Asian Nursing Research最新文献_第4页

Dyadic effects of family function and financial toxicity on quality of life in lung cancer patients and family caregivers: An actor-partner interdependence mediation model. 家庭功能和经济毒性对肺癌患者和家庭照顾者生活质量的双重影响：一个行动者-伴侣相互依赖的中介模型。

IF 2.3 3区医学 Q2 NURSING

Asian Nursing Research

Pub Date : 2025-11-03 DOI: 10.1016/j.anr.2025.09.004

Hui Shan, Weisong Wang, Xiaoying Wang, Fang Liu

Purpose: Lung cancer has a profound impact on the whole family, particularly patients and family caregivers. This research adopted a dyadic method to examine the dyadic effect of family function on quality of life (QoL), and the mediating role of financial toxicity in lung cancer patient-caregiver dyads.

Methods: This was cross-sectional research that included 218 pairs of participants. Family function, financial toxicity, and QoL were assessed by Family Assessment Device, Comprehensive scores for financial toxicity based on patient-reported outcome measures and The European Organization for the Research and Treatment of Cancer Quality of Life Questionnaire, respectively. SPSS 24.0 and AMOS 23.0 statistical software were used for statistical analysis.

Results: The actor-partner interdependence mediation model analysis demonstrated good model fit (χ²/df =2.333, RMSEA=0.078, NFI=0.995, TLI=0.992, CFI=0.997, SRMR =0.004). Results revealed significant dyadic interdependence, showing that both patients' and family caregivers' QoL was associated with their own and their partner's family function and financial toxicity. Notably, family function exerted both actor effects (individual's family function influencing their own QoL) and partner effects (individual's family function influencing their partner's QoL). Mediation analysis further indicated that these effects operated through both direct pathways and indirect pathways mediated by financial toxicity - where one's family function could impact either their own or their partner's QoL via their own or their partner's financial toxicity.

Conclusions: The findings highlight the need for integrated interventions targeting both family dynamics and financial distress to enhance well-being in cancer care dyads. Adopting this dyadic approach may significantly improve QoL for patients and caregivers, particularly in oncological settings where financial toxicity intensifies disease-related challenges.

目的：肺癌对整个家庭，特别是患者和家庭照顾者有着深远的影响。本研究采用二元方法考察家庭功能对生活质量（QoL）的二元效应，以及财务毒性在肺癌患者-照顾者二元关系中的中介作用。方法：这是一项横断面研究，包括218对参与者。家庭功能、财务毒性和生活质量分别通过家庭评估装置、基于患者报告的结果测量的财务毒性综合评分和欧洲癌症研究和治疗组织生活质量问卷进行评估。采用SPSS 24.0和AMOS 23.0统计软件进行统计分析。结果：行动者-伴侣相互依赖中介模型分析显示模型拟合良好（χ2/df =2.333， RMSEA=0.078， NFI=0.995， TLI=0.992， CFI=0.997, SRMR =0.004）。结果显示显着的二元相互依赖，表明患者和家庭照顾者的生活质量与他们自己和他们的伴侣的家庭功能和财务毒性有关。值得注意的是，家庭功能同时发挥行动者效应（个体的家庭功能影响其自身的生活质量）和伴侣效应（个体的家庭功能影响其伴侣的生活质量）。中介分析进一步表明，这些影响通过财务毒性介导的直接途径和间接途径起作用，其中一个家庭功能可能通过自己或伴侣的财务毒性影响自己或伴侣的生活质量。结论：研究结果强调需要针对家庭动态和经济困难进行综合干预，以提高癌症护理夫妇的福祉。采用这种二元方法可以显著改善患者和护理人员的生活质量，特别是在肿瘤环境中，经济毒性加剧了与疾病相关的挑战。

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引用次数: 0

Effects of early nursing intervention based on the theory of planned behavior in patients with non-proliferative diabetic retinopathy: A quasi-experimental study. 基于计划行为理论的早期护理干预对非增殖性糖尿病视网膜病变患者的影响：一项准实验研究。

IF 2.3 3区医学 Q2 NURSING

Asian Nursing Research

Pub Date : 2025-11-01 DOI: 10.1016/j.anr.2025.09.006

Jinghua Shi, Can Zhang, Lixia Guo, Tingting Jia, Juanfen Lv, Yan Wang

Purpose: To determine the effects of early nursing interventions based on the internet and planned behavior theory in patients with non-proliferative diabetic retinopathy (NPDR).

