Development and Validation of a Disaster Risk Prediction Model for Postoperative Anal Pain in Patients

Development and Validation of a Disaster Risk Prediction Model for Postoperative Anal Pain in Patients | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Development and Validation of a Disaster Risk Prediction Model for Postoperative Anal Pain in Patients Xiaomei Chen, Xiaodi Zhu, Fangfang Zhang This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-8431346/v1 This work is licensed under a CC BY 4.0 License Status: Under Review Version 1 posted 7 You are reading this latest preprint version Abstract Background Anorectal surgery frequently induces significant postoperative pain, which can precipitate pain catastrophizing, a maladaptive cognitive pattern that exacerbates suffering and delays recovery. The absence of validated tools for early identification of at-risk patients impedes targeted interventions. This study aimed to develop and internally validate a clinical prediction model for postoperative pain catastrophizing in this patient group. Methods We conducted a single-center study of 412 patients assessed 3–4 days after anorectal surgery (October–December 2025). Participants were randomly divided into a modeling group (n = 288) for model development and a validation group (n = 124) for internal validation. Data collected via structured questionnaires (demographics, Pain Catastrophizing Scale, Visual Analogue Scale for pain, Positive and Negative Affect Schedule). This study employed a multivariate logistic regression approach to analyze independent factors influencing catastrophic pain in patients following anorectal surgery. Using R software, we constructed a risk prediction model and a nomogram model for catastrophic pain in patients after anorectal surgery. The predictive efficacy of these models was validated through the area under the receiver operating characteristic curve (AUC) and the Hosmer-Lemeshow goodness-of-fit test. Result In the modeling group (n = 288), 127 patients (44.1%) experienced pain catastrophizing. Logistic regression identified Visual Analogue Scale (VAS) score, negative emotions, lack of preoperative pain cognition, chronic comorbidities, and postoperative constipation as predictors (P < 0.05). The model demonstrated excellent discriminative ability in the modeling group [area under the curve (AUC) = 0.957, 95% CI: 0.937–0.977; Youden index = 0.763], with a sensitivity of 82.6%, specificity of 93.7%, optimal cutoff value of 0.277, and good fit (Hosmer-Lemeshow test, P = 0.790). In the validation group (n = 124, 47.7% experiencing pain catastrophizing), model performance remained outstanding (AUC = 0.985, 95% CI: 0.970–1.000; Youden index = 0.871; sensitivity 92.3%, specificity 94.9%; optimal cutoff value 0.315; Hosmer-Lemeshow test P = 0.991). Calibration curves for both groups indicated good agreement between predicted and observed outcomes. Conclusion We developed and validated a practical nomogram using five clinical variables to effectively identify patients at high risk for post-anorectal surgery pain catastrophizing. This tool facilitates early targeted intervention. The main limitation is the single-center design. anal surgery anorectal diseases pain catastrophizing predictive model nomogram Figures Figure 1 Figure 2 Figure 3 Figure 4 Figure 5 Figure 6 Figure 7 1. Introduction Globally, the prevalence of anal diseases remains persistently high. Research indicates in Western countries [ 1 ] , the prevalence of anal diseases such as hemorrhoids ranges from 4.4% to 36.4% among adults, constituting a significant proportion of both outpatient and inpatient cases. Epidemiological survey results in China indicate that 51.14% of adults (21,885 out of 42,792) suffer from anorectal diseases [ 2 ] . Anal diseases, such as hemorrhoids, anal fissures, anal fistulas, and perianal abscesses, are common general surgical conditions worldwide [ 3 , 4 ] . Patients often experience symptoms such as rectal bleeding, prolapse, anal discomfort, and anal pain, which cause significant distress in their daily lives, work, and mental health, severely impacting their quality of life. Due to the high concentration of sensory nerve endings around the anus, which are extremely sensitive to pain, patients with anal diseases often experience heightened sensitivity to pain [ 1 ] . The anus is a relatively private part of the human body, leading to psychological anxiety in patients [ 5 ] . Colorectal diseases represent a significant public health issue, affecting numerous populations worldwide and imposing a substantial economic burden on society [ 6 ] . Surgical