阻塞性睡眠呼吸暂停低通气综合征病人自我报告的中重度心理痛苦现状及风险预测模型构建

    Construction of the self-reported moderate to severe psychological distress status and risk prediction model in patients with sleep apnea hypopnea syndrome

    • 摘要:
      目的: 了解阻塞性睡眠呼吸暂停低通气综合征(OSAHS)病人自我报告的心理痛苦现状,并分析其相关影响因素,构建OSAHS病人心理痛苦风险预测模型。
      方法: 选取OSAHS病人172例作为研究对象。采用一般资料问卷、心理痛苦温度计(DT)、Connor–Davidson韧性量表(CD–RISC–10)、匹兹堡睡眠质量指数(PSQI)、领悟社会支持量表(PSSS)进行问卷调查;采用便携式睡眠呼吸监测仪对OSAHS病人进行睡眠监测,建模探讨OSAHS病人心理痛苦发生的影响因素,采用ROC曲线评价模型区分度,Hosmer–Lemeshow检验评价模型拟合度,并绘制列线图验证。
      结果: 172例OSAHS病人心理痛苦阳性率为48.26%(83/172);多因素logistic回归显示,病程、体质量指数(BMI)、呼吸暂停低通气指数(AHI)、PSQI是心理痛苦的独立危险因素,CD–RISC–10、PSSS是独立保护因素(P < 0.05);构建的预测模型经检验拟合度良好,区分度优异(AUC = 0.845,95%CI:0.785 ~ 0.904),列线图可视化程度高、临床使用便捷。
      结论: 病程、BMI、AHI、CD–RISC–10、PSQI、PSSS均是心理痛苦发生的影响因素。

       

      Abstract:
      Objetcive  To understand the current situation of self-reported psychological distress in patients with obstructive sleep apnea-hypopnea syndrome (OSAHS), analyze its related influencing factors, and construct a risk prediction model for psychological distress in OSAHS patients.
      Methods A total of 172 patients with OSAHS were selected as the research subjects. The questionnaire surveys were conducted using the general information questionnaires, Psychological Distress Thermometer (DT), Connor-Davidson Resilience Scale (CD-RISC-10), Pittsburgh Sleep Quality Index (PSQI) and Perceived Social Support Scale (PSSS). Sleep monitoring of patients with OSAHS was conducted using a portable sleep apnea monitor. The influencing factors of psychological distress in patients with OSAHS were modeled to explore. The ROC curve was used to evaluate the discrimination of the model, and the Hosmer-Lemeshow test was used to evaluate the fit of the model. A nomogram was drawn for verification.
      Results The positive rate of psychological distress in 172 patients with OSAHS was 48.26% (83/172). The results of multivariate logistic regression showed that the disease duration, body mass index (BMI), apnea-hypopnea index (AHI) and PSQI were the independent risk factors of psychological distress, while the CD-RISC-10 and PSSS were the independent protective factors (P < 0.05). The constructed predictive model was verified to have a good fit and excellent discrimination (AUC = 0.845, 95%CI: 0.785−0.904). The nomogram had a high degree of visualization, and was convenient for clinical use.
      Conclusions The disease course, BMI, AHI, CD-RISC-10, PSQI and PSSS are all the influencing factors of the occurrence of psychological distress.

       

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