Methods: In this quasi-experimental study, convenience sampling was used to select 112 patients with NPDR admitted to the diabetic fundus disease clinic of a tertiary hospital in Shanxi. The control group received conventional interventions, while the intervention group received early nursing interventions based on the Theory of Planned Behavior. The primary outcome measure was glycemic control before and at the end of the intervention, while the secondary outcome measures included disease knowledge level, self-efficacy, self-management ability, and disease progression rate before the intervention and at 6 weeks and 12 weeks post-intervention. SPSS software (version 26.0) was used to analyze the data.

Results: In total, 109 patients completed the study, 54 in the control group and 55 in the intervention group. The scores for fasting blood glucose, two-hour postprandial blood glucose, disease knowledge level, self-efficacy, and self-management ability were compared between the two groups, and the group, time, and interaction effects were statistically significant (p < .001). Significant differences were observed in HbA1c levels and disease progression rates between the two groups after 12 weeks of intervention (p < .050).The Cox proportional hazards model showed that the risk of disease progression was relatively low in the test group ,and the effect sizes and 95% confidence interva were 0.35( 0.13/ 0.99).

Conclusion: Early nursing intervention based on the Theory of Planned Behavior is beneficial to improving blood glucose control levels, self-management ability, self-efficacy, and clinical prognosis in patients with NPDR.

目的：探讨基于互联网和计划行为理论的早期护理干预对非增殖性糖尿病视网膜病变（NPDR）患者的影响。方法：本准实验研究采用方便抽样的方法，选取山西省某三级医院糖尿病眼底病门诊收治的NPDR患者112例。对照组采用常规干预，干预组采用基于计划行为理论的早期护理干预。主要结局指标是干预前和干预结束时的血糖控制，次要结局指标包括干预前、干预后6周和12周的疾病知识水平、自我效能、自我管理能力和疾病进展率。采用SPSS 26.0软件对数据进行分析。结果：共109例患者完成研究，对照组54例，干预组55例。比较两组患者的空腹血糖、餐后2小时血糖、疾病知识水平、自我效能感、自我管理能力得分，组间、时间、交互效应均有统计学意义（p < 0.001）。干预12周后，两组患者的HbA1c水平和疾病进展率差异有统计学意义（p < 0.05）。Cox比例风险模型显示，试验组疾病进展风险相对较低，效应量和95%可信区间为0.35（0.13/ 0.99）。结论：基于计划行为理论的早期护理干预有利于提高NPDR患者的血糖控制水平、自我管理能力、自我效能感和临床预后。

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引用次数: 0

Effects of climate change anxiety and environmental sustainability attitudes on pro-environmental behaviors among nursing students: A cross-sectional study. 气候变化焦虑和环境可持续性态度对护生亲环境行为影响的横断面研究

IF 2.3 3区医学 Q2 NURSING

Asian Nursing Research

Pub Date : 2025-11-01 DOI: 10.1016/j.anr.2025.08.005

Yeonju Lee, Sun Joo Jang, Haeyoung Lee

Purpose: This study aimed to investigate the effects of climate change anxiety and environmental sustainability attitudes on pro-environmental behaviors among nursing students. As the core workforce of future nursing, nursing students must adapt to all nursing environments affected by climate change and be empowered to address its risks and impacts. They can play a crucial role in contributing to a healthy environment by enhancing their capacity to respond to climate change and practicing pro-environmental behaviors.