intervention remains the fundamental solution for numerous anorectal conditions. However, due to the region's dense concentration of nerve endings and the typically open nature of postoperative wounds, postoperative pain presents as the primary challenge nearly all patients must confront [ 7 , 8 ] . This pain is often severe and persistent [ 9 , 10 ] , this causes significant inconvenience to patients' post-operative lives. Beyond the pain itself, postoperative complications such as constipation further exacerbate patients' suffering [ 11 ] . Constipation causes patients to fear pain during bowel movements, making them reluctant to strain [ 10 ] , this creates a vicious cycle of "fear of pain → holding stool → constipation → more painful bowel movements," resulting in patients experiencing extreme psychological distress due to post-operative pain. Pain catastrophizing encompasses three aspects: helplessness, rumination, and amplification of pain sensations. It refers to the exaggerated negative psychological attitude that arises during actual or anticipated painful experiences, representing a negative cognitive and emotional coping mechanism for pain [ 12 ] . Catastrophizing pain is a risk factor for persistent pain and impaired physical functioning in patients [ 13 ] . Buvanendran A et al. [ 14 ] research indicates that patients' cognitive levels can influence their levels of pain catastrophizing. Patients may exaggerate postoperative issues when they fail to understand symptoms that arise after surgery. Markfelder T et al. [ 15 ] research indicates that the intensity of pain directly exacerbates the level of pain catastrophizing. Patients undergoing anal surgery experience anal swelling and defecation, which directly exacerbates perianal distension and stabbing pain, thereby worsening the level of pain catastrophizing. Jiang Weilian et al. [ 16 ] research indicates that negative emotions can exacerbate the level of pain catastrophizing. Gong Yan et [ 17 ] research indicates that patients with chronic illnesses lack confidence in achieving favorable treatment outcomes and prognosis, experience heightened feelings of helplessness, and consequently exhibit increased levels of pain catastrophizing. Jiang Weilian et al. [ 18 ] research indicates that postoperative constipation exacerbates patients' levels of pain catastrophizing. The catastrophic perception of pain can delay treatment cycles, compromise surgical outcomes, and adversely affect patients' post-operative quality of life. It also discourages other patients with anorectal conditions from undergoing surgery [ 16 ] . Risk prediction models can more accurately forecast disease occurrence probabilities or adverse event risks by analyzing patient clinical data. Currently, research both domestically and internationally primarily focuses on the current state of pain catastrophizing among patients following anorectal surgery, with relatively few studies addressing this topic [ 16 , 19 ] . No relevant studies have been identified regarding predictive models for catastrophic pain risk in patients following anorectal surgery. Therefore, this study employs regression analysis to identify factors influencing catastrophic pain in post-surgical patients, constructs and validates a risk prediction model, and aims to provide clinical healthcare professionals with an assessment tool for early identification of catastrophic pain risk. This enables the timely implementation of preventive measures to reduce the occurrence of catastrophic pain. 2. Method 2.1 Research Subjects Using convenience sampling, patients who underwent anorectal surgery and were admitted to the Anorectal Surgery Department of a Grade III Class A hospital in Hefei from October 31 to December 10, 2025, were selected as the study subjects during their 3rd to 4th postoperative days. Patient Inclusion Criteria:(1) Patient age ≥ 18 years. (2)Diagnosed as per the ACG clinical guidelines [ 4 ] : mixed hemorrhoids, anal fistula, perianal abscess, anal fissure. (3) The patient is fully conscious, communicates effectively, and can understand and cooperate in completing the questionnaire assessment. (4) Voluntary participation in this study. Exclusion Criteria: (1) Concurrent colorectal tumors or other anorectal diseases. (2) Concurrent severe cardiac, hepatic, or renal disease; immune system disorders; or psychiatric conditions. (3) Severe postoperative complications such as major hemorrhage or serious infection. Formula for Calculating the Sample Size of the Modeling Group and Verification Group [ 20 ] : N=༈tα/2༉ 2 ·p·(1 − p)/d², N = Sample size、a = 0.05、tα/2 = 1.96、d = 0.05, reviewing the literature reveals the prevalence rate [ 21 ] ( p = 26.47%), with a margin of error of d = 0.05 and accounting for a 10% sample loss rate, the calculated sample size was 333 cases. This study collected 423 questionnaires, with 412 valid responses, see Fig. 1 . Research Technology Roadmap, see Fig. 2。 