老年结直肠癌术后肠造口患者发生病耻感的风险预测列线图模型构建

苏艳霞; 穆晓燕; 方方; 汤东; 王爱华; 李琴; 唐玲; 程月芳

doi:10.7619/jcmp.20240788

老年结直肠癌术后肠造口患者发生病耻感的风险预测列线图模型构建

Establishment of a Nomogram model for predicting risk of stigma in elderly patients with colostomy after colorectal cancer surgery

摘要

摘要:
目的构建预测老年结直肠癌(CRC)术后肠造口患者发生病耻感的列线图模型。
方法选择2022年6月—2023年12月扬州大学附属苏北人民医院收治的123例老年CRC术后肠造口患者为研究对象，根据病耻感发生情况将其分为发生组(n=62)和未发生组(n=61)。采用Logistic回归分析筛选危险因素，绘制列线图并评估其区分度、一致性。
结果 123例老年CRC术后肠造口患者的社会影响量表(SIS)得分34~90分，平均(60.14±12.08)分，中位数得分48分。性别为女性(95%CI: 2.467~20.978, P < 0.001)、有造口并发症(95%CI: 1.766~10.093, P=0.001)、领悟社会支持水平为中低水平(95%CI: 1.654~12.710, P=0.003)、社会心理适应水平为中低水平(95%CI: 1.568~10.869, P=0.004)是老年CRC术后肠造口患者发生病耻感的独立危险因素。受试者工作特征曲线的曲线下面积为0.816(95%CI: 0.744~0.889); 校准曲线斜率接近1, Hosmer-Lemeshow拟合优度检验χ²=7.722, P=0.461。
结论性别为女性、有造口并发症、领悟社会支持水平为中低水平、社会心理适应水平为中低水平是老年CRC术后肠造口患者发生病耻感的独立危险因素，据此构建的列线图模型有助于筛选病耻感高危人群，从而实现个体精准化干预，降低病耻感的发生率。

Abstract:
Objective To establish a Nomogram model for predicting the occurrence of stigma in elderly patients with colostomy after colorectal cancer (CRC) surgery.
Methods A total of 123 elderly patients with colostomy after CRC surgery in the Northern Jiangsu People's Hospital Affiliated to Yangzhou University from June 2022 to December 2023 were selected as research objects, and they were divided into stigma group (n=62) and non-stigma group (n=61) according to the occurrence of stigma. Logistic regression analysis was used to screen risk factors, and a Nomogram was drawn and evaluated for its discrimination and consistency.
Results Score of the Social Impact Scale (SIS) in 123 elderly patients with colostomy after CRC surgery ranged from 34 to 90, with an average score of (60.14±12.08) and a median score of 48. Female (95%CI, 2.467 to 20.978, P < 0.001), presence of stoma complications (95%CI, 1.766 to 10.093, P=0.001), moderate to low level of perceived social support (95%CI, 1.654 to 12.710, P=0.003), and moderate to low level of psychosocial adaptation (95%CI, 1.568 to 10.869, P=0.004) were identified as independent risk factors for stigma in elderly patients with colostomy after CRC surgery. The area under the receiver operating characteristic curve was 0.816 (95% CI, 0.744 to 0.889); the calibration curve had a slope close to 1, and the Hosmer-Lemeshow goodness-of-fit test showed better results (χ²=7.722, P=0.461).
Conclusion Female, presence of stoma complications, moderate to low level of perceived social support, and moderate to low level of psychosocial adaptation are independent risk factors for stigma in elderly patients with colostomy after CRC surgery. Nomogram model established based on these factors can help identify high-risk populations for stigma, so as to obtain individualized precise intervention and reduce the incidence of stigma.

HTML全文

参考文献(22)

施引文献

资源附件(0)