Work ability and work ability expectations are distinguishing factors of return-to-work readiness in young and middle-aged patients with chronic kidney disease: a cross-sectional study using latent profile analysis

Sun Yuejie; Yang Beibei; Xu Shanshan; Kuang Li; Chen Xia

doi:10.16016/j.2097-0927.202607017

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Work ability and work ability expectations are distinguishing factors of return-to-work readiness in young and middle-aged patients with chronic kidney disease: a cross-sectional study using latent profile analysis

Evidence-Based Nursing Horizons | 更新时间：2026-10-19

- Work ability and work ability expectations are distinguishing factors of return-to-work readiness in young and middle-aged patients with chronic kidney disease: a cross-sectional study using latent profile analysis
- Journal of Army Medical University Vol. 48, Issue 19, Pages: 2819-2828(2026)
- 作者机构：
  
  1.安徽中医药大学护理学院，安徽合肥
  2.中国科学技术大学附属第一医院南区肾内科，安徽合肥
  3.蚌埠医科大学护理学院，安徽合肥
  4.中国科学技术大学附属第一医院护理部，安徽合肥
- 作者简介：
  
  Chen Xia，E-mail： 1569265542@qq.com
- 基金信息：
  
  the 2025 Anhui Provincial Philosophy and Social Sciences Planning Project(AHSKYQ2025D225)
- DOI：10.16016/j.2097-0927.202607017
  CLC： R195.4;R473.2;R692
- Received：04 July 2026，
  
  Revised：2026-08-19，
  
  Accepted：20 August 2026，
  
  Published：15 October 2026
- 稿件说明：
移动端阅览
孙悦杰，杨贝贝，徐山姗，等.工作能力与能力预期是中青年慢性肾脏病患者重返工作准备状态的区分因素：一项潜在剖面分析的横断面研究［J］.陆军军医大学学报，2026，48（19）：2819-2828.DOI：10.16016/j.2097-0927.202607017.

Sun Y J，Yang B B，Xu S S，et al.Work ability and work ability expectations are distinguishing factors of return-to-work readiness in young and middle-aged patients with chronic kidney disease： a cross-sectional study using latent profile analysis［J］.J Army Med Univ，2026，48（19）：2819-2828.DOI：10.16016/j.2097-0927.202607017.
孙悦杰，杨贝贝，徐山姗，等.工作能力与能力预期是中青年慢性肾脏病患者重返工作准备状态的区分因素：一项潜在剖面分析的横断面研究［J］.陆军军医大学学报，2026，48（19）：2819-2828.DOI：10.16016/j.2097-0927.202607017. DOI：

Sun Y J，Yang B B，Xu S S，et al.Work ability and work ability expectations are distinguishing factors of return-to-work readiness in young and middle-aged patients with chronic kidney disease： a cross-sectional study using latent profile analysis［J］.J Army Med Univ，2026，48（19）：2819-2828.DOI：10.16016/j.2097-0927.202607017. DOI：

摘要

目的

患病后的治疗负担、功能受限及疾病的因素不确定性等严重影响中青年慢性肾脏病（chronic kidney disease，CKD）患者的收入来源、职业功能和社会参与，单纯以“未重返工作”描述，难以反映CKD患者在重返工作意愿、行动准备和支持需求方面的差异。本研究旨在识别未重返工作的中青年CKD患者的潜在重返工作准备状态，比较不同状态的疾病、工作能力及心理社会特征，并分析类别归属的相关因素，为开展分层、个体化的重返工作支持提供依据。

方法

采用横断面研究设计方案，于2026年1—6月在中国科学技术大学附属第一医院南区肾内科门诊及病房开展的CKD患者调查，筛选出未重返工作者260例纳入分析。其中男性128例、女性132例，年龄43.00（33.00，51.25）岁。以重返工作准备度量表（readiness for return-to-work scale，RRTW）未重返工作分支条目1~13为外显指标，比较1~7类潜在剖面模型；采用Kruskal-Wallis

检验和Monte Carlo模拟

²检验比较不同潜在类别的特征，以高行动准备型为参照进行基于赤池信息量准则（akaike information criterion，AIC）的后退逐步多分类Logistic回归，并采用1 000次Bootstrap评价变量选择及效应方向的稳定性。

