young and middle-aged

青壮年
  • 文章类型: English Abstract
    UNASSIGNED: To compare the effectiveness of biplanar vertical fixation and inverted triangle fixation with hollow screw for Pauwels type Ⅲ femoral neck fracture in young and middle-aged patients.
    UNASSIGNED: The clinical data of 55 young and middle-aged patients with Pauwels type Ⅲ femoral neck fracture between June 2021 and December 2022 was retrospectively analyzed. All patients were treated with closed reduction and internal fixation with hollow screws, 25 cases were treated with biplanar vertical fixation (study group), 30 cases with inverted triangle fixation (control group). There was no significant difference in gender, age, affected side, cause of injury, underlying diseases, and time from injury to operation between the two groups ( P>0.05). The operation time, intraoperative blood loss, fluoroscopy times, guide needle puncture times, starting time of weight bearing, time of full weight bearing, time of fracture healing, and complications were recorded and compared between the two groups. The hip joint function was evaluated by Harris score at 1 day, 6 months, 12 months after operation, and at last follow-up, and the pain relief was evaluated by visual analogue scale (VAS) score. The femoral neck shortening was measured on the X-ray film at last follow-up.
    UNASSIGNED: All patients were followed up 12-31 months (mean, 22.0 months), and there was no significant difference in follow-up time between the two groups ( P>0.05). The operation time, intraoperative blood loss, and fluoroscopy times in the study group were higher than those in the control group, but the difference was not significant ( P>0.05). The guide needle puncture times in the study group was more than that in the control group, and the time of starting weight bearing and the time of full weight bearing in the study group were shorter than those in the control group, the differences were significant ( P<0.05). Bony healing was achieved in both groups, and there was no significant difference in fracture healing time between the two groups ( P>0.05). No osteonecrosis of the femoral head and incision-related complication was found in the two groups during follow-up, and the femoral neck shortening length in the study group was significantly shorter than that in the control group at last follow-up ( P<0.05). There was no significant difference in Harris score between the two groups at 1 day after operation ( P>0.05), and the Harris score of the study group was significantly better than that of the control group at other time points ( P<0.05); there was no significant difference in VAS score between the two groups at each time point after operation ( P>0.05).
    UNASSIGNED: Compared with the inverted triangle fixation, the treatment of Pauwels type Ⅲ femoral neck fracture with biplanar vertical fixation can effectively reduce femoral neck shortening without affecting fracture healing, and improve hip joint function in early stage.
    UNASSIGNED: 比较空心螺钉双平面垂直固定与倒三角固定治疗中青年Pauwels Ⅲ型股骨颈骨折的临床疗效。.
    UNASSIGNED: 回顾分析2021年6月—2022年12月收治且符合选择标准的55例中青年Pauwels Ⅲ型股骨颈骨折患者临床资料。均采用闭合复位空心螺钉治疗,25例采用双平面垂直固定(研究组),30例采用倒三角固定(对照组)。两组患者性别、年龄、患侧侧别、致伤原因、合并基础疾病、受伤至手术时间等基线资料比较差异均无统计学意义( P>0.05)。记录并比较两组手术时间、术中出血量、透视次数、导针穿刺次数、开始负重时间、完全负重时间、骨折愈合时间及并发症发生情况;术后1 d、6个月、12个月及末次随访时,采用Harris评分评价髋关节功能,疼痛视觉模拟评分(VAS)评价疼痛缓解情况。末次随访时于X线片上测量股骨颈短缩长度。.
    UNASSIGNED: 两组患者均获随访,随访时间12~31个月,平均22.0个月;两组随访时间比较差异无统计学意义( P>0.05)。研究组手术时间、术中出血量、透视次数均多于对照组,但差异无统计学意义( P>0.05);研究组导针穿刺次数多于对照组,开始负重时间及完全负重时间均短于对照组,差异有统计学意义( P<0.05);两组患者均获骨性愈合,骨折愈合时间差异无统计学意义( P>0.05)。随访期间两组均未发生股骨头坏死及切口相关并发症,末次随访时研究组股骨颈短缩长度明显短于对照组( P<0.05)。除术后1 d两组Harris评分比较差异无统计学意义( P>0.05)外,其余时间点研究组Harris评分均优于对照组( P<0.05);术后各时间点两组VAS评分比较差异均无统计学意义( P>0.05)。.
