Construction and validation of predictive model for the risk of stigma in enterostomy patients / 中国实用护理杂志

ABSTRACT

Objective:To explore the influencing factors of stigma and to construct a nomogram model for stigma perceptionin enterostomy patients. The basis for prevention of stigmatization in enterostomy patients.Methods:This was a prospective survey. By convenient sampling, 300 with enterostomy patients from the stoma clinic of the Sixth Medical Center of PLA General Hospital from March 2022 to July 2023 were investigated. Univariate analysis and logistic regression were explored the risk factors of stigma.R 4.2.2 software was constructed a nomogram to achieve the visualization display. Using receiver operating characteristic curve, Hosmer-Leme show test and calibration curves tested model predictive performance.Results:Totally 284 valid questionnaires were ultimately collected, including 161 males and 123 females. There were 21 cases aged 20-40, 117 cases aged 41-60, and 146 cases aged 60 and above. The incidence of stigma among 284 patients was 69.37% (197/284). Predictive model was constructed and validated based on six risk factors: fecal status ( OR=0.63, 95% CI 0.42-0.95), level of accept from spouse ( OR=0.56, 95% CI 0.34-0.94), body image change ( OR=0.51, 95% CI 0.28-0.91), effectiveness of WeChat platform ( OR=0.31, 95% CI 0.13-0.78), support from friends ( OR=0.34, 95% CI 0.14-0.82), confidence diet ( OR=0.37, 95% CI 0.19-0.71). The area under the ROC curve of the modeling group was 0.837, with a sensitivity of 0.923 and a specificity of 0.649. The area under the ROC curve of the validation group was 0.841, with a sensitivity of 0.846 and a specificity of 0.740. Conclusions:This study had a good prediction effect in constructing a model. The model can provide reference for medical staff to quickly identify the risk of stigma and in a timely manner take preventive management measuresin enterostomy patients.