老年2型糖尿病患者疾病进展恐惧现状及风险预测模型构建与验证OA

Objective To investigate the current status of fear of disease progression in elderly patients with type 2 diabetes mellitus(T2DM),and to construct and validate a corresponding risk prediction model.Methods A total of 174 elderly T2DM patients admitted to our hospital from January 2023 to January 2025 were selected as the training set,and another 151 elderly T2DM patients as the validation set.The Chinese version of the Fear of Progression Questionnaire-Short Form(FoP-Q-SF)for chronic disease patients was used to assess the level of fear of progression,and relevant patient data were collected.Independent risk factors for fear of disease progression were explored,and a Nomogram prediction model for the risk of fear of disease progression was constructed and validated.Results In the training set,the total FoP-Q-SF score was(36.87±10.34)points,with 95 patients experiencing fear of disease progression.According to the presence or absence of fear of disease pro-gression,patients in the training set were assigned to a fear of disease progression group(n=95)and a non-fear of disease progres-sion group(n=79).Univariate analysis showed statistically significant differences between the fear of disease progression group and the non-fear of disease progression group in duration of disease,monthly household income,negative emotions,social support level,glycemic control status,complications,coping style,and health cognition(P<0.05).Logistic regression analysis showed that duration of disease>10 years,monthly household income<5,000 yuan,presence of negative emotions,low social support level,poor glycemic control,presence of complications,negative coping style,and low health cognition were independent risk factors for fear of disease progression(P<0.05).A Nomogram prediction model for the risk of fear of disease progres-sion was constructed using duration of disease,monthly household income,negative emotions,social support level,glyce-mic control status,complications,coping style,and health cognition as predictors.Receiver operating characteristic(ROC)curve analysis showed that in the training set,the area under the curve(AUC)for predicting fear of disease progression was 0.923(95%CI:0.874-0.973),with a sensitivity of 0.900 and specificity of 0.820;in the validation set,the AUC was 0.902(95%CI:0.846-0.958),with a sensitivity of 0.830 and specificity of 0.810.The index of concordance(C-index)was 0.941(95%CI:0.894-0.952)in the training set and 0.976(95%CI:0.941-0.998)in the validation set;the Hosmer-Lemeshow goodness-of-fit test showed P>0.05;the calibration curve deviated only slightly from the ideal curve.The clinical decision curve showed that the prediction model had a high net clinical benefit and high clinical application value.Conclusion The incidence of fear of disease progression in elderly T2DM patients remains high.The construction of the No-mogram prediction model can help clinical medical staff identify high-risk patients early.