Gou Zhennan, Liu Yuhua, Tang Wenjie, Zhou Changming, Lu Zhenqi, Wang Lu, Feng Wei, Xu Weiqi, Wang Jun
Department of Nursing, Shanghai Cancer Center, Fudan University, Shanghai, China.
Department of Cancer Prevention, Shanghai Cancer Center, Fudan University, Shanghai, China.
Front Psychiatry. 2024 Dec 4;15:1450860. doi: 10.3389/fpsyt.2024.1450860. eCollection 2024.
This study aims to investigate the psychological distress and its influencing factors in patients with biliary tract malignant tumors, alongside the development of a predictive model.
A total of 219 patients diagnosed with biliary tract malignant tumors who were admitted to the Department of Liver Surgery at Fudan University Shanghai Cancer Center from July 2021 to May 2023, were selected using a convenience sampling method. Research tools involve psychological distress management screening tools, a demographic questionnaire, self-rating anxiety and depression scales, and the Chinese version of the Memorial Symptom Assessment Scale. Bootstrap method was utilized for repeated sampling to identify relevant factors influencing psychological distress in biliary tract cancer patients. The R software was employed to create a nomogram model, and the model's accuracy and predictive performance were assessed using the receiver operating characteristic curve (ROC) and the Hosmer-Lemeshow test.
The average score of psychological distress among the 219 patients was (3.91 ± 2.44), with a psychological distress detection rate of 54.8%. Regression model results indicated that factors such as the presence of distant metastasis, comorbidity with other major diseases, poor sleep quality, anxiety, and severity of anxiety and depression were the primary influencers of psychological distress.
The detection rate of psychological distress in patients with biliary tract malignant tumors is notably high. The predictive model constructed in this study exhibits good predictive efficacy and clinical value, providing valuable reference for healthcare professionals in developing targeted intervention strategies.
本研究旨在调查胆道恶性肿瘤患者的心理困扰及其影响因素，并建立一个预测模型。
采用便利抽样法，选取2021年7月至2023年5月在复旦大学附属肿瘤医院肝外科住院的219例确诊为胆道恶性肿瘤的患者。研究工具包括心理困扰管理筛查工具、人口统计学问卷、自评焦虑和抑郁量表以及中文版纪念症状评估量表。采用Bootstrap法进行重复抽样，以确定影响胆道癌患者心理困扰的相关因素。使用R软件创建列线图模型，并使用受试者工作特征曲线（ROC）和Hosmer-Lemeshow检验评估模型的准确性和预测性能。
219例患者心理困扰的平均得分为（3.91±2.44），心理困扰检出率为54.8%。回归模型结果表明，远处转移、合并其他重大疾病、睡眠质量差、焦虑以及焦虑和抑郁的严重程度等因素是心理困扰的主要影响因素。
胆道恶性肿瘤患者心理困扰的检出率较高。本研究构建的预测模型具有良好的预测效能和临床价值，为医护人员制定针对性干预策略提供了有价值的参考。