Figure 2: Technology Roadmap 2.2 Ethical Considerations This study was approved by the Medical Ethics Committee of the First Affiliated Hospital of Anhui Medical University (Clinical Research Ethics Review PJ-2025-09-22). All patients understood the procedures, voluntarily participated, and signed informed consent forms. This study complies with the Declaration of Helsinki. 2.3 Research Tools 2.3.1 General Information Questionnaire Self-designed after reviewing literature, including gender, age, education level, occupation type, marital status, monthly personal income, method of medical expense payment, place of residence, primary caregiver during hospitalization, nighttime sleep patterns during hospitalization, regular exercise habits, and whether preoperative knowledge of postoperative pain was obtained from healthcare providers/online sources/other channels. Clinical data were extracted from hospital electronic medical records, including disease type, whether it was the first anal surgery, postoperative use of an analgesic pump, occurrence of postoperative complications (including constipation and urinary retention), and presence of chronic pain (lasting more than one week) before surgery. 2.3.2 Pain Catastrophizing Scale, PCS Adopted by scholars from Hong Kong, China, including Yap et al. [ 22 ] , the Pain Catastrophizing Scale, translated into Chinese and validated for reliability and validity in 2008. The scale comprises three dimensions: helplessness (items 1, 2, 3, 4, 5, 12), grandiosity (items 6, 7, 13), and rumination (items 8, 9, 10, 11), totaling 13 items. Likert5 Rating scale: options range from "Never" to "Always," scored as 0–4 points respectively, with a total score of 0–52 points. The higher the score, the more severe the patient's catastrophic pain. A score of 30 or higher indicates catastrophic levels. In this study, scores ≥ 30 were classified as pain catastrophizing, while scores 30 were classified as no pain catastrophizing. Cronbach's αThe coefficient was 0.927, demonstrating good reliability. In this study, the Cronbach's α coefficient for the scale was 0.976, while the Cronbach's α coefficients for each dimension were 0.957, 0.907, and 0.934. 2.3.3 Visual Analog Scale, VAS To assess the severity of anal pain in patients, a 10-centimeter straight line is marked and precisely measured by the evaluator to quantify subjective pain intensity. A score of 0 indicates no pain, 1–3 indicates mild pain, 4–6 indicates moderate pain, and 7–10 indicates severe pain [ 23 ] . 2.3.4 The Positive and Negative Affect Scale, PANAS Adopted by Huang Li et al. [ 24 ] , The Positive and Negative Affect Schedule, translated into Chinese and validated for reliability and validity in 2003, is used to assess patients' emotional states and their intensity. The scale comprises two dimensions: positive affect and negative affect, each containing 10 items, totaling 20 items. The Likert 5-point scale yields a total score ranging from 20 to 100 points. The Cronbach's α coefficient for this scale is 0.82. Possesses good reliability this study, the Cronbach's α coefficient for the scale was 0.627, while the Cronbach's α coefficients for the individual dimensions were 0.898 and 0.941. 2.3 Data Collection and Quality Control Methods Questionnaires will be administered uniformly by researchers postoperatively 3-4days Conduct the survey. Before collecting questionnaires, inform participants about the purpose, significance, and content of this study, as well as their rights and obligations in participating. After obtaining informed consent, proceed to formal questionnaire completion. For participants experiencing difficulty understanding the questionnaire, researchers provided explanations, inquired about responses, completed entries on their behalf, and confirmed accuracy. Completed questionnaires were collected and verified on-site; any missing or incomplete sections were supplemented immediately. Data collection and entry were jointly conducted by the principal investigator and one trained study team member holding the title of nurse practitioner or higher with at least three years of experience in proctology. A third member performed final verification. 