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自我效能感和自我护理作为缺血性中风的危险因素:列线图的开发与验证

Self-Efficacy and Self-Care as Risk Factors for Ischemic Stroke: Development and Validation of a Nomogram.

作者信息

Rasyid Al, Pemila Uke, Aisah Siti, Harris Salim, Wiyarta Elvan, Fisher Marc

机构信息

Department of Neurology, Faculty of Medicine, Universitas Indonesia, Dr. Cipto Mangunkusumo National Hospital, Jakarta 10430, Indonesia.

Directorate of Health Service Governance, Indonesian Ministry of Health, Jakarta 12940, Indonesia.

出版信息

J Clin Med. 2023 Aug 31;12(17):5665. doi: 10.3390/jcm12175665.

Abstract

BACKGROUND

This study addresses the knowledge gap on how self-efficacy and self-care affect stroke risk as factors and develops a valuable tool for clinicians to assess stroke risk.

METHODS

From January 2022 to January 2023, this nested-case control study was conducted. Medical data including gender, age, ethnicity, locality, education, marital status, employment, caregiver, social environment, blood viscosity, Barthel Index, modified Rankin Scale (mRS), stroke risk score, self-care score, and self-efficacy score were collected. Logistic regression was used to predict stroke risk, and a nomogram was developed and validated.

RESULTS

240 patients were included in the analysis. Stroke risk score (OR: 3.513; = 0.005), self-efficacy score (OR: 0.753; = 0.048), and self-care score (OR: 0.817; = 0.018) were predictors of ischemic stroke. Internal validation was carried out, with a C-index of 0.774, and the Hosmer-Lemeshow test indicated a good fit ( = 0.92). The calibration plot also shows that this nomogram model has good calibration abilities. The decision curve analysis (DCA) results show a threshold probability range of 10-95%.

CONCLUSION

A nomogram has been developed with good validity, calibration, and clinical utility, including self-care and self-efficacy as risk factors for predicting ischemic stroke.

摘要

背景

本研究填补了关于自我效能感和自我护理作为影响中风风险因素方面的知识空白,并为临床医生开发了一种评估中风风险的有价值工具。

方法

2022年1月至2023年1月,开展了这项巢式病例对照研究。收集了包括性别、年龄、种族、地区、教育程度、婚姻状况、就业情况、照料者、社会环境、血液黏度、巴氏指数、改良Rankin量表(mRS)、中风风险评分、自我护理评分和自我效能感评分在内的医学数据。采用逻辑回归预测中风风险,并绘制和验证了列线图。

结果

240例患者纳入分析。中风风险评分(OR:3.513;P = 0.005)、自我效能感评分(OR:0.753;P = 0.048)和自我护理评分(OR:0.817;P = 0.018)是缺血性中风的预测因素。进行了内部验证,C指数为0.774,Hosmer-Lemeshow检验显示拟合良好(P = 0.92)。校准图也表明该列线图模型具有良好的校准能力。决策曲线分析(DCA)结果显示阈值概率范围为10% - 95%。

结论

已开发出一种具有良好效度、校准度和临床实用性的列线图,将自我护理和自我效能感作为预测缺血性中风的风险因素。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/71fd/10489054/5dbd3b98152c/jcm-12-05665-g001.jpg

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