神经内科终末期患者安宁疗护KAP现况调查及其相关影响因素的模型构建与验证

A nomogram to predict the risk factors of knowledge attitude and practices status of hospice care in end-stage patients in the neurology department

目的调查平顶山市第二人民医院神经内科终末期患者安宁疗护知信行(KAP)现况,分析其影响因素,并构建Nomogram预测模型。方法选取2021年6月至2023年6月平顶山市第二人民医院150例神经内科终末期患者为研究对象,调查患者安宁疗护KAP现况,以KAP平均分为分界划分高水平组、低水平组,对比两组临床资料,以Logistic多因素回归分析神经内科终末期患者安宁疗护KAP的影响因素,以影响因素为依据,构建低水平KAP的Nomogram预测模型,通过ROC曲线、DCA评价模型的预测价值和临床效能。结果本次研究共调查150例神经内科终末期患者,KAP评分为(115.68±14.72)分,均分比较中态度维度评分最高,为(4.02±0.35)分,其次为知识(3.84±0.49)分、行为(3.76±0.51)分;Logistic多因素分析显示,年龄、文化程度、性别、自理能力、病程、疼痛程度、对自身疾病了解程度是神经内科终末期患者低水平安宁疗护KAP的影响因素(P<0.05);且ROC曲线、DCA结果证实,该预测模型AUC为0.947,具有良好预测效能,可应用于神经内科终末期患者低水平安宁疗护KAP预测分析中。结论神经内科终末期患者安宁疗护KAP与自理能力、病程、文化程度等因素相关,护理工作者可主动进行针对性护理,提升患者安宁疗护KAP水平。

Objective To investigate the knowledge attitude and practices(KAP)status of hospice care for end-stage patients in the Neurology Department of Pingdingshan Second People's Hospital and its risk factors,and to construct a nomogram.Methods A total of 150 end-stage patients in the Neurology Department of Pingdingshan Second People's Hospital from June 2021 to June 2023 were selected as research objects.The KAP status of hospice care in them was surveyed.Based on the mean KAP score,patients were divided into high-level group and low-level group.Clinical data of the two groups were compared.Multivariate logistic regression was used to analyze the influencing factors of KAP status in hospice care for end-stage patients in the neurology department.Based on the influencing factors,a nomogram to predict low-level KAP status of hospice care for end-stage patients in the neurology department was constructed,and its predictive value and clinical efficacy were evaluated by the receiver operating characteristic(ROC)curves and decision curve analysis(DCA).Results A total of 150 end-stage patients in the neurology department were investigated in this study,and the mean KAP score was(115.68±14.72)points.The attitude score remained highest at(4.02±0.35)points,followed by knowledge score(3.84±0.49)points and behavior score(3.76±0.51)points.Multivariate logistic analysis showed that age,education level,gender,self-care ability,course of disease,pain degree and understanding degree of disease were the influencing factors of low-level KAP of hospice care for end-stage patients in the neurology department(P<0.05).Moreover,ROC curve and DCA results confirmed that the area under the curve(AUC)of this predictive model was 0.947,which had good predictive efficacy and could be applied to predict low-level KAP of hospice care for end-stage patients in the neurology department.Conclusion KAP of hospice care for end-stage patients in the neurology department is related to self-care ability,course of disease,educational level and other factors.Nursing care providers can take the initiative to provide targeted care to improve KAP of hospice care for end-stage patients in the neurology department.