2.4 Statistical Methods Statistical analysis was performed using SPSS 29.0 software. Quantitative data meeting normal distribution requirements were expressed as mean ± standard deviation ( x¯±s ) and analyzed using the independent samples t -test. Qualitative data were expressed as frequencies and percentages ( % ) and analyzed using the χ ² test. Variables showing statistical significance in univariate analysis were incorporated into a multivariate logistic regression model. After variable selection, a predictive model was established using the rms package in R software, and a column chart was generated. Model fit and predictive performance were assessed using the Hosmer-Lemeshow test, receiver operating characteristic (ROC) curves, and calibration curves. P <0.05 was considered statistically significant. 3. Results 3.1 Baseline Data The modeling group comprised 288 patients with a mean age of 39.57±12.37 years, including 196 males and 92 females. The mean PCS score was 35.71±13.81 points, as shown in Table 1。 Table 1 ： Baseline Characteristics of 288 Patients in the Modeling Cohort Variable n %/x¯±s Age（years） 288 39.57±12.37 Gender Male 196 68.1 Female 92 31.9 Education level Elementary school and below 37 12.8 Junior high school 58 20.2 High school/Vocational school 59 20.5 Associate degree or higher 134 46.5 Occupation No job 58 20.2 Physical labor 73 25.3 Mental work 157 54.5 Marital status Married 216 75.0 Unmarried 62 21.5 Divorced/Widowed 10 3.5 Monthly personal income（RMB） ＜1000 59 20.5 1000-3000 54 18.8 3000-5000 88 30.5 ＞5000 87 30.2 Medical expense payment methods Health insurance 273 94.8 No health insurance 15 5.2 Place of residence Rural 85 29.5 Urban 203 70.5 Primary caregiver during hospitalization Children 33 11.5 Parents 54 18.8 Spouse 142 49.2 Others 59 20.5 Sleep quality during nighttime hours while hospitalized Good 99 34.4 General 155 53.8 Poor/Bad 34 11.8 Exercise（%） At least 3 times per week 23 8.0 Occasionally 101 35.1 Hardly any 164 56.9 Understanding postoperative pain before surgery Fully understand 49 17.0 Partial understanding 131 45.5 Rarely understand 108 37.5 Diagnosis（%） Mixed hemorrhoids 102 35.4 Fistula 18 6.3 Perianal abscess 28 9.7 Mixed hemorrhoids and anal fissure 60 20.8 Mixed hemorrhoids and perianal abscess 34 11.8 Mixed hemorrhoids and anal fistula 35 12.2 Mixed hemorrhoids and anal fistula 11 3.8 First anal surgery Yes 261 90.4 No 27 9.6 Postoperative use of an analgesic pump Yes 168 58.3 No 120 41.7 Combined Chronic Diseases Yes 247 85.8 No 41 14.2 Chronic pain before surgery Yes 66 22.9 No 222 77.1 Postoperative urinary retention Yes 240 83.3 No 48 16.7 Postoperative constipation Yes 82 28.5 No 206 71.5 VAS（score） 288 4.52±1.62 Positive emotions（score） 288 25.45±6.07 Negative emotions（score） 288 17.94±7.95 Abbreviation: VAS， visual analog scale；s， Sample standard deviation; x̄, Sample mean;%， Variable proportion. 3.2Univariate Analysis of Risk Factors for Catastrophic Pain in Patients Following Anal Sphincter Reconstruction Surgery The modeling group was divided into no pain catastrophizing161 cases, and pain catastrophizing in 127 cases, with a 44.1% incidence of pain catastrophizing risk. Univariate analysis was conducted using the occurrence of pain catastrophizing as the dependent variable， Results indicate that age, gender, place of residence, sleep during hospitalization, preoperative knowledge of postoperative pain, presence of chronic comorbidities, postoperative complications (urinary retention, constipation), VAS score, positive affect score, and negative affect score are factors influencing the risk of pain catastrophizing（ P ＜0. 05）, See Table 2. Table 2 ： Results of the Single-Factor Analysis for the Modeling Module （ n=288 ） Variable No PCS ( n =161) PCS ( n =127) t/x 2 p Age（years，x¯±s） 38.01±12.35 41.55±12.16 -2.431 0.016 Gender（%） 7.049 0.008 Male 120(74.5) 76(59.8) Female 41(25.5) 51(40.2) Education level（%） 5.668 0.129 Elementary school and below 16(9.9) 21(16.5) Junior high school 28(17.4) 30(23.7) High school/Vocational school 37(23.0) 22(17.3) Associate degree or higher 80(49.7) 54(42.5) Occupation（%） 3.073 0.215 No job 27(16.8) 31(24.4) Physical labor 45(28.0) 28(22.1) Mental work 89(55.2) 68(53.5) Marital status（%） 5.769 0.056 Married 112(69.9) 104(81.9) Unmarried 42(26.1) 20 (15.7) Divorced/Widowed 7(4.3) 3(2.4) Monthly personal income（RMB，%） 7.138 0.068 ＜1000 34 (21.1) 25(19.7) 1000-3000 24(14.9) 30(23.6) 3000-5000 58(36.0) 30(23.6) ＞5000 45(28.0) 42(33.1) Medical expense payment methods（%） 0.042 0.837 Health insurance 153(95.0) 120(94.5) No health insurance 8(5.0) 7(5.5) Place of residence（%） 6.133 0.013 Rural 38(23.6) 47(37.0) Urban 123(76.4) 80(63.0) Primary caregiver during hospitalization（%） 1.678 0.642 Children 