Methods: Data were collected from April 15 to 22, 2024, through an online survey distributed to junior and senior nursing students with clinical experience. Responses from 334 participants were analyzed using multiple regression analysis to examine the relationships between climate change anxiety, environmental sustainability attitudes, and pro-environmental behaviors.

Results: Multiple regression analysis revealed environmental sustainability attitudes, cognitive impairment (a subfactor of climate change anxiety), academic year, and gender (in decreasing order of effect size) to be significant predictors of pro-environmental behaviors. The regression model explained 15% of the variance in pro-environmental behaviors.

Conclusions: Higher environmental sustainability attitudes and lower levels of cognitive anxiety are associated with an increase in pro-environmental behaviors. To boost such behaviors among nursing students, enhancing environmental sustainability attitudes and effectively managing climate change anxiety, specifically cognitive impairment, are essential.

目的：探讨气候变化焦虑和环境可持续性态度对护生亲环境行为的影响。作为未来护理的核心劳动力，护生必须适应受气候变化影响的所有护理环境，并有能力应对气候变化的风险和影响。他们可以通过提高应对气候变化的能力和采取有利于环境的行为，在促进健康环境方面发挥关键作用。方法：于2024年4月15日至22日，通过在线调查的方式对有临床经验的大三、大四护生进行调查。采用多元回归分析对334名被试的反馈进行分析，探讨了气候变化焦虑、环境可持续性态度和亲环境行为之间的关系。结果：多元回归分析显示，环境可持续性态度、认知障碍（气候变化焦虑的子因素）、学年和性别（效应量由大到小）是亲环境行为的显著预测因子。回归模型解释了亲环境行为中15%的方差。结论：较高的环境可持续性态度和较低的认知焦虑水平与亲环境行为的增加有关。为了促进护理专业学生的这种行为，提高环境可持续性的态度和有效管理气候变化焦虑，特别是认知障碍，是必不可少的。

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引用次数: 0

PSYCHOMETRIC PROPERTIES OF THE KOREAN VERSION OF THE ADVANCE CARE PLANNING ENGAGEMENT SURVEY. 韩国版提前护理计划参与调查的心理测量特性。

IF 2.3 3区医学 Q2 NURSING

Asian Nursing Research

Pub Date : 2025-11-01 DOI: 10.1016/j.anr.2025.09.003

Heejung Jeon, Sanghee Kim

Purpose: To develop a Korean version of the Advance Care Planning Engagement Survey and evaluate its psychometric properties among adults with chronic diseases, following the World Health Organization's instrument translation guidelines.

Methods: This study is a methodological design and has been validated through translation and back translation, content validity assessed through expert evaluations by five experts and cognitive interviews with five participants diagnosed with chronic diseases, and construct and criterion validity assessed through an online survey. A total of 340 adults with chronic diseases were recruited through a panel research service, with 170 assigned to each group for exploratory factor analysis and confirmatory factor analysis.

Results: The Korean version of the Advance Care Planning Engagement Survey comprises 34 items and demonstrated good internal consistency (.95). The exploratory factor analysis identified four behavioral factors-Knowledge, Contemplation, Self-efficacy, and Readiness-accounting for 64.4% of the cumulative variance. The confirmatory factor analysis results indicated a good model fit.

Conclusion: The Korean version of the Advance Care Planning Engagement Survey demonstrated strong validity and reliability in assessing advance care planning engagement within the Korean context. By reflecting cultural nuances, this instrument supports cross-cultural comparisons and contributes to evidence-based end-of-life care policies. It also aligns with global healthcare needs, facilitating culturally informed research and enhancing patient-centered care. Additionally, it aids in the development of advance care planning programs that consider cultural contexts, supporting more effective end-of-life care in diverse settings.

