ArticleFrontiers in public health2026
Latent profile analysis of alexithymia and its influencing factors in patients undergoing total knee arthroplasty.
Article in Frontiers in public health, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: Alexithymia, characterized by difficulty identifying and describing emotions and a tendency toward externally oriented thinking, is common among people living with chronic pain and may compromise perioperative communication and rehabilitation engagement. However, previous studies have largely adopted variable-centered approaches, which may overlook clinically meaningful heterogeneity in alexithymia among patients undergoing TKA. Objective: To identify latent alexithymia profiles using latent profile analysis (LPA) of alexithymia among patients undergoing TKA and to determine demographic, clinical, and psychosocial factors associated with profile membership. Methods: A cross-sectional survey was conducted among 467 patients scheduled for TKA at a tertiary hospital in Ningxia, China, between July 2025 and April 2026. Participants completed a general information questionnaire, the Chinese version of the 20-item Toronto Alexithymia Scale (TAS-20), the Numerical Rating Scale for pain (NRS), the Hospital Anxiety and Depression Scale (HADS), and the Perceived Social Support Scale (PSSS). LPA was conducted using the three TAS-20 subscale scores (difficulty identifying feelings, difficulty describing feelings, and externally oriented thinking) as profile indicators. Multinomial logistic regression was used to identify factors associated with profile membership. Results: The mean TAS-20 score was 57.02 ± 5.76, indicating moderate alexithymic traits. A three-profile solution was identified: emotionally competent ( Conclusion: Alexithymia in patients undergoing TKA comprises three clinically distinguishable profiles. Profile membership is closely related to socioeconomic status, pain burden, psychological distress, and social support. Implications for nursing: Routine preoperative TAS-20 screening could facilitate early identification of patients at risk for alexithymia-related communication barriers. Profile-specific interventions should combine tailored communication strategies, pain management, psychological support, and family-inclusive social support, particularly for patients with emotional-cognitive deficits.
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