摘要
目的调查肠造口患者病耻感危险因素,构建风险预测模型,为病耻感预防提供依据。方法本研究为前瞻性调查研究。采用便利抽样法,选取2022年3月至2023年7月中国人民解放军总医院第六医学中心造口门诊300例结直肠癌肠造口患者作为研究对象。通过单因素分析和Logistic回归探索病耻感危险因素,应用R 4.2.2软件构建列线图进行可视化展示,应用受试者操作特征曲线、Hosmer-Lemeshow检验、校准曲线检验模型预测性能。结果最终回收有效问卷284份,其中男161例,女123例;年龄20~40岁21例,41~60岁117例,60岁以上146例。284例患者病耻感发生率为69.37%(197/284)。造口排泄物情况(OR=0.63,95%CI 0.42~0.95)、配偶接受造口程度(OR=0.56,95%CI 0.34~0.94)、身体形象改变(OR=0.51,95%CI 0.28~0.91)、微信平台是否有效(OR=0.31,95%CI 0.13~0.78)、朋友支持水平(OR=0.34,95%CI 0.14~0.82)、正常饮食信心(OR=0.37,95%CI 0.19~0.71)6个危险因素构建预测模型并进行验证。建模组ROC曲线下面积为0.837,敏感度0.923,特异度0.649。验证组ROC曲线下面积为0.841,敏感度0.846,特异度0.740。结论该模型预测效果较好,可为医护人员快速识别肠造口患者病耻感发生风险,采取预防性管理措施提供借鉴。
Objective To explore the influencing factors of stigma and to construct a nomogram model for stigma perceptionin enterostomy patients.The basis for prevention of stigmatization in enterostomy patients.Methods This was a prospective survey.By convenient sampling,300 with enterostomy patients from the stoma clinic of the Sixth Medical Center of PLA General Hospital from March 2022 to July 2023 were investigated.Univariate analysis and logistic regression were explored the risk factors of stigma.R 4.2.2 software was constructed a nomogram to achieve the visualization display.Using receiver operating characteristic curve,Hosmer-Leme show test and calibration curves tested model predictive performance.Results Totally 284 valid questionnaires were ultimately collected,including 161 males and 123 females.There were 21 cases aged 20-40,117 cases aged 41-60,and 146 cases aged 60 and above.The incidence of stigma among 284 patients was 69.37%(197/284).Predictive model was constructed and validated based on six risk factors:fecal status(OR=0.63,95%CI 0.42-0.95),level of accept from spouse(OR=0.56,95%CI 0.34-0.94),body image change(OR=0.51,95%CI 0.28-0.91),effectiveness of WeChat platform(OR=0.31,95%CI 0.13-0.78),support from friends(OR=0.34,95%CI 0.14-0.82),confidence diet(OR=0.37,95%CI 0.19-0.71).The area under the ROC curve of the modeling group was 0.837,with a sensitivity of 0.923 and a specificity of 0.649.The area under the ROC curve of the validation group was 0.841,with a sensitivity of 0.846 and a specificity of 0.740.Conclusions This study had a good prediction effect in constructing a model.The model can provide reference for medical staff to quickly identify the risk of stigma and in a timely manner take preventive management measuresin enterostomy patients.
作者
刘瑞
金慧玉
Liu Rui;Jin Huiyu(School of Nursing,Anhui Medical University,Hefei 230032,China;Department of Stomatology,the Sixth Medical Center of PLA General Hospital,Beijing 100048,China)
出处
《中国实用护理杂志》
2024年第7期494-500,共7页
Chinese Journal of Practical Nursing
基金
2023年度安徽医科大学护理学院研究生青苗培育项目(hlqml2023063)。