    UNASSIGNED: 与倒三角固定相比,利用空心螺钉双平面垂直固定治疗中青年Pauwels Ⅲ型股骨颈骨折能有效减少股骨颈短缩且不影响骨折愈合,早期恢复髋关节功能,临床疗效肯定。.
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  • 文章类型: Editorial
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  • 文章类型: Journal Article
    目的:本研究旨在探讨首发急性心肌梗死(AMI)中青年患者心理社会适应水平的变化趋势和群体异质性及其影响因素。
    结果:使用疾病心理社会适应量表评估患者出院后1、3和6个月的心理社会适应水平,分别。数据采用Pearson相关分析,广义估计方程,和增长混合模型。共纳入233例患者,三个时间点的心理社会适应得分分别为57.18±15.50、36.17±15.02和24.22±12.98。患者心理社会适应水平的变化轨迹分为三个潜在类别:中度调整改善组(72.5%),低调整改善组(16.3%),和持续性不适应组(11.2%)。其中,持续性适应不良组的预测因素不包括配偶,家庭人均月收入低,正常体重指数,从不吸烟,从不锻炼,合并高脂血症,社会支持低,提交应对,和高感知压力。
    结论:中青年首发AMI患者出院后6个月内心理社会适应水平呈上升趋势。心理社会适应水平的变化轨迹存在群体异质性。有人建议多中心,未来应开展大样本纵向研究,延长随访调查时间,进一步明确不同亚型患者心理社会适应的变化轨迹及影响因素,为制定有针对性的干预方案提供理论依据。
    OBJECTIVE: This study aimed to explore the change trend and group heterogeneity of psychosocial adjustment level and to determine its influencing factors among young and middle-aged patients with first-episode acute myocardial infarction (AMI).
    RESULTS: The Psychosocial Adjustment Scale of Illness was used to assess the psychosocial adjustment level of the patients at 1, 3, and 6 months after discharge, respectively. Data were analyzed using Pearson correlation analysis, generalized estimating equations, and growth mixed models. A total of 233 patients were included, and their psychosocial adjustment scores at the three-time points were 57.18 ± 15.50, 36.17 ± 15.02, and 24.22 ± 12.98, respectively. The trajectories of changes in patients\' psychosocial adjustment levels were divided into three latent categories: moderate adjustment improvement group (72.5%), low adjustment improvement group (16.3%), and persistent maladjustment group (11.2%). Among them, predictors of the persistent maladjustment group included no spouse, low monthly family income per capita, normal body mass index, never smoking, never exercising, combined with hyperlipidemia, low social support, submission coping, and high perceived stress.
    CONCLUSIONS: The psychosocial adjustment level of young and middle-aged patients with first-episode AMI showed an upward trend within 6 months after discharge, and there was group heterogeneity in the change trajectory of psychosocial adjustment level. It is suggested that a multi-center, large-sample longitudinal study should be carried out in the future, and the time of follow-up investigation should be extended to further clarify the change trajectory and influencing factors of psychosocial adjustment of patients with different subtypes, to provide the theoretical basis for formulating targeted intervention programs.