目的：根据世界卫生组织的工具翻译指南，开发韩国版的提前护理计划参与调查，并评估其在成人慢性病患者中的心理测量特性。方法：本研究采用方法学设计，通过翻译和回译进行验证，通过5位专家的专家评价和5位慢性疾病诊断参与者的认知访谈评估内容效度，通过在线调查评估结构效度和效度。通过小组研究服务共招募了340名患有慢性疾病的成年人，每组170人进行探索性因素分析和验证性因素分析。结果：韩国版的事前护理计划参与调查包括34个项目，具有良好的内部一致性（0.95）。探索性因素分析确定了四个行为因素-知识，沉思，自我效能和准备-占累积方差的64.4%。验证性因子分析结果表明，模型拟合良好。结论：韩国版的提前护理计划参与调查在评估韩国背景下的提前护理计划参与方面表现出很强的有效性和可靠性。通过反映文化差异，该工具支持跨文化比较，并有助于基于证据的临终关怀政策。它还与全球医疗保健需求保持一致，促进了解文化的研究并加强以患者为中心的护理。此外，它有助于制定考虑文化背景的预先护理计划方案，支持在不同环境中更有效的临终关怀。

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引用次数: 0

Path Analysis of Career Decision-Making Among Nursing Students: A Descriptive Cross-Sectional Study. 护生职业决策路径分析：一项描述性横断面研究。

IF 2.3 3区医学 Q2 NURSING

Asian Nursing Research

Pub Date : 2025-11-01 DOI: 10.1016/j.anr.2025.09.002

Seohyun Kwon, Taewha Lee

Purpose: A career refers to all the work-related activities and experiences that occur throughout an individual's life. As healthcare technology advances, jobs become more diverse, making nursing students' careers increasingly important. However, little is known about the career decision-making process of nursing students. To address this, we investigated how nursing students decide about their careers. This study aimed to conduct a path analysis of career decisions among nursing students based on the social cognitive model of career self-management.

Methods: This was a descriptive cross-sectional study. It recruited junior and senior nursing students from 18 universities in a metropolitan area of South Korea. In total, 439 nursing students participated in the study. Data were collected using a structured questionnaire between May 15 and June 5, 2023. The data were analyzed using descriptive statistics and path analysis.

Results: The hypothesized model showed acceptable model fit indices. The path analysis showed that career decision-making self-efficacy (β = .52, p < .001), career outcome expectations (β = .11, p = .041), and nursing competence (β = .11, p = .046) directly impacted career decisions. Furthermore, nursing competence (β = .29, p < .001), satisfaction with the nursing major (β = .13, p < .001), and the learning environment (β = .12, p < .001) indirectly influenced career decisions through the mediation of career decision-making self-efficacy and career outcome expectations.

Conclusion: Career decision-making self-efficacy and nursing competence are crucial factors in nursing students' career decisions. The proposed model provides a foundation for developing strategies to enhance nursing students' career decision-making. Nursing educators and institutions can use this model to design and implement a tailored career education curriculum that empowers nursing students to manage and advance their careers effectively.

目的：职业是指个人一生中所有与工作相关的活动和经历。随着医疗技术的进步，工作变得更加多样化，这使得护理专业学生的职业生涯变得越来越重要。然而，对护理专业学生的职业决策过程了解甚少。为了解决这个问题，我们调查了护理专业的学生如何决定他们的职业。本研究旨在基于职业生涯自我管理的社会认知模型，对护生职业生涯决策进行路径分析。方法：采用描述性横断面研究。它招募了来自韩国大都市地区18所大学的大三和大四护理专业的学生。共有439名护理专业学生参与了研究。数据是在2023年5月15日至6月5日期间通过结构化问卷收集的。采用描述性统计和通径分析对数据进行分析。结果：假设模型的模型拟合指标可接受。通径分析显示，职业决策自我效能感（β = .52, p < .001）、职业结果预期（β = .11, p = .041）和护理能力（β = .11, p = .046）直接影响职业决策。此外，护理能力（β = .29, p < .001）、护理专业满意度（β = .13, p < .001）和学习环境（β = .12, p < .001）通过职业决策自我效能感和职业结果期望中介间接影响职业决策。结论：职业决策自我效能感和护理能力是影响护生职业决策的关键因素。该模型为制定护理学生职业决策策略提供了基础。护理教育工作者和机构可以使用这一模式来设计和实施量身定制的职业教育课程，使护理学生能够有效地管理和推进他们的职业生涯。