19(11.8) 14(11.0) Parents 34(21.1) 20 (15.7) Spouse 75(46.6) 67(52.8) Others 33(20.5) 26(20.5) Sleep quality during nighttime hours while hospitalized（%） 13.511 0.001 Good 65(40.4) 34(26.8) General 86(53.4) 69(54.3) Poor/Bad 10(6.2) 24(18.9) Exercise（%） 2.008 0.352 At least 3 times per week 16(9.9) 7(5.5) Occasionally 57(35.4) 44(34.6) Hardly any 88(54.7) 76(59.9) Understanding postoperative pain before surgery（%） 10.274 0.006 Fully understand 36(22.4) 13(10.2) Partial understanding 75(46.4) 56(44.1) Rarely understand 50(31.1) 58(45.7) Diagnosis（%） 5.986 0.541 Mixed hemorrhoids 60(37.3) 42(33.1) Fistula 12(7.5) 12(9.5) Perianal abscess 17(10.6) 17(13.4) Mixed hemorrhoids and anal fissure 29(18.0) 31(24.4) Mixed hemorrhoids and perianal abscess 17(10.6) 17(13.4) Mixed hemorrhoids and anal fistula 18(11.2) 17(13.4) Mixed hemorrhoids and anal fistula 8(5.0) 3(2.4) First anal surgery（%） 2.623 0.269 Yes 147(91.3) 114(89.9) No 14(8.7) 13(10.2) Postoperative use of an analgesic pump（%） 2.145 0.143 Yes 100() 68(53.5) No 61() 59(46.5) Combined Chronic Diseases（%） 7.237 0.007 Yes 15(9.3) 26(20.5) No 146(90.7) 101(79.5) Chronic pain before surgery（%） 0.001 0.977 Yes 37(23.0) 29(22.8) No 124(77.0) 98(77.2) Postoperative urinary retention（%） 16.702 ＜0.001 Yes 14(8.7) 34(26.8) No 147(91.3) 93(73.2) Postoperative constipation（%） 70.117 ＜0.001 Yes 14(8.7) 68(53.5) No 147(91.3) 59(46.5) VAS（score，x¯±s） 3.60±1.20 5.69±1.31 -14.091 ＜0.001 Positive emotions（score，x¯±s） 128.38±5.53 21.57±4.51 10.944 ＜0.001 Negative emotions（score，x¯±s） 13.52±3.85 23.56±8.26 -12.667 ＜0.001 Abbreviation: PCS， Pain Catastrophizing Scale； VAS， Visual Analog Scale； s ， Sample standard deviation; χ² , Chi-Square Test； x̄ , Sample mean; t， Independent samples test. %， Variable proportion. 3.3 Screening of Risk Factors for Pain Catastrophizing and Development of a Predictive Model Using the occurrence of pain catastrophizing risk as the dependent variable (No=0, Yes=1), and incorporating observation indicators with clinically significant differences in univariate analysis ( P< 0.05) as independent variables, ultimately, 11 variables were included in the multivariate logistic regression analysis. The variable assignment methods are shown in Table 3. Results indicated that patients with chronic comorbidities, minimal preoperative knowledge of postoperative pain management, postoperative complications (urinary retention, constipation), anal visual analog scale scores, and negative emotional scores were independent risk factors for pain catastrophizing ( P <0.05), entering the predictive model as shown in Table 4. Column plots were generated using the "rms" package in RStudio, as depicted in Figure 3. Table 3: Modeling Module Assignment Method for Independent Variables Variable Assign a value Gender Male=0，woman=1 Age (years) Original value input Place of residence Rural=0, Urban=1 Sleep quality during nighttime hours while hospitalized Good=0, General =1，Poor/Bad =2 Understanding postoperative pain before surgery Fully understand =0，Partial understanding =1，Rarely understand =2 Combined Chronic Diseases No=0，Yes=1 Postoperative urinary retention No=0，Yes=1 Postoperative constipation No=0，Yes=1 VAS Original value input Positive emotions Original value input negative emotions Original value input Abbreviation: PCS， Pain Catastrophizing Scale； VAS， Visual Analog Scale. Table 4:Multivariate linear regression analysis of the modeling group (n=288) Variable value SE Value Waldx 2 Value P Value OR Value 95% CI Constant -8.907 8.824 9.905 0.002 0.000 - VAS 1.393 0.285 29.137 ＜0.001 4.028 2.429-6.679 Negative emotions 0.180 0.05 13.098 ＜0.001 1.197 1.068-1.320 Understanding postoperative pain before surgery 0.901 0.372 5.861 0.015 2.462 1.187-5.108 Postoperative constipation 2.585 0.602 18.41 ＜0.001 13.262 4.072-43.195 Combined Chronic Diseases 1.751 0.718 5.939 0.015 5.759 1.409-23.546 Abbreviation: VAS， Visual Analog Scale. SE, standard error; β , regression coefficient; OR , Odds Ratio； CI , Confidence interval； Wald χ² ， the statistic used for hypothesis testing of a single regression coefficient β in logistic regression. 3.4 Performance Evaluation of Predictive Models The area under the ROC curve (AUC) for the modeling group was 0.957 [95% CI (0.937, 0.977)], with a J statistic of 0.763, sensitivity of 82.6%, specificity of 93.7%, and an optimal cutoff value of 0.277， see Figure 4. The ROC curve area under the curve (AUC) for the validation cohort was 0.985 [95% CI (0.970, 1.000)], with a Yordens index of 0.871, sensitivity of 92.3%, specificity of 94.9%, and optimal cutoff value of 0.315, see Figure 5.The Hosmer-Lemeshow goodness-of-fit test yielded χ ² =4.965 ( P =0.790). Calibration curves for the modeling cohort demonstrated good agreement between model predictions and observed outcomes, as shown in Figure 6. The Hosmer-Lemeshow goodness-of-fit test for the validation cohort yielded χ ² = 1.594 (P =0.991). Calibration curves consistently demonstrated good agreement between model predictions and observed outcomes in the validation cohort, as shown in Figure 7. 