Development of a risk prediction model for chronic disease adaptation in patients with acute exacerbation of chro-nic obstructive pulmonary disease based on domain theory

ZHANG Yuan; TAO Lian-de; ZHAO Run-ping; LUO Yu; ZHAO Ya-ning

doi:10.13820/j.cnki.gdyx.20241477

Abstract：Objective To construct and validate a risk prediction model for chronic disease adaptation in patients with acute exacerbation of chronic obstructive pulmonary disease(AECOPD)based on domain theory in chronic disease adaptation nursing.Methods Guided by the domain theory of chronic disease nursing,a convenience sampling method was used to select diagnosed AECOPD patients from the Cangzhou People's Hospital Affiliated to North China University of Science and Technology between October 2020 and September 2021.Patients were followed up 90 days post-discharge and categorized into a good adaptation group(250 cases)and a poor adaptation group(164 cases).Logistic regression a-nalysis identified factors influencing poor chronic disease adaptation,and R software was used to develop the risk predic-tion model and nomogram.Results The final prediction formula is:Logit P=-4.958+1.695 × severity of illness+1.900 × history of frequent acute exacerbations+1.277 × chronic disease resource support+1.319 × future-oriented cop-ing level+0.984 × pulmonary rehabilitation experience.The area under the curve(AUC)for the AECOPD adaptation risk nomogram model is 0.922(95％CI:0.896-0.948),with a sensitivity of 84.8％,specificity of 85.6％,and a Youden index of 70.4％.The consistency index after Bootstrap validation is 0.918.Conclusion Severe illness,a history of fre-quent acute exacerbations,poor chronic disease resource support,low future-oriented coping levels,and inadequate pul-monary rehabilitation experience are risk factors for poor chronic disease adaptation in AECOPD patients.The constructed prediction model demonstrates good discrimination and calibration,assisting healthcare providers in identifying high-risk populations for targeted interventions to improve chronic disease adaptation behaviors and reduce the risk of poor adaptation.