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    无创正压通气患儿医疗恐惧感现状及影响因素模型构建分析

    The current situation of medical fear in children with non-invasive positive pressure ventilation and cnstruction of the influencing factor model

      摘要
    • 摘要:
      目的： 探究无创正压通气（NIPPV）患儿医疗恐惧感现状及影响因素，并构建风险预测模型。
      方法： 选取接受NIPPV治疗的140例患儿为研究对象，通过一般资料调查表、儿童医疗恐惧量表（CMFS）进行调查，根据CMFS评分分为CMFS评分≥30分组与CMFS评分＜30分组。对比两组患儿年龄、性别等指标，多因素logistic回归分析NIPPV患儿医疗恐惧感影响因素，并构建预测模型。Hosmer–Lemeshow检验及受试者工作特征（ROC）曲线分析该预测模型的校准度及区分度。
      结果： 140份问卷有效回收132份，有效回收率94.29%。NIPPV患儿CMFS评分（29.87 ± 2.24）分，其中CMFS评分≥30分组60例（45.45%），＜30分组72例（54.55%）。logistic回归分析显示年龄、气质类型、NIPPV教育、NIPPV治疗时间是影响NIPPV患儿医疗恐惧感的独立影响因素（P ＜ 0.05）。基于logistic回归分析构建NIPPV患儿医疗恐惧感高水平发生的风险预测列线图模型，ROC曲线下面积为0.903（95%CI：0.846 ~ 0.960），Hosmer–Lemeshow检验显示该模型校准能力较一般（χ2 = 19.824，P ＜ 0.05）。
      结论： 年龄、气质类型、NIPPV教育、NIPPV治疗时间是NIPPV患儿医疗恐惧感高水平发生的影响因素，基于上述因素构建的预测模型区分能力较好，灵敏度较高，但其校准能力一般。

       

      Abstract:
      Objective To explore the current situation and influencing factors of medical fear in children with non-invasive positive pressure ventilation (NIPPV), and establish a risk prediction model.
      Methods A total of 140 NIPPV children were selected as the study objects, and the investigation was carried out through the general data questionnaire and childeren medical fear scale (CMFS). According to the CMFS score, the patients were divided into the CMFS score ≥30 points group and CMFS score ＜ 30 points group. The age, gender and other indicators were compared between two groups, and the influencing factors of medical fear in NIPPV children were analyzed by multivariate logistic regression, and the prediction model was built. Hosmer-Lemeshow test and receiver operating characteristic (ROC) curve were used to analyze the calibration and differentiation of the prediction model.
      Results Out of 140 questionnaires, 132 were effectively retrieved, with an effective recovery rate of 94.29%. The CMFS score of children with NIPPV was (29.87 ± 2.24) points. Among them, there were 60 cases (45.45%) in the CMFS score ≥30 group and 72 cases (54.55%) in the CMFS score ＜ 30 group. The results of logistic regression analysis showed that the age, temperament type, NIPPV education, and NIPPV treatment duration were the independent influencing factors of the medical fear of children with NIPPV (P ＜ 0.05). Based on the logistic regression analysis, a risk prediction nomogram model for the high-level occurrence of medical fear in children with NIPPV was constructed. The area under the ROC curve was 0.903 (95%CI: 0.846–0.960). The Hosmer-Lemeshow test showed that the calibration ability of this model was relatively modest (χ2 = 19.824, P ＜ 0.05).
      Conclusions The age, temperament type, NIPPV education and NIPPV treatment time are the factors influencing the occurrence of high level of medical fear in NIPPV children. The prediction model built based on the above factors has good distinguishing ability and high sensitivity, but its calibration ability is modest.

       

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