淋巴瘤患者病耻感临床预测模型的构建与评估  

Construction and evaluation of clinical predictive model of stigma in patients with lymphoma

作　　者：李科瑾 周建梅[1] 孟爱凤[2] 刘建红[1] 刘腊根[3] 智晓旭[2] 李敏[1] Li Kejin;Zhou Jianmei;Meng Aifeng;Liu Jianhong;Liu Lagen;Zhi Xiaoxu;Li Min(Department of Internal Medicine,Jiangsu Cancer Hospital,Nanjing 210009,China;Nursing Department,Jiangsu Cancer Hospital,Nanjing 210009,China;Surgery Department,Jiangsu Cancer Hospital,Nanjing 210009,China)

机构地区：[1]江苏省肿瘤医院内科,南京210009 [2]江苏省肿瘤医院护理部,南京210009 [3]江苏省肿瘤医院外科,南京210009

出　　处：《中华现代护理杂志》2020年第28期3862-3868,共7页Chinese Journal of Modern Nursing

基　　金：国家自然科学基金项目(71804073);江苏省科技项目(BE2019757)。

摘　　要：目的建立并评估淋巴瘤患者病耻感临床预测模型,为淋巴瘤患者病耻感的评估及应对提供依据。方法采用便利抽样法,选取2019年6—12月江苏省肿瘤医院住院治疗的130例淋巴瘤患者,收集患者的临床资料,评定患者的生活质量和病耻感。应用R软件分析处理数据,结合LASSO回归模型预测筛选的特征因素,采用多变量Logistic回归分析对淋巴瘤患者病耻感的影响因素进行分析。构建列线图模型,通过C指数、校准图和决策曲线分析对预测模型的鉴别、校准和临床实用性进行评估。结果共收集120例患者的有效资料。淋巴瘤患者具有较高的病耻感,预测模型的预测因子包含是否首次入院、年龄、患者医疗保险类型、生活质量量表第30问的评分、生活质量量表第27问评分。模型显示出良好的预测能力,训练组、整体样本和验证组的C指数分别为0.824、0.776和0.684,C指数表现优异。结论本研究开发的列线图模型可帮助临床护士及早识别淋巴瘤病耻高的患者,给予针对性应对方案,能更大限度改善患者生活质量及预后,值得临床推广应用。Objective To establish and evaluate the clinical prediction model of stigma in patients with lymphoma so as to provide a basis for the assessment and response of stigma in patients with lymphoma.Methods Convenience sampling method was used to select 130 patients with lymphoma who were hospitalized in Jiangsu Cancer Hospital from June to December 2019.We collected patients'clinical data,and assessed patients'quality of life and stigma.The R software was used to analyze and process the data,and screened characteristic factors were predicted by combining with the LASSO regression model.Multivariate Logistic regression analysis was used to analyze the influencing factors of stigma in patients with lymphoma.We constructed a nomogram model to evaluate the identification,calibration and clinical applicability of the predictive model through C index,calibration chart and decision curve analysis.Results A total of 120 patients'valid data were gathered.Patients with lymphoma had a high level of stigma.The predictive factors of the predictive model included whether to be hospitalized for the first time,age,patient's medical insurance type,scores of the thirtieth and twenty-seventh question of the quality of life questionnaire.The model showed good predictive ability.The C index of training group,overall sample and validation group were 0.824,0.776 and 0.684 respectively,and the C index performed well.Conclusions The nomogram model developed in this research can help clinical nurses early identify lymphoma patients with a high level stigma,and give targeted response plans,which can greatly improve the quality of life and prognosis of patients,and is worthy of clinical application.

关 键 词：淋巴瘤 病耻感 生活质量 预测因子 

分 类 号：R473.73[医药卫生—护理学]