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引用次数: 0

Factors Predicting Depression among Disadvantaged Adolescents 预测弱势青少年抑郁的因素。

IF 2.3 3区医学 Q2 NURSING

Asian Nursing Research

Pub Date : 2025-10-01 DOI: 10.1016/j.anr.2025.05.009

Maliwan Wongkhan, Patcharin Nintachan, Sopin Sangon, Pisamai Orathai

Purpose

This study had two main objectives. First, it aimed to validate a causal model of the relationships between gender, family history of depression, rumination, perceived negative life events, perceived stress, resilience, and depression among disadvantaged adolescents. Second, it aimed to investigate both the direct and indirect effects of gender, family history of depression, rumination, perceived negative life events, perceived stress, and resilience on depression among disadvantaged adolescents.

Methods

This study used a cross-sectional model-testing design. The participants were 510 adolescents from four schools for disadvantaged adolescents in four regions of Thailand. Six questionnaires—a personal data questionnaire, the Center for Epidemiologic Studies Depression Scale, the Ruminative Response Scale-10, the Negative Event Scale, the Thai version of the Perceived Stress Scale-10, and the Resilience Inventory—were used to collect data, which were analyzed using descriptive statistics and structural equation modeling.

Results

The findings showed that the model fit the empirical data (Chi-square value = 222.33, degrees of freedom = 162, goodness of fit index = .96, adjusted goodness of fit index = .94, Tucker-Lewis index = .98, comparative fit index = .99, root mean square error of approximation = .03). Rumination had a positive direct effect on depression and an indirect effect through both perceived negative life events and resilience serially. Perceived negative life events had a positive direct effect on depression and an indirect effect through resilience. Perceived stress had a positive direct effect on depression and an indirect effect through resilience. Gender and family history of depression had neither direct nor indirect effects on depression among disadvantaged adolescents.

Conclusion

The findings can be used to help develop programs to promote resilience and reduce rumination, perceived negative life events, and perceived stress to prevent and reduce depression among disadvantaged adolescents.

目的：本研究有两个主要目的。首先，本研究旨在验证弱势青少年性别、抑郁家族史、反刍、感知负面生活事件、感知压力、心理弹性和抑郁之间的因果关系模型。其次，探讨性别、抑郁家族史、反刍、感知负面生活事件、感知压力和心理弹性对弱势青少年抑郁的直接和间接影响。方法：本研究采用横断面模型检验设计。参与者是来自泰国四个地区四所弱势青少年学校的510名青少年。采用个人资料问卷、美国流行病学研究中心抑郁量表、反思反应量表-10、消极事件量表、泰国版压力感知量表-10和弹性量表等6份问卷收集数据，采用描述性统计和结构方程模型对数据进行分析。结果：模型与实证数据拟合良好（卡方值= 222.33，自由度= 162，拟合优度指数= 0.96，调整拟合优度指数= 0.94，Tucker-Lewis指数= 0.98，比较拟合指数= 0.99，近似均方根误差= 0.03）。反刍对抑郁有正面的直接影响，并通过感知到的负面生活事件和恢复力依次产生间接影响。感知到的负面生活事件对抑郁有正面的直接影响，并通过恢复力产生间接影响。感知压力对抑郁有积极的直接影响，并通过恢复力产生间接影响。性别和抑郁家族史对弱势青少年抑郁无直接或间接影响。结论：该研究结果可用于帮助制定计划，以提高适应力，减少反刍，感知负面生活事件和感知压力，以预防和减少弱势青少年的抑郁。

