Psychological distress in biliary tract malignancy patients: influencing factors and development of a predictive nomogram model

胆道恶性肿瘤患者的心理困扰:影响因素及预测列线图模型的构建

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Abstract

OBJECTIVE: 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. METHODS: 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. RESULTS: 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. CONCLUSION: 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.

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