肠造口病人生命意义感与其正视疾病相关性的模型分析  

Model analysis of the correlation and influencing factors between patients with enterostomy and their sense of meaning in life

作　　者：敬文丹[1] 谢平[1] 寇红艳[1] 刘建军[1] JING Wendan;XIE Ping;KOU Hongyan;LIU Jianjun(Department of Gastrointestinal Surgery,Affiliated Hospital of North Sichuan Medical College,Nanchong,Sichuan 637000,China)

机构地区：[1]川北医学院附属医院胃肠外一科,四川南充637000

出　　处：《安徽医药》2023年第5期980-984,共5页Anhui Medical and Pharmaceutical Journal

基　　金：南充市科学技术局市校合作科研专项(19SXHZ0385)。

摘　　要：目的 探讨肠造口病人生命意义感与其正视疾病相关性,及评估生命意义感影响因素。方法 选取川北医学院附属医院2018年1月至2021年1月收治的125例结直肠癌造口病人,收集病人病历资料信息。采用生命意义感量表(C-MLQ)测量生命意义感,采用社会影响量表(SIS)评估病人正视疾病情况,采用Pearson相关分析肠造口病人生命意义感与其正视疾病相关性,采用多元线性回归分析生命意义感的影响因素。按照6∶4将病人采用随机数字表法分成建模组(75例)、验证组(50例),采用R软件建立预测肠造口病人生命意义感的列线图模型并进行验证。结果 125例病人中明确生命意义感12例,无明确生命意义感63例,较低生命意义感50例。年龄、文化程度、得知疾病诊断时间、家庭人均月收入影响生命意义感评分(P<0.05)。多元线性回归分析结果显示:年龄、文化程度、得知疾病诊断时间、家庭人均月收入均是影响生命意义感的影响因素(P<0.05)。SIS量表总得分为(62.32±6.37)分,经济歧视、社会排斥、社会隔离以及内在羞耻评分分别为(8.58±1.64)分、(21.63±2.63)分、(19.36±3.22)分、(12.75±2.19)分。pearson相关分析显示生命意义感与经济歧视(r=-0.42)、社会排斥(r=-0.56)、社会隔离(r=-0.52)以及内在羞耻(r=-0.46)呈负相关性(P<0.05)。列线图模型预测建模组、验证组的C-index分别为0.76和0.75。受试者操作特征曲线(ROC曲线)显示,列线图模型预测建模组、验证组发生无生命意义感的AUC分别为0.83,95%CI:(0.70,0.96),0.81,95%CI:(0.69,0.93)。结论 结直肠癌造口病人生命意义感多处于中等水平,病人年龄、文化程度、家庭收入等因素是生命意义感的影响因素,以上述指标建立的列线图模型对于生命意义感具有良好预测效能。Objective To explore the relationship between the meaning of life in patients with intestinal stoma and face up to the disease,and to evaluate the influencing factors of the meaning of life.Methods 125 patients with colorectal cancer stoma treated in the Affiliated Hospital of North Sichuan Medical College from January 2018 to January 2021 were selected to collect patient medical record information.The meaning of life scale(C-MLQ)was used to measure the meaning of life,and the social impact scale(SIS)was used to assess the patient's face of the disease.Pearson correlation was used to analyze the correlation between the meaning of life in patients with intestinal stoma and the relationship between the disease,and multiple linear regression was used to analyze the influencing factors of the sense of life.The patients were randomly divided into modeling group(75 cases),validation group(50 cases)according to 6:4,and the nomogram model for predicting the sense of life of enterostomy patients was established and verified by R software.Results Among 125 patients,12 had a clear sense of life,63 had no clear sense of life,and 50 had a low sense of life.Age,education level,time to know the diagnosis of the disease,family monthly income per capita affected the meaning of life score(P<0.05).The re‐sults of multiple linear regression analysis showed that age,education level,time to know the diagnosis of the disease,family monthly income per capita were all influential factors affecting the sense of life(P<0.05).The total score of the SIS scale was(62.32±6.37)points,The scores of economic discrimination,social exclusion,social isolation and intrinsic shame were(8.58±1.64),(21.63±2.63),(19.36±3.22)and(12.75±2.19)points,respectively.Pearson correlation analysis showed that the meaning of life was negatively correlated with economic discrimination(r=−0.42),social exclusion(r=−0.56),social isolation(r=−0.52),and intrinsic shame(r=−0.46)(P<0.05).The C-index of the nomogram model prediction modeling group and the vali

关 键 词：结肠造口术 结直肠癌 生命意义感 正视疾病 病耻感 

分 类 号：R735.34[医药卫生—肿瘤]