目的 探讨居家安宁疗护家庭照顾者照护能力的潜在类别及其影响因素。方法 2025年1-3月，便利抽样法选取上海市4家社区卫生服务中心的280名正在接受或3个月内曾接受居家安宁疗护服务的临终患者家庭照顾者为研究对象，采用一般资料调查表、居家安宁疗护家庭照顾者照护能力量表、中文版一般自我效能量表、医学应对方式问卷对其进行调查。运用Mplus 8.3软件进行潜在剖面分析，采用单因素分析与无序多分类Logistic回归分析其影响因素。结果 居家安宁疗护家庭照顾者照护能力可划分为4个类别：全面薄弱组（7.5%）、双峰优势组（14.3%）、均衡中等组（48.4%）、综合高能组（29.8%）。居住地、自我效能、应对方式是居家安宁疗护家庭照顾者照护能力潜在类别的影响因素（均P＜0.05）。结论 居家安宁疗护家庭照顾者照护能力存在异质性，医务人员应根据不同类别的家庭照顾者能力特征，制订个体化的照护能力提升策略，以提升居家临终患者的死亡质量。

Objective To explore the latent profiles and influencing factors of caregiving competence of family caregivers in home-based hospice.Methods From January to March 2025,280 family caregivers of terminally-ill patients receiving (or having received within the past 3 months) home-based hospice care services from 4 community health centers in Shanghai were selected via convenience sampling.Data were collected using a general information questionnaire,the Home-Based Hospice Family Caregiver Competence Scale,the Chinese version of the General Self-Efficacy Scale,and the Medical Coping Modes Questionnaire.Latent profile analysis was conducted using Mplus 8.3,and univariate analysis and multinomial logistic regression were used to identify influencing factors.Results The caregiving competence of family caregivers in home-based hospice was classified into 4 latent profiles:comprehensively weak(7.5%),dual-peak strong(14.3%),balanced intermediate(48.4%),and comprehensively competent(29.8%).Residence location,self-efficacy,and coping style were significant influencing factors (all P＜ 0.05).Conclusions Family caregivers in home-based hospice exhibit heterogeneous caregiving competence.Healthcare professionals should develop tailored strategies to enhance competence based on different caregiver profiles,thereby improving the quality of life before death for home-based terminally-ill patients.

R473.2

国家社会科学基金一般项目（22BSH106）；老年长期照护教育部重点实验室（海军军医大学）