结果

综合模型拟合、分类质量、类别规模和临床可解释性，最终选择5类模型［贝叶斯信息准则（bayesian information criterion，BIC）=7 835.4，Entropy=0.949，最小类别比例=11.5%，最小平均后验概率=0.954］，共识别高行动准备型61例（23.5%）、中等准备型72例（27.7%）、低意向型30例（11.5%）、高支持需求-行动不足型66例（25.4%）和高障碍感知-求助型31例（11.9%）。以高行动准备型为参照，当前工作能力每增加1分，归入上述4类而非高行动准备型的

分别为0.521（95%

：0.334~0.812）、0.179（95%

：0.098~0.325）、0.401（95%

：0.255~0.630）、0.243（95%

：0.139~0.423），

均

0.01。自评健康一般/差与高支持需求-行动不足型相关（

=3.076，95%

：1.187~7.971，

=0.021）。Bootstrap中当前工作能力和未来2年工作能力预期的入模频率分别为100.0%和99.7%，效应方向一致率为99.7%~100.0%。

结论

未重返工作的中青年CKD患者可被识别为5种不同的重返工作准备状态，当前工作能力和未来2年工作能力预期是区分不同准备状态最稳定的相关特征。临床护理不宜将“尽快重返工作”作为统一目标，应在病情、患者意愿和岗位条件允许的前提下，依据准备状态、现实工作能力和具体支持需求实施分层护理。

Abstract

Objective

Treatment burden

functional limitations

and illness uncertainty following disease onset substantially compromise income sources

occupational functioning

and social participation among young and middle-aged patients with chronic kidney disease(CKD). Categorizing them simply as "not return-to-work" fails to reflect differences in their intention

action readiness

and support needs. This study aims to identify the latent return-to-work readiness statuses among young and middle-aged CKD patients who had not returned to work

to compare disease-related factors

work ability

and psychosocial characteristics across different statuses

and to analyze factors associated with class memberships

thereby providing evidence for stratified and individualized return-to-work support.

Methods

A cross-sectional study was conducted using data from a concurrent CKD survey carried out from January to June 2026 with convenience sampling in the outpatient clinic and inpatient ward of Department of Nephrology

South Branch of the First Affiliated Hospital of University of Science and Technology of China. A total of 260 young and middle-aged CKD patients who had not returned to work were screened out for analysis

including 128 males and 132 females

with a mean age of 43.00(33.00

51.25) years. Items 1 to 13 of the Readiness for Return-to-Work Scale(RRTW) were used as observed indicators

and latent profile models with 1 to 7 classes were compared. Profile differences of different latent classes were examined using Kruskal-Wallis H test and Monte Carlo

Chi

-square test. Backward stepwise multinomial logistic regression based on the Akaike information criterion(AIC) was performed using the high-action-readiness profile as the reference

and 1

000 bootstrap resamples were employed to assess the model-selection and directional stability.

Results

Based on model fit

classification quality

class size

and clinical interpretability

a 5-profile model was finally selected

with a Bayesian information criterion(BIC)=7 835.4

entropy=0.949

smallest class=11.5%

minimum average posterior probability=0.954

identifying 61 cases(23.5%) of high action readiness

72 cases(27.7%) of moderate readiness

30 cases(11.5%) of low intention

66 cases(25.4%) of high support need-insufficient action

and 31 cases(11.9%) of high perceived barriers-help seeking. Compared with high action readiness

higher curren

t work ability was associated with lower odds of moderate readiness [odds ratio(

)=0.521

95% confidence interval(

): 0.334 to 0.812

]

low intention(

=0.179

95%

: 0.098 to 0.325)

high support need-insufficient action(

=0.401

95%

: 0.255 to 0.630)

and high perceived barriers-help seeking(

=0.243

95%

: 0.139 to 0.423

all

0.01). Fair/poor self-rated health was associated with the high support need-insufficient action profile(

=3.076

95%

: 1.187 to 7.971

=0.021). Bootstrap inclusion frequencies were 100.0% for current work ability and 99.7% for expected work ability in 2 years

with directional consistency of 99.7% to 100.0%.

Conclusion

Young and middle-aged CKD patients who have not returned to work can be identified as 5 distinct return-to-work readiness statuses

and current work ability and expected work ability for the next 2 years are the most stable distinguishing characteristics. Clinical nursing care should not set “returning to work as soon as possible” as a uniform goal; instead

stratified nursing support should be implemented according to readiness states

actual work ability

and specific support needs

disease condition

patient willingness

and job conditions permit.when the patient’s medical condition

preferences

and job conditions permit

关键词

Keywords

references

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