Construction of a novel predictive model for hope level in patients with primary liver cancer from a positive psychology perspective

Abstract

This study aimed to investigate the current hope levels in patients with primary liver cancer by analyzing the risk indicators of hope levels, constructing and validating a novel hope score-based predictive model. A total of 206 patients with primary liver cancer admitted to the hepato-pancreato-biliary surgery department of a tertiary hospital from October 2020 to June 2021 were included. The Herth Hope Index was utilized to assess hope levels, and based on the questionnaire results, the patients were categorized into low-hope (≤ 30 points) and high-hope (> 30 points) groups. Single-factor analysis and logistic multivariate regression analysis were conducted to explore the factors influencing hope levels in patients with primary liver cancer. A nomogram was plotted, and a risk prediction model for hope levels in these patients was developed. The predictive performance of the nomogram model was evaluated using calibration plots, the Hosmer–Lemeshow test, and other relevant assessments. Total of 206 patients participated in the questionnaire survey, with 82 patients (39.81%) categorized as belonging to the low-hope group. The results of the single-factor analysis showed statistically significant differences (all P < 0.05) in marriage status, education level, residence, occupation, family monthly income, reason for hospitalization or outpatient visit, pressure caused by the disease on the family, history of cirrhosis, and level of social support between the two groups. These variables were subsequently included in the logistic multivariate regression model. The results of the regression analysis indicated that marriage status, residence, family monthly income, and level of social support were independent risk factors. These four influencing factors were transformed into a visual predictive model, which yielded an area under the ROC curve of 0.931 (95% CI 0.899–0.963) and demonstrated model significance (Hosmer–Lemeshow test: χ2 = 4.008, P = 0.856, P > 0.05). The observed and expected values generated by the Hosmer–Lemeshow test were plotted as a scatter plot with a fitted linear trend, showing good consistency between the predictive model and actual risk. The constructed predictive model developed in this study exhibited good predictive capability for assessing the hope levels of patients with primary liver cancer. This model can assist clinical staff in rapidly identifying the psychological risk of low hope levels in patients, thereby providing valuable insights for the timely implementation of proactive management measures.