全飞秒激光近视手术治疗病人术前固视训练依从性预测模型的建立与验证

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Establishment and verification of a prediction model for preoperative fixation training compliance in patients treated with small incision lenticule extraction surgery

LU Haiyan，HE Kunxia，HAN YunThe People′s Hospital of Guangxi Zhuang Autonomous Region，Guangxi 530021 ChinaCorresponding Author  LU Haiyan，E-mail：lhyluhaiy@163.com

Abstract  Objective：To explore the influencing factors of preoperative fixation training compliance in patients undergoing Small Incision Lenticule Extraction （SMILE） surgery and to construct and verify a nomogram prediction model.Methods：A total of 345 patients treated with SMILE surgery from January 2022 to March 2023 were enrolled as subjects by the convenience sampling method. The first 70% of admitted patients were set as the modeling group （242 cases） in order of enrollment，and the last 30% were the validation group （103 cases）. The patients′ general information were collected，and the patients were investigated using the self-made Fixation Training Knowledge Scale，Belief and Action Questionnaire，the Chinese version of the General Self-Efficacy Scale，and the self-made Patient Fixation Training Compliance Scale. Logistic regression analysis was used to screen risk factors for fixation training compliance，and a nomogram model was constructed and verified using R software.Results：Among 345 patients treated with SMILE surgery，108 （31.30%） had poor compliance with preoperative fixation training. Multi-factor Logistic regression analysis of the modeling group showed that age，working status，knowledge，belief and behavior，and self-efficacy affect the compliance of preoperative fixation training in patients treated with SMILE surgery （all P<0.05）. The nomogram model verification results showed that the AUC was 0.793，95%CI （0.734-0.852）;the ideal curve in the Calibration curve was consistent with the actual curve，and the slope was close to 1. Conclusions：The constructed risk prediction nomogram model for preoperative fixation training compliance in patients treated with SMILE surgery has good discrimination and prediction accuracy，which could be used to evaluate preoperative fixation in patients treated with SMILE surgery. The risk of poor training compliance is conducive to taking early intervention measures to improve patients′ training compliance.

Keywords  small incision lenticule extraction surgery;fixation training;compliance;influencing factors;prediction model

摘要  目的：探讨全飞秒激光近视手术治疗病人术前固视训练依从性的影响因素，构建列线图预测模型并验证。（剩余6433字）