目的 分析宫颈癌患者术后同步放化疗（concurrent chemoradiotherapy,CCRT)期间的心理痛苦发展轨迹及其影响因素。方法 采用便利抽样法，选取2022年6月至2024年3月在安徽省某三级甲等医院就诊的宫颈癌患者为研究对象，采用痛苦温度计等工具调查患者术后、首次化疗、化疗中期、化疗结束及化疗结束3个月后痛苦水平。通过增长混合模型识别患者心理痛苦的发展轨迹，并运用多分类logistics回归分析轨迹的影响因素。结果 共纳入177例患者，识别4个心理痛苦轨迹，分别为“无痛苦组”“中度痛苦组”“缓解组”和“调试组”；肿瘤分期、体育锻炼、照顾者健康状况、领悟社会支持、夫妻疾病沟通、恐惧疾病进展及负向信息注意水平是宫颈癌患者术后CCRT期间心理痛苦发展轨迹的影响因素（均P＜0.05）。结论 宫颈癌患者术后CCRT期间心理痛苦存在群体异质性，护理人员应根据心理痛苦变化轨迹实施针对性干预措施。

Objective To analyze the development trajectory of psychological distress in patients with cervical cancer undergoing CCRT and identify the influencing factors.Methods A convenience sampling method was employed to select patients with cervical cancer who underwent CCRT at a hospital in Anhui Province from June 2022 to March 2023.The psychological distress levels were assessed using the DT at five time points:post-surgery,first chemotherapy,mid-chemotherapy,end of chemotherapy,and three months after chemotherapy.GMM was used to identify the trajectory of psychological distress,and a multinomial logistics regression analysis was conducted to explore the influencing factors.Results A total of 177 patients were included,and four distinct psychological distress trajectories were identified:the “No Distress Group,” “Moderate Distress Group,” “Relief Group,” and “Regulatory Group.” The influencing factors of these trajectories included tumor staging,physical exercise,caregiver health status,social support,communication about the disease with a partner,fear of disease progression,and attention to negative information (all P＜0.05).Conclusions Psychological distress in patients with cervical cancer during CCRT exhibits heterogeneity,and targeted interventions should be implemented based on the trajectory of psychological distress to improve patient outcomes.

R473.6；R473.73

蚌埠医科大学科研课题（2024byzd163sk）