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  • 文章类型: Journal Article
    急性心肌梗死(AMI)后的心理健康影响患者的预后。复原力可能有助于改善患者的心理健康。然而,尚无研究调查首次AMI后接受急诊经皮冠状动脉介入治疗(PCI)的中青年患者的韧性及其相关因素.这项研究旨在确定影响这些患者心理弹性的关键相关因素。这项横断面研究使用有目的的抽样方法招募了161名首发AMI的中青年患者。这些患者在急诊PCI术后48小时使用一般信息问卷进行评估,康纳-戴维森弹性量表-10,感知社会支持量表,一般自我效能感量表,和创伤后应激障碍量表平民版。采用逐步回归和logistic回归分析心理弹性的影响因素。使用接受者操作特征(ROC)来比较每个指标的曲线下面积(AUC)。161名参与者的弹性为29.50±4.158。家庭月收入,自我效能感,社会支持,创伤后应激障碍解释了51.4%的韧性差异。自我效能(OR0.716,CI0.589~0.870,P<0.01)和社会支持(OR0.772,CI0.635~0.938,P<0.01)是心理韧性的保护因素,创伤后应激障碍(OR1.278,CI1.077-1.515,P<0.01)是创伤后应激障碍的危险因素。ROC曲线显示,自我效能感,社会支持,和PTSD的AUC分别为0.822、0.855和0.889。自我效能感和社会支持提高,PTSD降低了接受急诊PCI的中青年AMI患者的心理弹性。
    Mental health after acute myocardial infarction (AMI) influences the prognosis of patients. Resilience may contribute to improving a patient\'s mental health. However, no study has investigated resilience and its associated factors in young and middle-aged patients undergoing emergency percutaneous coronary intervention (PCI) after the first AMI. This study aimed to identify critical associated factors influencing resilience in these patients. This cross-sectional study recruited 161 young and middle-aged patients with first-episode AMI using a purposive sampling method. These patients were assessed 48 h after emergency PCI using the General Information Questionnaire, the Connor-Davidson Resilience Scale-10, the Perceived Social Support Scale, the General Self-Efficacy Scale, and the Post-traumatic Stress Disorder Scale Civilian Version. Stepwise and logistic regression were conducted to analyze the factors influencing resilience. Receiver operating characteristics (ROC) were used to compare the area under the curves (AUC) for each indicator. The resilience of the 161 participants was 29.50 ± 4.158. Monthly household income, self-efficacy, social support, and post-traumatic stress disorder explained 51.4% of the variance in resilience. Self-efficacy (OR 0.716, CI 0.589-0.870, P < 0.01) and social support (OR 0.772, CI 0.635-0.938, P < 0.01) were protective factors for psychological resilience, while post-traumatic stress disorder (OR 1.278, CI 1.077-1.515, P < 0.01) was a risk factor. ROC curve revealed that self-efficacy, social support, and PTSD had an AUC of 0.822, 0.855, and 0.889, respectively. Self-efficacy and social support improve, and PTSD degrades psychological resilience in young and middle-aged AMI patients undergoing emergency PCI.
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  • 文章类型: Journal Article
    背景:急性心肌梗死(AMI)的发病率在中青年人群中呈上升趋势,从个人和社会的角度来看,此类患者在AMI事件后需要重新就业。然而,AMI后就业情况不理想。早期识别易受工作能力下降的患者并提供有针对性的干预可能是有益的。
    目的:探讨中青年AMI患者工作能力的特点及影响因素。
    方法:在广州进行了一项横断面研究,中国,从2022年9月到2023年10月。工作能力,重返工作岗位的自我效能感,社会支持,焦虑,抑郁是通过工作能力支持量表(WSS)测量的,回归工作自我效能感问卷,社会支持评定量表,7项广义焦虑症量表,和患者健康问卷9。我们使用Mplus8.3基于WSS的三个子域进行了潜在谱分析。采用多因素logistic回归分析与工作能力相关的因素。
    结果:共有155名参与者(年龄48.58±7.153岁,男性占95.5%)。我们确定了三个潜在的工作能力:低工作能力(28.1%),中等工作能力(51%),和较高的工作能力(20.6%)。家庭人均月收入,NYHA功能类,总胆固醇,住院时间,社会支持,返回工作的自我效能感是与工作能力相关的因素。
    结论:本研究显示了中青年AMI患者工作能力的不同特征和相关因素。建议医疗保健提供者识别和监测相关因素,以提高该亚群的工作能力。
    BACKGROUND: The incidence of acute myocardial infarction (AMI) is increasing among young and middle-aged people, and such patients need to be reemployed after AMI events from the individual and society perspectives. However, the situation of employment after AMI was not ideal. Early identification of patients vulnerable to decreased work ability and provided targeted intervention may be beneficial.
    OBJECTIVE: To identify the profiles and associated factors of work ability in young and middle-aged AMI patients.
    METHODS: A cross-sectional study was conducted in Guangzhou, China, from September 2022 to October 2023. Work ability, self-efficacy for return-to-work, social support, anxiety, and depression were measured by the Work-ability Support Scale (WSS), Return-To-Work Self-Efficacy Questionnaire, Social Support Rating Scale, 7-item Generalized Anxiety Disorder Scale, and Patient Health Questionnaire 9, respectively. We performed latent profile analysis based on three subdomains of the WSS by using Mplus 8.3. Multiple logistic regression was used to identify factors associated with work ability.
