中华护理杂志 ›› 2023, Vol. 58 ›› Issue (6): 682-688.DOI: 10.3761/j.issn.0254-1769.2023.06.006
江淀淀, 崔妙玲, 黄维, 陈庆梅, 麻月娥, 陈泉芳
出版日期:
2023-03-20
发布日期:
2023-03-23
JIANG Diandian, CUI Miaoling, HUANG Wei, CHEN Qingmei, MA Yue’e, CHEN Quanfang
Online:
2023-03-20
Published:
2023-03-23
摘要:
目的 构建并验证肺癌患者就医延迟风险预测模型。 方法 2021年9月—2022年6月,采用便利抽样法,选取广西壮族自治区某三级甲等医院收治的493例肺癌患者作为调查对象,将其随机分为建模组345例和内部验证组148例,选取另一所三级甲等医院收治的47例肺癌患者作为外部验证组;采用Logistic回归分析筛选肺癌患者就医延迟的危险因素,使用R软件构建风险预测模型和列线图模型,采用受试者操作特征曲线下面积检验模型预测效果。 结果 最终构建的模型为Y=ez/(1+ez),其中Z=9.04 × 低疾病感知水平+2.01 × 未定期体检-0.08 × 领悟社会支持量表得分+0.23 × 就医行为感知障碍量表得分-0.15 × 慢性病患者健康素养量表得分。内部验证组受试者操作特征曲线下面积为0.849,灵敏度为82.39%,特异度为78.83%,阳性预测值为90.61%,阴性预测值为63.57%。外部验证组受试者操作特征曲线下面积为0.830,灵敏度为97.36%,特异度为80.03%,阳性预测值为94.62%,阴性预测值为80.05%。 结论 低疾病感知水平、未定期体检、领悟社会支持水平低、就医行为感知障碍高、健康素养水平低是肺癌患者就医延迟的危险因素,该研究构建的预测模型具有良好的区分度和校准度,能够帮助护士筛查肺癌就医延迟高危人群,采取合适的干预措施改善其就医行为,降低就医延迟风险。
江淀淀, 崔妙玲, 黄维, 陈庆梅, 麻月娥, 陈泉芳. 肺癌患者就医延迟风险预测模型的构建及验证[J]. 中华护理杂志, 2023, 58(6): 682-688.
JIANG Diandian, CUI Miaoling, HUANG Wei, CHEN Qingmei, MA Yue’e, CHEN Quanfang. Construction and validation of a risk predictive model for treatment delay of patients with lung cancer[J]. Chinese Journal of Nursing, 2023, 58(6): 682-688.
图1 肺癌患者就医延迟风险预测列线图 注:PSSS为领悟社会支持评定量表;PBHSD-C为就医行为感知障碍量表中文版;HLSCP为慢性病患者健康素养量表。
Figure 1 Treatment delay risk prediction nomograms for patients with lung cancer
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