摘要
目的探究乳腺癌患者疾病进展恐惧(FoP)的影响因素,构建并验证其风险预测模型,旨在为乳腺癌患者Fo P的防范提供参考。方法于2024年7月至2025年1月,采用便利抽样法选取皖南医学院第一附属医院、皖南医学院附属太和医院收治的321例乳腺癌患者作为研究对象。采用一般资料调查表、恐惧疾病进展简化量表(Fop-Q-SF)、疾病接受度量表(AIS)、一般社会疏离感量表(GAS)进行调查研究。采用单因素分析和logistic回归筛选乳腺癌患者Fo P的影响因素,基于R软件建立风险预测模型及列线图,并进行验证。结果321例乳腺癌患者Fop-Q-SF评分为(32.85±5.44)分,其中155例患者出现Fo P心理功能失调,发生率为48.3%。两组年龄、月收入、诊断时间、合并症、临床分期、疾病接受度、社会疏离感比较,差异有统计学意义(P<0.05)。logistic回归分析结果显示,月收入、临床分期、疾病接受度、社会疏离感是乳腺癌患者Fo P心理功能失调的影响因素(P<0.05)。基于上述因素构建列线图模型,Hosmer-Lemeshow检验结果显示χ^(2)=3.036,P=0.932;受试者操作特征曲线下面积为0.805(95%CI:0.757~0.853),灵敏度为0.717,特异度为0.787;校准曲线和决策分析曲线证实模型具有较好的校准度和临床应用价值。结论该研究建立的风险预测模型预测能力较好,可为临床医务工作者早期识别高风险患者,制订精准化干预策略提供参考。
Objective To investigate the factors influencing fear of progression(FoP)in breast cancer patients and to construct and validate a risk prediction model,aiming to provide reference for preventing FoP in breast cancer patients.Methods From July 2024 to January 2025,321 breast cancer patients admitted to the First Affiliated Hospital of Wannnan Medical College and the Taihe Hospital Affiliated to Wannan Medical College were selected using convenience sampling.A survey study was conducted using the general information questionnaire,fear of progress questionnaire-short form(Fop-Q-SF),acceptance of illness scale(AIS),and general alienation scale(GAS).One-way analysis and logistic regression were used to screen the influencing factors of FoP in breast cancer patients,and the risk prediction model and nomogram were established and validated based on R software.Results The FOP-Q-SF score for 321 breast cancer patients was(32.85±5.44)points,with 155 patients(48.3%)exhibiting psychological dysfunction related to FOP.There were statistically significant differences in age,monthly income,diagnosis time,complications,clinical stage,disease acceptance,and social alienation between the two groups(P<0.05).Logistic regression analysis revealed that monthly income,clinical stage,disease acceptance,and social alienation were significant predictors of FoP psychological dysfunction in breast cancer patients(P<0.05).Based on the aforementioned factors,a nomogram model was constructed.The Hosmer-Lemeshow test showedχ^(2)=3.036,P=0.932;the area under the receiver operating characteristic curve was 0.805(95%CI:0.757-0.853),with a sensitivity of 0.717 and a specificity of 0.787.The calibration curves and decision analysis curves confirmed the model’s good calibration and clinical applicability.Conclusion The risk prediction model established in this study has a good predictive ability,which can provide a reference for clinical health workers to identify high-risk patients at an early stage and develop precise intervention strategies.
作者
段梦影
杨静
董奥奇
徐东亮
王凯璐
陶秀彬
DUAN Mengying;YANG Jing;DONG Aoqi;XU Dongliang;WANG Kailu;TAO Xiubin(Graduate School,Wannan Medical College,Anhui Province,Wuhu241002,China;Department of Nursing,the Taihe Hospital Affiliated to Wannan Medical College,Anhui Province,Fuyang236600,China;Department of Nursing,the First Affiliated Hospital of Wannan Medical College,Anhui Province,Wuhu241001,China)
出处
《中国医药导报》
2026年第2期33-38,共6页
China Medical Herald
基金
安徽省教育厅研究项目(2024AH051930)。
关键词
乳腺癌
疾病进展恐惧
列线图
预测模型
Breast cancer
Fear of progression
Nomogram
Prediction model
