头颈癌病人身体意象障碍风险预测模型的构建及验证OA北大核心CSTPCD
Construction and validation of a risk prediction model for body image disturbance in patients with head and neck cancer
目的:分析头颈癌病人发生身体意象障碍的危险因素,构建列线图预测模型,并验证模型的预测效果.方法:采用便利抽样法,选取2022年6月—11月在太原市某三级甲等医院耳鼻咽喉头颈外科、口腔科、放疗科住院的头颈癌病人以及2022年7月-9月在太原市某肿瘤专科医院头颈外科住院的共 332例头颈癌病人作为研究对象,按照 7∶3的比例分为建模组(235例)和验证组(97例).依据治疗后是否发生身体意象障碍将建模组病人分为身体意象障碍组和身体意象正常组,通过Logistic回归分析探索身体意象障碍的危险因素,建立预测模型,绘制列线图,通过受试者工作特征(ROC)曲线下面积、Hosmer-Lemeshow拟合优度检验分别评价模型的区分度、校准度.结果:332例头颈癌病人中,身体意象障碍发生率为37.05%;根据肿瘤分期、有无气管套管、功能状况得分、焦虑得分、领悟社会支持得分、消极应对得分6个影响因素构建预测模型.该模型在建模组和验证组中的ROC曲线下面积分别为0.897(P<0.001)和0.850(P<0.001),区分度良好;Hosmer-Lemeshow χ2值分别为7.828(P=0.348)和5.409(P=0.610),校准度较好.结论:构建的预测模型效果良好,可为临床医护人员评估头颈癌病人发生身体意象障碍的风险、进行早期干预提供参考.
Objective:Analyze the risk factors for the development of body image disturbance in head and neck cancer patients,construct a nomogram graph prediction model,and validate the predictive effect of the model.Methods:A total of 332 head and neck cancer patients hospitalized in the Department of otolaryngology,head and neck surgery,stomatology,and radiotherapy of A tertiary hospital in Taiyuan from June to November 2022 and hospitalized in the Department of Head and Neck Surgery of a specialized oncology hospital in Taiyuan from July to September 2022 were selected as study subjects.The patients were divided into the modeling group(235 cases)and the validation group(97 cases)according to the ratio of 7∶3.Based on whether body image disturbance occurred after treatment,the patients in the modeling group were divided into body image disturbance group and normal body image group,and the risk factors of body image disturbance were explored by logistic regression analysis,prediction model were established,nomogram were drawn,and the discrimination and calibration of the model were evaluated by area under the ROC curve and Hosmer-Lemeshow χ2 test,respectively.Results:The incidence of body image disturbance was 37.05%in 332 patients with head and neck cancer;a prediction model was constructed based on six influencing factors:tumor stage,presence of tracheal cannula,functional status score,anxiety score,comprehension social support score,and negative coping score.The area under the ROC curve of the model was 0.897(P<0.001)and 0.850(P<0.001)in the modeling and validation groups,respectively,with good discrimination;the Hosmer-Lemeshow χ2 values were 7.828(P=0.348)and 5.409(P=0.610),respectively,with good calibration.Conclusion:The study constructed a nomogram graph prediction model of body image disturbance in head and neck cancer patients with good prediction effect,which can provide reference for clinical nurses to assess the risk of body image disturbance in head and neck cancer patients and make early intervention.
贾泽欢;宁艳;朱瑞芳;余琳;韩世范
山西医科大学护理学院,山西 030001山西医科大学第一医院
头颈癌身体意象障碍危险因素预测模型护理
head and neck cancerbody image disturbancerisk factorsprediction modelnursing
《护理研究》 2024 (011)
1895-1902 / 8
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