关键词: 经皮冠状动脉介入治疗, 恐动症, 列线图, 预测模型, Lasso回归, 护理

Abstract:

Objective This study aims to develop and validate a dynamic web-based nomogram for predicting kinetophobia in patients following percutaneous coronary intervention（PCI）. Methods A prospective design was employed to selectively enroll 330 PCI patients admitted to a hospital in Hangzhou from December 2022 to July 2023. Single-factor analysis and Lasso regression were utilized to identify independent risk factors for kinesophobia post-PCI. Logistic regression was performed using R software，and a nomogram was constructed. The model was assessed through the area under the receiver operating characteristic curve（AUC） and Hosmer-Lemeshow tests. Results There were 206 cases of kinesiophobia in 330 patients after PCI，and the incidence was 62.4%. Logistic regression analysis identified combined heart failure，emergency surgery，NYHA cardiac function grade，ADL level，sedentary behavior，Chinese version of PROMIS Physical Function Summary Table score，and Chinese version of Perceptive Social Support Scale score as independent influencing factors for kinesophobia after PCI（P<0.05）. The AUC value of the model was 0.821，with a sensitivity of 70.4% and specificity of 82.0%. The Hosmer-Lemeshow fit test yielded a non-significant result（χ²=9.350，P=0.314）. Calibration and decision curves demonstrated the model’s favorable calibration and clinical practicability. The C-index of the nomogram prediction model was 0.778，0.774，and 0.800，respectively，by 5-fold cross-validation，10-fold cross-validation，and the Bootstrap method. Conclusion The dynamic nomogram model developed in this study effectively predicts kinesophobia in patients after PCI. It provides valuable references and support for clinical staff in early identification of high-risk patients，enabling the formulation of individualized health education strategies and exercise rehabilitation plans.

Key words: Percutaneous Coronary Intervention, Kinesiophobia, Nomogram, Prediction Model, Lasso Regression, Nursing Care