与癌症患者心理瘤支持下降相关的预测因素
Karoline Hecht1, Moritz Philipp Günther1, Johannes Kirchebner2
1Department of Consultation-Liaison-Psychiatry and Psychosomatic Medicine, University Hospital Zurich, University of Zurich, Culmannstrasse 8, 8091 Zürich, Switzerland.
Current oncology (Toronto, Ont.)
|November 24, 2023
概括
护士有效地选癌症患者的精神瘤学支持需求. 老年患者,那些痛苦较低,健康问题较少的患者更有可能拒绝支持,这表明需要改善患者教育.
科学领域:
- 在瘤学瘤学.
- 精神瘤学 精神瘤学
- 医疗保健服务研究 医疗服务研究
背景情况:
- 国际指南主张护士进行例行应急查,以促进癌症患者的精神瘤学支持.
- 应急温度计和问题列表是常用的工具,用于识别需要心理社会支持的患者.
- 了解与支持下降相关的因素对于优化选效率至关重要.
研究的目的:
- 通过机器学习识别患者拒绝心理瘤支持的预测因素.
- 提高护士在查瘤学环境中心理瘤学支持需求方面的效率.
- 为那些可能受益但拒绝支持的患者提供有针对性的干预信息.
主要方法:
- 机器学习分析了从4064名癌症患者定期收集的临床数据.
- 使用交叉验证和嵌套重新采样技术来确保模型的稳定性并防止过度拟合.
- 使用预测建模来确定拒绝精神瘤支持的患者的特征.
主要成果:
- 开发的机器学习模型在检测拒绝支持的患者时实现了89%的灵敏度和68.5%的准确性 (AUC79%).
- 支持下降的关键预测因素包括年龄较大,危险温度计得分较低,并发症较少,报告的身体问题较少.
- 报告忧伤,恐惧或担忧较少的患者也更有可能拒绝支持.
结论:
- 目前的应急查程序对瘤学中的日常护理实践有价值.
- 护士可能需要额外的培训和时间来解决患者对精神瘤支持的误解.
- 完善查协议可以改善癌症患者对心理社会护理的识别和接受.
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