    RESULTS: A total of 155 participants (aged 48.58±7.153 years, 95.5 % male) were included. We identified three latent profiles of work ability: low work ability (28.1 %), moderate work ability (51 %), and high work ability (20.6 %). The per capita monthly household income, NYHA functional class, total cholesterol, length of hospital stay, social support, and self-efficacy for return-to-work were factors associated with work ability.
    CONCLUSIONS: This study demonstrated different profiles and associated factors of work ability in young and middle-aged AMI patients. It is suggested that healthcare providers identify and monitor associated factors to improve work ability among this subpopulation.
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  • 文章类型: Journal Article
    甲状腺乳头状癌(PTC)在年轻人群中普遍存在,并且具有良好的生存率。然而,相当数量的患者在手术治疗后经历心理社会压力和生活质量(QoL)下降.因此,对患者进行全面评估对于改善他们的康复至关重要。
    本研究招募了512名诊断为PTC的中青年患者,他们在2020年9月至2021年8月期间在我们机构接受了手术。每位参与者完成了一系列问卷:广泛性焦虑症7(GAD-7),欧洲癌症研究和治疗组织生活质量问卷(EORTCQLQ-C30)甲状腺癌特异性生活质量问卷(THYCA-QoL),和准备返回工作规模(RRTW)。
    GAD-7数据显示,几乎一半的研究对象正在经历焦虑。关于健康相关生活质量(HRQoL),参与者报告的疲劳程度最高,失眠,声音问题,和疤痕,处于焦虑状态的患者报告症状更严重。基于RRTW,与其他评估可能重返工作岗位的受试者相比,超过一半的受试者已经重返工作岗位,并且HRQoL更好。年龄,性别,BMI,教育,饮食,residence,健康保险,手术几个月后,月收入,和照顾者状态与重返工作岗位显着相关。此外,有一个照顾者,月收入较高,手术后有更多的时间,生活在城市或村庄与重返工作岗位呈正相关。
    年轻和中年PTC患者在手术后通常会遇到一系列与健康相关的问题和疾病特异性症状,伴随着较差的心理健康,HRQoL,和工作准备。重要的是优先考虑以术后心理支持为目标的及时干预措施,HRQoL改进,以及PTC患者工作能力的恢复。
    UNASSIGNED: Papillary thyroid cancer (PTC) is prevalent among younger populations and has a favorable survival rate. However, a significant number of patients experience psychosocial stress and a reduced quality of life (QoL) after surgical treatment. Therefore, comprehensive evaluations of the patients are essential to improve their recovery.
    UNASSIGNED: The present study enrolled 512 young and middle-aged patients diagnosed with PTC who underwent surgery at our institution between September 2020 and August 2021. Each participant completed a series of questionnaires: Generalized Anxiety Disorder 7 (GAD-7), European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ-C30), Thyroid Cancer-Specific Quality of Life Questionnaire (THYCA-QoL), and Readiness to Return-to-Work Scale (RRTW).
    UNASSIGNED: GAD-7 data showed that almost half of the study subjects were experiencing anxiety. Regarding health-related quality of life (HRQoL), participants reported the highest levels of fatigue, insomnia, voice problems, and scarring, with patients in anxious states reporting worse symptoms. Based on RRTW, more than half of the subjects had returned to work and had better HRQoL compared to the others who were evaluating a possible return to work. Age, gender, BMI, education, diet, residence, health insurance, months since surgery, monthly income, and caregiver status were significantly correlated with return to work. Additionally, having a caregiver, higher monthly income, more time since surgery, and living in a city or village were positively associated with return to work.
    UNASSIGNED: Young and middle-aged patients with PTC commonly experience a range of health-related issues and disease-specific symptoms following surgery, accompanied by inferior psychological well-being, HRQoL, and work readiness. It is crucial to prioritize timely interventions targeting postoperative psychological support, HRQoL improvement, and the restoration of working ability in PTC patients.
