Perioperative Body Image Trajectories in Amputation Patients with Malignant Bone Tumors: A Latent Transition Analysis

Objective: To explore the changes in latent categories of body image among patients with malignant bone tumors before and after amputation surgery over time, and to analyze the influencing factors. Methods: Between October 2021 and December 2024, 194 patients with malignant bone tumors were assessed before and after surgery using a general questionnaire and the Body Image Scale to analyze latent changes. Results: Patients were categorized into two groups based on their body image before and after amputation: the high body image group and the low body image group. The high body image group exhibited strong stability, with a probability of 0.849 of maintaining their original group status. Patients with malignant bone tumors in the low body image group tended to transition to the high body image group over time, with a transition probability of 36.4%. Logistic regression analysis revealed that patients with low social support (OR=3.580), amputation sites on the thigh (OR=2.687), forearm (OR=1.568), and hemipelvis (OR=4.015) were more likely to shift from the low body image group to the high body image group (OR > 1). Conversely, patients aged 60 years or older (OR=0.697) had a lower probability of transitioning from the low body image group to the high body image group (OR < 1). When considering the change from the high body image group to the high body image group as the reference, the probability of patients with family residence (OR=1.582) and high social support (OR=2.567) transitioning from the high body image group to the low body image group increased (OR > 1). Conclusion: Clinical medical staff should focus on high-risk groups and intensify perioperative psychological interventions for patients. This includes providing psychological counseling and enhancing social support to improve patients’ body image and enhance their quality of life and rehabilitation outcomes. Keywords: malignant bone tumors, amputation, body image, latent profile analysis, latent transition analysis, influencing factors