4. Discussion 4.1 Patients undergoing anorectal surgery have a relatively high incidence of catastrophic pain. In this study, 127 out of 288 patients in the modeling group experienced pain catastrophizing, yielding an incidence rate of 44.1%, consistent with the findings of Jiang et al. [16] , the incidence of catastrophic pain in patients with mixed hemorrhoids is 42.15%. The perianal region contains a high concentration of sensory nerve endings, making it extremely sensitive to pain. Patients often experience severe pain following anal surgery, which directly exacerbates the level of pain catastrophizing. Due to the private nature of the anal region, dressing changes and wound care after surgery frequently require exposing intimate areas, leading to negative emotions in patients [5] , thereby increasing the risk of pain becoming catastrophic. 4.2 Visual Anal Scale This study indicates that the visual analog scale (VAS) for anal pain is the strongest predictor of pain catastrophizing. The findings reveal a small to moderate positive correlation between fear of pain and pain intensity [15] ， consistent with the findings of this study. Patients undergoing anal surgery experience intense pain, which can cause both physical suffering and psychological distress, potentially leading to negative coping mechanisms. This indicates that high-intensity pain serves as a direct and powerful physiological basis for triggering catastrophic thinking. As the key site controlling fundamental excretory functions, pain in the anus directly induces a profound sense of loss of control and a threat to vital survival functions; At the same time, due to the highly private and shameful nature of this area, patients often find themselves trapped in a negative psychological state of loneliness and helplessness [25] , due to fear of pain, individuals may avoid bowel movements, which exacerbates constipation and intensifies discomfort. This cycle of pain-fear-avoidance-exacerbated pain, coupled with inevitable triggers in daily activities, continually reinforces the patient's catastrophic thinking. 4.3 Constipation Within 7 days after anal surgery, the patient's wound remains in the edema phase, and bowel movements may exacerbate anal pain [26] . Patients often refuse to defecate due to fear of pain, which further hardens and dries the stool. Each straining episode directly pulls and compresses the unhealed anal wound, causing mechanical pain impulses to multiply [27] . Following anal surgery, anal edema increases resistance during bowel movements, leading to elevated resting anal pressure and exacerbating anal pain [28] . As pain intensifies, it exacerbates patients' negative emotions, providing an objective sensory basis for catastrophic thinking [29] . Postoperative constipation following anorectal surgery exacerbates pain and increases its catastrophic level, consistent with the findings of Jiang Weilian et al. [18] . 4.4 Preoperative Understanding of Pain Knowledge and Awareness of Chronic Conditions This study reveals the pivotal role of psychological factors in the catastrophizing of pain. Lack of knowledge about postoperative pain and the presence of chronic comorbidities are significant risk factors. Research indicates that thorough preoperative health education about the disease helps alleviate patients' psychological burden [11] , Similar to the findings of this study. Patients who lack understanding of the nature, duration, and relief methods for postoperative pain may misinterpret every instance of normal postoperative discomfort as "surgical failure" or "wound dehiscence". Patients' preoperative pain expectations influence their actual postoperative pain experience [30] . Healthcare providers should ensure that surgical patients receive comprehensive information about postoperative pain before surgery research indicates that patients with chronic illnesses exhibit heightened levels of pain catastrophizing [17] , consistent with the findings of this study. For patients with long-term chronic conditions, concerns about elevated blood sugar and blood pressure post-surgery may affect wound healing. When experiencing normal postoperative pain, these patients often attribute worsening perianal discomfort to their chronic illness. When patients cannot explain their pain through medical reasoning, their attention repeatedly focuses on the pain sensation, generating anxiety that elevates the level of pain catastrophizing [31] . 