【摘要】 目的 探讨头颈部肿瘤(head and neck cancer, HNC)患者放疗期间衰弱变化的轨迹及其影响因素，为临床护理人员管理衰弱提供数据支持和理论参考。方法 2023年4-12月，采用便利抽样法选取在长沙市某三级甲等医院接受放疗的202例HNC患者为研究对象，使用一般资料及疾病资料调查表、日常生活能力评定量表(Activity of Daily Living Scale, ADL)、阿森斯失眠量表(Athens Insomnia Scale, AIS)、蒂尔堡衰弱量表(Tilburg Frailty Indicator, TFI)对其放疗前、放疗第3周末及放疗毕的衰弱情况进行调查。使用潜在类别增长模型识别患者衰弱的变化轨迹，并采用二元Logistic回归分析轨迹的影响因素。结果 202例患者，识别出2类衰弱变化轨迹，分别为“低水平缓慢上升组(54.50%)”和“高水平快速上升组(45.50%)”;年龄、体质量指数(body mass index, BMI)、治疗方式、日常生活能力和失眠是HNC患者放疗期间衰弱变化轨迹的影响因素(均P<0.05)。结论 HNC患者放疗期间衰弱变化轨迹呈上升趋势，存在异质性；临床护理人员应根据衰弱变化轨迹实施精准化干预措施。更多还原

【Abstract】 Objective To investigate the trajectories of frailty and their influencing factors in head and neck cancer(HNC) patients undergoing radiotherapy, thereby providing data support and a theoretical framework for clinical frailty management in nursing practice.Methods From April to December 2023,202 HNC patients receiving radiotherapy at a tertiary A hospital in Changsha were conveniently sampled.Data were collected using the General Information Questionnaire, Activity of Daily Living Scale(ADL),Athens Insomnia Scale(AIS),and Tilburg Frailty Indicator(TFI) at three time points: before radiotherapy, at the end of the third week of radiotherapy, and upon completion of radiotherapypre-radiotherapy, 3 weeks’ post-radiotherapy initiation, and post-radiotherapy completion.Latent class growth modeling identified frailty trajectories, and binary logistic regression was used to analyze influencing factors.Results Two distinct frailty trajectories were identified: a low-level gradual increase group(54.50%) and a high-level rapid increase group(45.50%).Key influencing factors included age, body mass index(BMI),treatment modality, self-care ability, and insomnia.Conclusions Frailty trajectories during radiotherapy in HNC patients show increasing trends with heterogeneity.Clinical nurses should implement precision interventions tailored to different frailty trajectories.更多还原