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  • 文章类型: Journal Article
    传统的治疗方法有一定的局限性。近年来,提出了基于X线图像的双平面双支撑螺钉内固定技术,以提高治疗效果。这项研究的主要目的是检查基于X射线图像的双平面双支撑螺钉内固定技术的有效性。手术期间,该程序是根据X射线图像确定的,然后在骨折部位进行切开复位手术,最后使用双平面双支撑螺钉进行内固定。所有患者均成功采用基于X线图像的双平面双支撑螺钉固定治疗。手术后,X线图像显示骨折部位复位良好,内固定无明显松动或失效。在术后随访时,患者疼痛症状明显缓解,恢复期间无明显并发症发生。
    Traditional treatment methods have certain limitations. In recent years, the technique of internal fixation with double-plane double-supported screws based on X-ray images has been proposed to improve the therapeutic effect. The main objective of this research was to examine the effectiveness of the X-ray image-based bi-planar double-braced screw internal fixation technique . During surgery, the procedure was determined based on X-ray images, followed by an open reduction procedure at the fracture site, and finally internal fixation using bi-planar double-support screws. All patients were successfully treated with X-ray image-based bi-planar double support screw fixation. After surgery, X-ray images showed a good reduction of the fracture site without significant loosening or failure of the internal fixation. At the postoperative follow-up, the patient\'s pain symptoms were significantly relieved, and no significant complications occurred during recovery.
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  • 文章类型: Journal Article
    本研究旨在检查诊断为2型糖尿病的中国中青年个体中药物治疗不依从性的患病率,并探讨这种偏差的根本原因。
    使用药物差异工具(MDT)评估100名出院患者的用药偏差。此外,对15名受试者进行了访谈,以更好地了解他们的药物非依从性经历。
    研究队列中的用药偏差率为79.5%,最常见的偏差是所服用药物类型的减少。发现这种偏差的主要原因是源于患者,最常见的原因是症状改善。医源性用药偏差最常见的原因是医务人员出院时用药教育不完整或不准确,导致患者不得不猜测自己的药物。内部和外部激励因素被确定为药物偏离行为的主要原因。
    这项研究表明,在被诊断为2型糖尿病的中国中青年个体中,药物治疗不依从性是一个主要问题。因此,护士必须意识到用药依从性管理和工作的重要性。
    UNASSIGNED: This study aimed to examine the prevalence of medication non-adherence among young and middle-aged Chinese individuals diagnosed with type 2 diabetes, and to explore the underlying causes of such deviations.
    UNASSIGNED: The Medication Discrepancy Tool (MDT) was used to assess medication deviations in a cohort of 100 patients who had been discharged from the hospital. Furthermore, 15 subjects were interviewed to gain a better understanding of their medication non-adherence experiences.
    UNASSIGNED: The rate of medication deviation in the studied cohort was 79.5%, with the most frequent deviation being a reduction in the types of drugs taken. The primary cause of this deviation was found to be patient-derived, with the most common reason being symptom improvement. Iatrogenic medication deviation was most often caused by incomplete or inaccurate medication education for medical staff at discharge, resulting in patients having to guess their own medication. Internal and extrinsic motivating factors were identified as the primary causes of medication deviation behavior.
    UNASSIGNED: This study has demonstrated that medication non-adherence is a major issue among young and middle-aged Chinese individuals diagnosed with type 2 diabetes. Therefore, it is essential for nurses to be aware of the importance of medication adherence management and working.
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  • 文章类型: Journal Article
    描述中青年乳腺癌术后患者的社会参与和残疾接受度(AOD)及其动态轨迹,并探讨与社会参与相关的关键因素。
    招募212名手术后患有乳腺癌的中青年患者进行为期6个月的随访研究,其中158人完成了四项调查。参与者被要求填写问卷,包括一般信息问卷,社会功能障碍筛查量表,和在基线时修订的残疾量表的适应性,在1、3和6个月。采用T检验和卡方检验分析基线数据的差异。采用线性广义估计方程对动态趋势和影响因素进行分析。采用Cochran-Armitage趋势检验分析社会功能缺陷发生率的变化趋势。
    乳腺癌术后患者的社会参与状况较差,77.9%,59.3%,45.9%,29.1%有社会功能缺陷,分别。AOD处于中等水平。社会参与和AOD均呈现动态改善趋势。年龄(P​=0.044),居住地(P​=0.007),手术类型(P=0.043),术后化疗(P=0.003),AOD(P<0.001)是影响社会参与的关键因素。
    医务人员应关注老年患者,他住在省会城市之外,接受了全乳房切除术,或改良根治术和术后化疗。AOD可能是提高中青年乳腺癌患者术后社会参与水平的重要潜在途径。
    UNASSIGNED: To describe the social participation and acceptance of disability (AOD) in young and middle-aged patients with breast cancer after surgery and their dynamic trajectories and to explore the critical factors associated with social participation.
