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| 结直肠癌患者身体意象失调影响因素及列线图预测模型构建 |
| The influencing factors of body image disturbance in colorectal cancer patients and construction of a nomogram prediction model |
| 投稿时间：2025-11-11 |
| DOI：10.3969/j.issn.1000-0399.2026.08.017 |
| 中文关键词: 结直肠癌 身体意象失调 影响因素 列线图 预测模型 |
| 英文关键词: Colorectal cancer Body image disturbance Influencing factors Nomogram Prediction model |
| 基金项目:安徽省高等学校省级质量工程项目(编号:2022jyxm745);安徽医科大学护理学院研究生青苗培育项目(编号:hlqm12025090) |
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| 中文摘要: |
| 目的 分析结直肠癌患者身体意象失调的影响因素，并构建列线图预测模型。方法 采用便利抽样法选取2024年10月至2025年7月于安徽省两所三级甲等医院就诊的507例结直肠癌患者为研究对象，按照7∶3的比例分为建模组（354例）和验证组（153例）。建模组采用单因素和多因素logistic回归分析探讨身体意象失调发生的影响因素，建立预测模型并绘制列线图。采用受试者工作特征（ROC）曲线及校准曲线评价该模型的区分度和一致性，采用决策曲线分析评价模型的临床获益能力。结果 507例结直肠癌患者中，有120例患者发生身体意象失调，身体意象失调总发生率为23.67%。多因素logistic回归结果显示，年龄、造口、造口并发症、领悟社会支持评分、抑郁、胃肠道症状评分是身体意象失调发生的独立影响因素（P<0.05）。建模组ROC的曲线下面积为0.934，灵敏度为0.925，特异度为0.854；验证组ROC的曲线下面积为0.902，灵敏度为0.700，特异度为0.965。校准曲线和决策曲线结果显示，该模型具有良好的校准度和临床有效性。结论 本研究构建的列线图预测模型具有良好的预测效能，可为医护人员早期筛查结直肠癌患者身体意象失调并进行干预提供参考依据。 |
| 英文摘要: |
| Objective To analyze the influencing factors of body image disturbance in colorectal cancer patients and construct a nomogram prediction model. Methods A convenience sampling method was used to select 507 colorectal cancer patients from two tertiary Grade A hospitals in Anhui province from October 2024 to July 2025. The patients were divided into the modeling group(354 cases) and the validation group(153 cases) according to the ratio of 7:3. Univariate and multivariate logistic regression analysis were applied to explore the influencing factors for body image disturbance occurrence in the modeling group, and a nomogram prediction model was constructed. Receiver operating characteristic(ROC) curve and calibration curve were used to evaluate the differentiation and consistency of the model, while decision curve analysis(DCA) was used to assess the model's clinical utility. Results Among 507 colorectal cancer patients, 120 patients developed body image disturbance, with a total incidence rate of 23.67%. Multivariate logistic regression showed that age, stoma, stoma complication, perceived social support score, depression and gastrointestinal symptoms score were independent influencing factors for body image disturbance(P<0.05). The area under the ROC curve(AUC) of the modeling group was 0.934, the sensitivity was 0.925, and the specificity was 0.854. The area under the ROC curve(AUC) of the validation group was 0.902, the sensitivity was 0.700, and the specificity was 0.965. Calibration curve and decision curve analysis showed that the model had good calibration and clinical effectiveness. Conclusion The nomogram prediction model constructed in this study has good predictive performance, which can provide a reference basis for medical staff to early screen for body image disturbance in colorectal cancer patients and to implement appropriate interventions. |
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