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引用次数: 0

The Remarkable Journey of ANR: From Inception to Q1 Achievement ANR的非凡之旅：从开始到Q1的成就

IF 2.3 3区医学 Q2 NURSING

Asian Nursing Research

Pub Date : 2025-10-01 DOI: 10.1016/j.anr.2025.10.001

Eunyoung E. Suh

引用次数: 0

Effects of an Empowerment Program on Promoting Self-reliance Among Low-income Welfare Recipients in Korea: A Repeated-measures Design 赋权计划对促进韩国低收入福利受助人自力更生的影响：重复措施设计。

IF 2.3 3区医学 Q2 NURSING

Asian Nursing Research

Pub Date : 2025-10-01 DOI: 10.1016/j.anr.2025.05.004

Myungsun Hyun , Dabok Noh , Eunyoung Park

Purpose

This study examined the effectiveness of an empowerment program based on reality therapy in helping low-income welfare recipients become self-reliant.

Methods

This study used a repeated-measures design with a control group. Sixty-four participants were selected through convenience sampling from among welfare recipients who accessed self-sufficiency services at local self-sufficiency centers. The empowerment program consisted of eight sessions. The outcome variables were self-sufficiency motivation, self-esteem, and empowerment. Data were collected at baseline, immediately after intervention, and 4 weeks after intervention, and were analyzed using the independent t-test, χ² test, or Fisher's exact test, and generalized estimating equations (GEE).

Results

GEE revealed significant group × time interaction effects on self-sufficiency motivation, self-esteem, and empowerment, after adjusting the baseline scores for the three outcome variables.

Conclusion

The developed empowerment program significantly improved self-sufficiency motivation, self-esteem, and empowerment among welfare recipients who accessed self-sufficiency services at local self-sufficiency centers. This study provides direction for the development of psychosocial empowerment programs to help welfare recipients become self-reliant. Future research should focus on the long-term effects of this empowerment program.

Trial registration

This study was retrospectively registered with the Clinical Research Information Service of Korea (https://cris.nih.go.kr) under the registration number KCT0009782 on September 10, 2024.

目的：本研究考察了一项基于现实疗法的赋权计划在帮助低收入福利受助人自力更生方面的有效性。方法：本研究采用重复测量设计，设对照组。通过方便抽样，从当地自给自足中心获得自给自足服务的福利受助人中选出64名参与者。赋权项目包括八个环节。结果变量为自我满足、动机、自尊和赋权。在基线、干预后立即和干预后4周收集数据，并使用独立t检验、χ2检验或Fisher精确检验和广义估计方程（GEE）进行分析。结果：在调整三个结果变量的基线得分后，GEE显示了显著的组×时间交互作用在自我满足动机、自尊和授权上。结论：开发的赋权方案显著提高了在当地自给自足中心获得自给自足服务的福利受助人的自给自足动机、自尊和赋权。本研究为社会心理赋权计划的发展提供方向，以帮助受助人自力更生。未来的研究应该集中在这项授权计划的长期影响上。试验注册：本研究于2024年9月10日在韩国临床研究信息服务中心（https://cris.nih.go.kr）回顾性注册，注册号为KCT0009782。

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引用次数: 0

Research Topics of Self-efficacy in Nursing from 2013 to 2022: A Bibliometric Analysis 2013 - 2022年护理人员自我效能感研究课题：文献计量学分析

IF 2.3 3区医学 Q2 NURSING

Asian Nursing Research

Pub Date : 2025-10-01 DOI: 10.1016/j.anr.2025.05.007

Qian Cao , Yue Hu , Wan-Ting Cai

Purpose

Despite the long-standing recognition of self-efficacy theory in nursing, it remains relevant in contemporary nursing practice. This study aimed to map and assess the scope of research related to self-efficacy in the nursing field from 2013 to 2022 to identify the global trends and new themes that have emerged in recent years.

