Analysis of influencing factors of low self-management in patients with non-alcoholic fatty liver disease(NAFLD)and construction of nomogram model
李琴 1马雪儿 1杨雪霞 1何晓萱 1蔡雯1
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作者信息
1. 新疆医科大学护理学院,乌鲁木齐 830017
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摘要
目的 探讨影响非酒精性脂肪肝(Non-alcoholic fatty liver disease,NAFLD)患者低自我管理的危险因素,并构建列线图模型.方法 采用便利抽样法,选取2022年3月至2023年3月在乌鲁木齐市某社区卫生服务中心体检的650名NAFLD,其中2022年3月至2023年3月的650例作为建模组,2023年4月至9月的300例作为验证组.验证组依据《成年人健康自我管理能力测评量表》评分分为低自我管理患者和高自我管理组患者.采用单因素分析和二元、多元Logistic回归分析,筛查NAFLD低自我管理的独立危险因素.采用R软件构建列线图模型,校准曲线和决策曲线分别对列线图模型进行内部、外部验证和预测效能评估.结果 Logistic回归分析表明,男性、25～64岁、小学及以下文化程度、军人、腰围、体重指数(Body mass index,BMI)、自我效能感、社会支持评分为NAFLD患者低自我管理的危险因素(P＜0.001);模型内部及外部验证结果显示,曲线下面积(Area under curve,AUC)分别为0.988、0.959,95％CI分别为(0.981～0.988)、(0.940～0.959),校准曲线与决策曲线贴合良好.结论 本研究构建的列线图模型具有良好的预测效果,可量化NAFLD患者低自我管理的风险,有利于护理人员早期准确识别高危患者并制定针对性的护理干预策略.
Abstract
Objective To investigate the risk factors of low self-management in patients with non-alcoholic fatty liver disease(NAFLD),and to construct a nomogram model.Methods A total of 650 NAFLD pa-tients who underwent physical examination in a community health service center in Urumqi from March 2022 to March 2023 were selected by convenience sampling method.650 NAFLD patients from March 2022 to March 2023 were selected as modeling group,and 300 NAFLD patients from April to September 2023 were selected as verification group.The verification group was divided into low self-management pa-tients and high self-management patients according to the score of Adult Health Self-management Ability Assessment Scale.Univariate analysis and binary and multiple Logistic regression analysis were used to screen for independent risk factors for low self-management of NAFLD.R software was used to construct the nomogram model.Calibration curve and decision curve were used to verify the nomogram model inter-nally and externally and evaluate the prediction efficiency.Results Logistic regression analysis showed that male,25～64 years old,primary school education or below,military,waist circumference,body mass index(BMI),self-efficacy and social support score were risk factors for low self-management in NAFLD patients(P＜0.001).The results of internal and external verification of the model showed that the area under curve(AUC)was 0.988 and 0.959,and the 95％CI was(0.981～0.988)and(0.940～0.959),respectively.The calibration curve fit well with the decision curve.Conclusion The nomogram model constructed in this study has a good predictive effect and can quantify the risk of low self-manage-ment in NAFLD patients,which is conducive to early and accurate identification of high-risk patients and formulation of targeted nursing intervention strategies.
关键词
非酒精性脂肪肝/低自我管理/影响因素/列线图模型
Key words
non-alcoholic fatty liver disease(NAFLD)/low self-management/influencing factors/nomo-gram model
维普
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