    UNASSIGNED: 212 young and middle-aged patients with breast cancer after surgery were recruited for a 6-month follow-up study, and 158 of whom completed four surveys. Participants were asked to complete questionnaires including a general information questionnaire, Social Dysfunction Screening Scale, and Adaptation of Disability Scale Revised at baseline, and at 1, 3, and 6 months. T-test and chi-square test were used to analyze the difference in baseline data. Linear generalized estimating equations were used to analyze the dynamic trend and influencing factors. The Cochran-Armitage trend test was used to analyze the trend of the incidence of social function defects.
    UNASSIGNED: The status of social participation in patients after breast cancer surgery was poor, and 77.9%, 59.3%, 45.9%, and 29.1% had social function defects, respectively. The AOD was at a moderate level. Both social participation and AOD showed a trend of dynamic improvement. Age (P ​= ​0.044), residence (P ​= ​0.007), surgery type (P ​= ​0.043), postoperative chemotherapy (P ​= ​0.003), and AOD (P < 0.001) were the key factors associated with social participation.
    UNASSIGNED: Medical staff should focus on elderly patients, who lived outside the provincial capital city, received total mastectomy, or modified radical mastectomy and postoperative chemotherapy. AOD might be an important potential avenue for improving the social participation level of young and middle-aged patients with breast cancer after surgery.
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  • 文章类型: Journal Article
    背景:中青年患者的AMI发病率逐年上升,这些患者在患病后容易产生负面情绪,影响健康结果。然而,创伤后的成长可以给患者带来积极的变化,这有利于他们的康复。
    目的:本研究旨在了解中青年急性心肌梗死患者不同类型创伤后成长特点及其相关因素,以帮助寻找精准的干预措施。
    方法:这是一项横断面研究。自我报告问卷用于评估一般人口统计学特征,创伤后成长,和沉思。创伤后生长量表的五个维度的平均值用于进行潜在特征分析。
    结果:总共312名参与者,包括285名男性和27名女性患者,平均年龄为51.95±5.75。潜在剖面分析结果表明,三剖面模型是最合适的。三个不同的配置文件被命名为:“Malgrowth组”(45.51%),“良好增长组”(18.91%),和“优秀增长群体”(35.58%)。相关因素包括反省,年龄,月收入,是否重返工作岗位,婚姻状况,住宅地址,疾病分类,是否行PCI治疗(P<0.05)。
    结论:根据我们的结果,中青年AMI患者的创伤后成长可分为三个方面,可以根据确定的患者概况对患者进行针对性的干预。
    AMI incidence in young and middle-aged patients is increasing year by year, and such patients are prone to negative emotions after illness, which affects health outcomes. However, post-traumatic growth can bring about positive changes in the patient, which is beneficial to their recovery.
    This study aimed to understand the different types of post-traumatic growth characteristics and their related factors in young and middle-aged patients with acute myocardial infarction to help find precise intervention measures.
    This was a cross-sectional study. Self-reported questionnaires were used to assess general demographic characteristics, post-traumatic growth, and rumination. The mean of the five dimensions of the Post-traumatic Growth Scale was used to perform a Latent profile analysis.
    A total of 312 participants, including 285 male and 27 female patients, with the mean age was 51.95±5.75. Latent profile analysis results showed that three-profile model was the most suitable. Three different profiles were named: the \"Malgrowth group\" (45.51%), the \"Good growth group\" (18.91%), and the \"Excellent growth group\" (35.58%). The related factors included rumination, age, monthly income, whether to return to work, marital status, residential address, classification of disease, and whether to perform PCI treatment (P<0.05).
    According to our results, the post-traumatic growth of young and middle-aged AMI patients can be divided into three profiles, and targeted intervention can be carried out for patients according to the determined patient profiles.
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