦虑混合组或高无意义焦虑组，研究表明参与治疗、重建自我和获取支持水平较高是老年慢性病病人存在无意义焦虑的危险因素，与陈俊杰等[31]提出的病人自我管理能力会影响心理健康观点有相似之处，但与杨阳等[32]研究结果不同。杨阳等[32]研究结果显示，当老年慢性病病人健康赋权不足时，他们在疾病治疗和自我管理方面缺乏主动性和参与感，对自身健康状况的了解和掌控能力较弱，容易感到无助和恐惧，其研究结果与本研究结果不同的原因可能与病人健康赋权过高导致存在无意义焦虑中的生命无意义焦虑变高有关。病人对自身健康状况的了解越多、掌控能力越强可能越会对自己的存在感到没有意义，越了解自身的病情状况可能越会对后续的治疗存在担忧，使生命无意义的焦虑加重。医护人员应重视这一类老年慢性病病人，加强与其沟通，耐心倾听其焦虑原因并给予相应的心理护理，精准、专业地解答疾病相关疑问，消除信息不确定性给病人带来的担忧。同时，要肯定病人对健康的重视，帮助他们客观看待疾病，区分合理关注和过度焦虑。将他们的健康赋权能力用于积极方面，如制订科学的康复计划等，帮助病人降低存在无意义焦虑，理性对待健康管理。
4　小结
收起
老年慢性病病人存在无意义焦虑具有群体异质性，可分为低无意义焦虑组、中等无意义焦虑混合组、高无意义焦虑组3类。经济来源、家庭月收入、对待生活的态度、医保类型、健康赋权是老年慢性病病人存在无意义焦虑类别的影响因素。医护人员应重点关注高无意义焦虑组病人。在交流时温和引导病人倾诉，解答病人疑惑；护理时密切关注病人的情绪变化并及时安抚，提供细致的护理，增加病人信心；和家属合作让病人感受到温暖，减轻焦虑。但本研究也存在一定局限性，如本研究为横断面研究，同时研究对象仅来自湖南省内，样本代表性不足。未来研究可采用多中心、大样本的随机抽样方法；同时结合访谈、观察等多种研究方法，更全面地了解老年慢性病病人存在无意义焦虑状况及其影响因素。

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2026年第40卷第6期
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doi: 10.12102/j.issn.1009-6493.2026.06.004
  • 接收时间：2025-04-23
  • 首发时间：2026-10-28
  • 出版时间：2026-03-25
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  • 收稿日期：2025-04-23
  • 修回日期：2026-02-09
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鹅膏菌科Amanitaceae 2 11 5.26 鹅膏菌属 Amanita 10 4.78
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红菇科 Russulaceae 3 23 11.00 小皮伞属 Marasmius 6 2.87
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