Methods

This study employed descriptive and bibliometric analysis. Data were sourced from the Web of Science Core Collection database on October 20, 2023. Performance analysis and scientific mapping were undertaken using VOSviewer and CiteSpace, evaluating 2008 publications that featured themes of self-efficacy in nursing.

Results

The review period saw an increase in the number of publications. Recurrent keywords found in the research included “self-efficacy”, “nursing”, “self-management”, “social support”, and “quality of life”, with a notable prevalence of studies on “nursing students” and “breastfeeding”. The concept of “evidence-based practice” has consistently appeared as a focal topic.

Conclusion

The enduring interest in and relevance of self-efficacy in nursing are evident in an increasing literature volume. This study underscores the vitality of the field and the necessity of integrating qualitative research to deepen the understanding of self-efficacy in various nursing contexts. As the demand for evidence-based nursing practice increases, the corpus of literature on self-efficacy in nursing is poised for further growth.

目的：尽管自我效能理论在护理学中得到了长期的认可，但它在当代护理实践中仍然具有相关性。本研究旨在绘制和评估2013年至2022年护理领域自我效能感相关研究的范围，以确定近年来出现的全球趋势和新主题。方法：本研究采用描述性和文献计量学分析。数据来源于Web of Science Core Collection数据库，时间为2023年10月20日。使用VOSviewer和CiteSpace进行绩效分析和科学制图，评估2008年以护理自我效能为主题的出版物。结果：审评期论文发表数量有所增加。研究中反复出现的关键词包括“自我效能”、“护理”、“自我管理”、“社会支持”和“生活质量”，其中“护生”和“母乳喂养”的研究较为普遍。“循证实践”的概念一直是一个焦点话题。结论：在越来越多的文献中，对护理自我效能感的持续关注和相关性是显而易见的。本研究强调了该领域的活力和整合定性研究的必要性，以加深对各种护理环境中自我效能感的理解。随着对循证护理实践的需求增加，关于护理自我效能的文献语料库有望进一步增长。

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引用次数: 0

Development and verification of a prediction model for delirium in critically ill children 危重症患儿谵妄预测模型的建立与验证。

IF 2.3 3区医学 Q2 NURSING

Asian Nursing Research

Pub Date : 2025-10-01 DOI: 10.1016/j.anr.2025.05.008

Ting-Ting Xu , Yan Li , Cong-Hui Fu , Min-Jie Ju , Ji Liu , Xiao-Ya Yang , Wen-Juan Tang , Wei-Ying Zhang

Purpose

Delirium is a common syndrome in the intensive care unit (ICU), with a high incidence in critically ill children. This study aims to develop and validate a prediction model for delirium in critically ill children, which could potentially enhance early identification and management strategies.

Methods

In this prospective cohort study, we collected 1,047 critically ill children admitted to the pediatric intensive care unit (PICU) of a tertiary children's hospital from November 2021 to November 2023. Based on the risk prediction model derived from multiple logistic regression analysis performed with SPSS software, a nomogram was constructed using R software. The model's predictive performance was evaluated through analysis of the area under the curve (AUC) of the receiver operating characteristic curve (ROC) and the calibration curve for discriminatory ability and accuracy.

Results

Among the 1,047 critically ill children, delirium occurred in 26.6% of cases. Mechanical ventilation, benzodiazepines, age ≤2 years, number of catheters ≥3, and physical restraints were independent predictors of delirium in critically ill children. The predictive model demonstrated a sensitivity of 85.6% and a specificity of 76.1%, with a Youden index of .62. The validation analysis demonstrated an AUC of .88 (95% CI: 0.86-0.90). The Hosmer-Lemeshow goodnessoffit test yielded a

x^{2}

value of 15.23 (P > .05), demonstrating satisfactory discriminatory performance and good calibration of the predictive model.

