Latent Class Of Symptom Cluster And Its Relationship With Quality Of Life In Patients With Knee Osteoarthritis

Objective To understand the individual differences in symptoms experienced among patients with knee osteoarthritis,to analyze and identify the latent class of symptom clusters,and to explore the differences of each latent class of symptom clusters in demographic characteristics,disease characteristics,demographic characteristics and quality of life(QOL).Methods A cross-sectional survey method was used in this study.Patients with knee osteoarthritis were selected from 2 tertiary hospital in Jinan via convenience sampling method,and the data were collected from March to June in 2019.We used the self-designed general data questionnaire,Numerical Rating Scale,Hospital Anxiety and Depression Scale,Fatigue scale-14,Self-rating scale of sleep,Self-efficacy for Managing Chronic Disease,the MOS item short from health survey as research tools.Mplus7.0 software was used to fit the latent class of symptom clusters of patients with knee osteoarthritis.The characteristics of different latent classes were analyzed by Spss22.0.Specific statistical methods:descriptive analysis,one-way ANOVA.chi square test,latent profile analysis,multiple logistic regression analysis,multiple linear analysis.Results1.230 knee osteoarthritis patients had a pain score of(5.78±1.49).mild pain accounted for 3.5%,moderate pain accounted for 67.8%,and severe pain accounted for 28.7%;39.6%of patients were screened for mild and above anxiety symptoms,anxiety score was(6.84±3.59);38.3%of patients had mild or above depressive symptoms,depression score was(6.57±3.]4);fatigue score was(6.43±3.92),including physical fatigue(4.50 ±3.11)),mental fatigue(1.94±1·64);sleep score(24.18 ± 7.49).The quality of life score was(44.18 ±17.16),including physiological function(36.70± 18.38).physiological function(21.09 ± 31.71).physical pain(40.11± 19.93),overall health(48.56 ± 17.92),vitality(61.46 ± 16.42),social function(47.77± 24.47),emotional function(35.94 ± 39.80),mental health(61.84 ± 15.76).2.According to the latent profile analysis and practical significance,the symptom clusters of patients with knee osteoarthritis is divided into three latent classes:Low Symptom Class(LSC,56%),High Psychological Disorder Class(HPDC,24%),High Fatigue and Sleep Disorder Class(HFSDC,20%).3.Logistic regression analysis showed that there were significant differences between these three latent classes in education,age,chronic comorbidities,economic status,imaging grade of knee joint,negative life events and self-efficacy level among the participants(P<0.05).Compared with LSC,HPDC tended to be poor economic status,higher imaging grade of knee join and low self-efficacy.Compared with LSC,the older,less educated,more complicated with other chronic diseases,have experienced negative life events in the past year,and lower self-efficacy level were more likely to appear in HFSDC.4.The results of multiple linear regression analysis showed that the QOL scores of knee osteoarthritis patients in HPDC and HFSDC were lower than those in LSC(P<0.01),the scores between HPDC and HFSDC were also statistically different(P<0.01);but,after controlling demographic characteristics,disease characteristics and individual characteristics,there was no significant difference in QOL between these two groups(P>0.05).Conclusion1.Patients with knee osteoarthritis experienced multiple symptoms,including pain,anxiety,depression,fatigue and sleep disorders.The total score of QOL was lower than the standard value of domestic norm,which suggested that medical staff should pay attention to the evaluation of patients' symptoms,reduce the burden of symptoms and improve the QOL.2.There was obvious heterogeneity among the symptom clusters in patients with knee osteoarthritis,which can be divided into three classes:LSC,HPDC and HFSDC.3.The three latent classes of symptom clusters had significant differences among age,education level,economic status,chronic complications,image classification of knee joint,negative life events,self-efficacy level.4.The QOL of knee osteoarthritis patients in LSC was significantly higher than that in HPDC and HFSDC.However,there was no significant difference between HPDC and HFSDC in QOL.