Department of the International Special Needs Ward, First Hospital of China Medical University, Shenyang, 110001, Liaoning, China.
Department of Hepatobiliary Surgery, First Hospital of China Medical University, Shenyang, 110001, Liaoning, China.
Sci Rep. 2024 Aug 28;14(1):20016. doi: 10.1038/s41598-024-70772-1.
This study aimed to investigate the current hope levels in patients with primary liver cancer by analyzing the risk indicators of hope levels, constructing and validating a novel hope score-based predictive model. A total of 206 patients with primary liver cancer admitted to the hepato-pancreato-biliary surgery department of a tertiary hospital from October 2020 to June 2021 were included. The Herth Hope Index was utilized to assess hope levels, and based on the questionnaire results, the patients were categorized into low-hope (≤ 30 points) and high-hope (> 30 points) groups. Single-factor analysis and logistic multivariate regression analysis were conducted to explore the factors influencing hope levels in patients with primary liver cancer. A nomogram was plotted, and a risk prediction model for hope levels in these patients was developed. The predictive performance of the nomogram model was evaluated using calibration plots, the Hosmer-Lemeshow test, and other relevant assessments. Total of 206 patients participated in the questionnaire survey, with 82 patients (39.81%) categorized as belonging to the low-hope group. The results of the single-factor analysis showed statistically significant differences (all P < 0.05) in marriage status, education level, residence, occupation, family monthly income, reason for hospitalization or outpatient visit, pressure caused by the disease on the family, history of cirrhosis, and level of social support between the two groups. These variables were subsequently included in the logistic multivariate regression model. The results of the regression analysis indicated that marriage status, residence, family monthly income, and level of social support were independent risk factors. These four influencing factors were transformed into a visual predictive model, which yielded an area under the ROC curve of 0.931 (95% CI 0.899-0.963) and demonstrated model significance (Hosmer-Lemeshow test: χ2 = 4.008, P = 0.856, P > 0.05). The observed and expected values generated by the Hosmer-Lemeshow test were plotted as a scatter plot with a fitted linear trend, showing good consistency between the predictive model and actual risk. The constructed predictive model developed in this study exhibited good predictive capability for assessing the hope levels of patients with primary liver cancer. This model can assist clinical staff in rapidly identifying the psychological risk of low hope levels in patients, thereby providing valuable insights for the timely implementation of proactive management measures.
本研究旨在通过分析原发性肝癌患者希望水平的风险指标，构建并验证一种新的基于希望评分的预测模型，从而探讨原发性肝癌患者的当前希望水平。选取 2020 年 10 月至 2021 年 6 月在某三级医院肝胆胰外科住院的 206 例原发性肝癌患者为研究对象。采用 Herth 希望量表评估患者的希望水平，根据问卷结果将患者分为低希望（≤30 分）和高希望（>30 分）组。对两组患者进行单因素分析和 Logistic 多因素回归分析，探讨影响原发性肝癌患者希望水平的因素。绘制列线图，建立患者希望水平的风险预测模型。通过校准图、Hosmer-Lemeshow 检验等相关评估方法对列线图模型的预测性能进行评价。共纳入 206 例患者进行问卷调查，其中 82 例（39.81%）患者属于低希望组。单因素分析结果显示，两组患者的婚姻状况、文化程度、居住情况、职业、家庭月收入、住院或门诊原因、疾病对家庭的压力、肝硬化史和社会支持水平比较，差异均有统计学意义（均 P<0.05）。将上述有统计学意义的变量纳入 Logistic 多因素回归模型。回归分析结果显示，婚姻状况、居住情况、家庭月收入和社会支持水平是独立的危险因素。将这 4 个影响因素转化为可视化预测模型，ROC 曲线下面积为 0.931（95%CI 0.899~0.963），模型有意义（Hosmer-Lemeshow 检验：χ2=4.008，P=0.856，P>0.05）。Hosmer-Lemeshow 检验的观测值和预期值绘制散点图，拟合线性趋势，预测模型与实际风险具有良好的一致性。本研究构建的预测模型对原发性肝癌患者的希望水平评估具有良好的预测能力。该模型有助于临床工作人员快速识别患者低希望水平的心理风险，从而为及时实施积极的管理措施提供有价值的见解。