Conclusions

This study provided a predictive model for the occurrence of delirium in critically ill children, enabling nurses to accurately assess delirium risk and enhance the quality of nursing care for this vulnerable patient population.

目的：谵妄是重症监护病房（ICU）常见的一种综合征，在危重症患儿中发病率较高。本研究旨在建立和验证危重症儿童谵妄的预测模型，以潜在地提高早期识别和管理策略。方法：在这项前瞻性队列研究中，我们收集了2021年11月至2023年11月在某三级儿童医院儿科重症监护病房（PICU）住院的1,047名危重儿童。基于SPSS软件进行多变量logistic回归分析得出的风险预测模型，采用R软件构建nomogram。通过分析受试者工作特征曲线（ROC）的曲线下面积（AUC）和校正曲线的判别能力和准确度来评价模型的预测性能。结果：1047例危重患儿中谵妄发生率为26.6%。机械通气、苯二氮卓类药物、年龄≤2岁、导管数≥3根和肢体约束是危重患儿谵妄的独立预测因素。该预测模型敏感性为85.61%，特异性为76.07%，约登指数为0.62。验证分析显示AUC为0.88 （95% CI: 0.86-0.90）。Hosmer-Lemeshow拟合优度检验的结果为15.23 (P < 0.05)，表明该预测模型具有令人满意的判别性能和良好的校正性。结论：本研究为危重症患儿谵妄的发生提供了预测模型，使护士能够准确评估谵妄风险，提高对这一弱势患者群体的护理质量。

{"title":"Development and verification of a prediction model for delirium in critically ill children","authors":"Ting-Ting Xu , Yan Li , Cong-Hui Fu , Min-Jie Ju , Ji Liu , Xiao-Ya Yang , Wen-Juan Tang , Wei-Ying Zhang","doi":"10.1016/j.anr.2025.05.008","DOIUrl":"10.1016/j.anr.2025.05.008","url":null,"abstract":"<div><h3>Purpose</h3><div>Delirium is a common syndrome in the intensive care unit (ICU), with a high incidence in critically ill children. This study aims to develop and validate a prediction model for delirium in critically ill children, which could potentially enhance early identification and management strategies.</div></div><div><h3>Methods</h3><div>In this prospective cohort study, we collected 1,047 critically ill children admitted to the pediatric intensive care unit (PICU) of a tertiary children's hospital from November 2021 to November 2023. Based on the risk prediction model derived from multiple logistic regression analysis performed with SPSS software, a nomogram was constructed using R software. The model's predictive performance was evaluated through analysis of the area under the curve (AUC) of the receiver operating characteristic curve (ROC) and the calibration curve for discriminatory ability and accuracy.</div></div><div><h3>Results</h3><div>Among the 1,047 critically ill children, delirium occurred in 26.6% of cases. Mechanical ventilation, benzodiazepines, age ≤2 years, number of catheters ≥3, and physical restraints were independent predictors of delirium in critically ill children. The predictive model demonstrated a sensitivity of 85.6% and a specificity of 76.1%, with a Youden index of .62. The validation analysis demonstrated an AUC of .88 (95% <em>CI</em>: 0.86-0.90). The Hosmer-Lemeshow goodnessoffit test yielded a <span><math><mrow><msup><mi>x</mi><mn>2</mn></msup></mrow></math></span> value of 15.23 (<em>P</em> > .05), demonstrating satisfactory discriminatory performance and good calibration of the predictive model.</div></div><div><h3>Conclusions</h3><div>This study provided a predictive model for the occurrence of delirium in critically ill children, enabling nurses to accurately assess delirium risk and enhance the quality of nursing care for this vulnerable patient population.</div></div>","PeriodicalId":55450,"journal":{"name":"Asian Nursing Research","volume":"19 4","pages":"Pages 382-388"},"PeriodicalIF":2.3,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144340619","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

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