Latent profile analysis of social alienation and its influencing factors in patients undergoing maintenance hemodialysis

Abstract

Social alienation severely impairs the mental health and quality of life of patients undergoing maintenance hemodialysis (MHD). However, most studies conducted have been variable-centered, group-level analyses, which cannot capture inherent heterogeneity in social alienation, hindering the development of precise intervention strategies. To address this, this study applied the biopsychosocial (BPS) model to investigate latent profiles of social alienation and their influencing factors in patients undergoing MHD. A cross-sectional survey was conducted using convenience sampling among patients receiving maintenance dialysis at a tertiary care hospital in Southwest China from January to May 2025. Data were collected using a general information questionnaire, the General Alienation Scale, and the General Self-Efficacy Scale. Potential classes of social alienation were identified by latent profile analysis (LPA). Univariate analysis and binary logistic regression were employed to identify influencing factors. Among the 283 valid questionnaires, LPA identified two profiles of social alienation: a low-risk adaptive subgroup (71.7%) and a high-risk impaired subgroup (28.3%). Logistic regression analysis indicated that insurance type, perceived economic burden, and self-efficacy may be influencing factors of the latent profile of social alienation (all P < 0.05). Heterogeneity exists in the social alienation of MHD patients. Inadequate health insurance coverage, heavy economic burden, and low self-efficacy may be associated with high-risk social alienation. Therefore, healthcare professionals should develop and implement hierarchical and individualized intervention strategies based on the influencing factors of different latent profiles.