关键词: 脆性骨折；老年患者；自我效能；潜变量增长混合模型

Abstract: Objective: To explore the differences and influencing factors of the development trajectories of self-efficacy among elderly patients with fragile fractures based on the latent growth mixture model. Methods: A total of 266 elderly patients with fragile fractures who received treatment in a hospital in Jiangxi province from March 2021 to March 2024 were recruited using convenience sampling. The Osteoporosis Self-efficacy Scale was used to assess the patients' self-efficacy level before treatment and 1 month, 3 months, 6 months after treatment. The latent growth mixture model was applied to identify the optimal number of trajectory categories and characterize the classes. Multinomial Logistic regression were used to identify the independent influencing factors of trajectory differences. Results: The development trajectories of self-efficacy was divided into 4 categories: 36 cases (13.53%) in the low efficacy-maintaining type, 87 cases (32.71%) in the low efficacy-improving type, 78 cases (29.32%) in the moderate efficacy-improving type, and 65 cases (24.44%) in the high efficacy-improving type. Age, educational level, income, fracture site, treatment method, use of anti-osteoporosis drugs, cognitive function, depression, anxiety, and social support level were all independent influencing factors for the differences in self-efficacy development trajectories (P<0.05). Conclusion: There is certain heterogeneity in the development trajectories of self-efficacy among elderly patients with fragile fractures. Medical staff should formulate personalized nursing measures based on the influencing factors to ensure the improvement of patients' self-efficacy.

Key words: fragility fracture; elderly patients; self-efficacy; latent growth mixture model