目的 了解老年压力性损伤(pressure injury,PI）患者躯体复原力（physical resilience，PR）的动态变化及影响因素，为临床护理实践提供精准干预策略。 方法 2022年10月至2024年10月，采用便利抽样法选取在浙江省某三级甲等医院治疗的老年PI患者140例为研究对象，使用老年人躯体复原力量表、简版老年抑郁量表等工具，在其确诊PI并住院治疗的第1周内（T1）、治疗1个月（T2）和2个月（T3）进行追踪调查。通过潜类别增长拟合PR轨迹，多元Logisti回归分析确定影响因素。 结果 T1、T2、T3阶段，129例患者的躯体复原力量表得分分别为（25.27±7.15）分、（26.99±9.48）分和（28.31±8.91）分。根据PR纵向轨迹变化，将其分为C1（PR下降组，27.13%）、C2（PR稳定组，48.84%）、C3（PR上升组，24.03%）3类。不定期翻身、缺乏PI知识教育、抑郁程度高、日常生活活动（activities of daily living,ADL）能力差、营养状况不佳是C1的影响因素。而合并其他疾病种类少、抑郁程度低、ADL能力好、营养状况佳是C3影响因素。 结论 老年PI患者的PR轨迹具有群体异质性，应根据个体差异制订针对性的干预措施。

Objective To explore the dynamic trajectories and influencing factors of physical resilience (PR) in elderly patients with pressure injury (PI),and to provide precise intervention strategies for clinical nursing practice.Methods A total of 140 elderly PI patients from a tertiary A hospital in Zhejiang Province were selected by the convenience sampling method from October 2022 to October 2024,and a survey was conducted with physical resilience instrument for older adults (PRIFOR) and the geriatric depression scale-15(GDS-15) at 3 time points,i.e.within the first week after diagnosis of PI or hospitalization (T1),one month after treatment (T2),and two months after treatment (T3).Latent class growth analysis (LCGA) was used to identify PR trajectories,and logistic regression explored influencing factors.Results At the T1,T2,and T3 stages,the scores of the PRIFOR for 129 patients were (25.27±7.15) points,(26.99±9.48) points, and (28.31±8.91) points,respectively.According to the longitudinal trajectory changes of PR,they were classified into 3 categories:C1 (PR decline group,27.13%),C2 (PR stable group,48.84%),and C3 (PR increase group,24.03%).Turning over at irregular intervals,lack of pressure ulcer knowledge education,high depression level, poor activities of daily living(ADL) ability,and poor nutritional status were the influencing factors of C1.While having fewer other diseases,low depression level,good ADL ability,and good nutritional status were the influencing factors of C3.Conclusions The PR trajectories of elderly PI patients show population heterogeneity,and targeted intervention measures should be formulated based on individual differences.

R473.59

浙江省中医药科技计划临床研究应用项目 （2024ZL034）