4.5 Negative Emotions At the emotional level, the findings of this study indicate that negative emotions exacerbate the risk of pain catastrophizing. Research shows that negative cognitive emotions intensify the level of pain catastrophizing [32] , consistent with the findings of this study. The reason may be that patients with negative emotions often experience psychological distress when facing postoperative pain and various complications, thereby amplifying their actual perception of pain [29,33] . This aligns with the findings of Wei Lian et al. [16] and Pan Qi et al. [34] , indicating that negative emotions exacerbate the level of pain catastrophizing. Emotional states are not merely responses to pain but also serve as crucial regulatory variables that directly influence an individual's perception of events. 4.6 Predictive Model Analysis This study constructed and internally validated a predictive model for catastrophic postoperative anal pain risk, demonstrating exceptional discriminatory performance and calibration (AUC=0.957 in the modeling cohort, AUC=0.985 in the validation cohort). This model integrates five core factors: postoperative pain intensity, negative emotions, insufficient preoperative pain knowledge, comorbid chronic diseases, and postoperative constipation, into an intuitive nomogram tool, enabling early, quantitative assessment of patient risk. Its high sensitivity and specificity ensure clinical identification accuracy, while each predictor targets specific, modifiable factors. This provides critical evidence for implementing precision intervention strategies centered on pain management optimization, psychological counseling, constipation prevention, and personalized health education. 5. Conclusion The incidence of pain catastrophizing among patients after anorectal surgery is 44.1%, influenced by comorbid chronic diseases, preoperative knowledge of postoperative pain, postoperative constipation, anal visual analog scale scores, and negative emotion scores. The risk prediction model for pain catastrophizing was developed based on these factors and demonstrated good validation results, providing healthcare professionals with a reference for early identification and intervention of pain catastrophizing risk in anorectal surgery patients. This study has the following limitations: First, it did not include potential predictors such as psychological factors; future research should incorporate additional predictive variables. Second, due to the lack of external validation, the generalizability and reliability of these findings remain to be confirmed. Future studies should validate the model using external datasets to enhance its external validity. Abbreviations English full name Abbreviation Pain Catastrophizing Scale PCS Visual Analog Scale VAS The Positive and Negative Affect Scale PANAS Sample standard deviation s Sample mean x̄ Chi-Square Test χ² Independent samples test t regression coefficient β Odds Ratio OR Confidence interval CI the statistic used for hypothesis testing of a single regression coefficientβin logistic regression. Wald χ² Declarations Ethics approval and consent to participate ： This study was approved by the Medical Ethics Committee of the First Affiliated Hospital of Anhui Medical University (Clinical Research Ethics Review PJ-2025-09-22), and all stages of the study were conducted in accordance with the established research ethics principles. Informed consent has been obtained from all participants. This study complies with the Declaration of Helsinki. Consent for publication ： The manuscript contains personal data in any form (including personal details, images, or videos)，approved for publication. Availability of data and materials ： The datasets generated and analyzed by this research are not publicly available to ensure patient privacy and comply with ethical guidelines regarding informed consent for online raw data. However, interested researchers may request access to the data from the corresponding author, subject to reasonable requirements. Competing Interests ： The authors declare no conflicts of interest. Funding: This research was supported by the Provincial Quality Engineering Program of Anhui Higher Education Institutions（Number:2024：jyxm0753）. Authors’ Contributions: Xiaomei Chen: Questionnaire design, data collection, data statistics, article writing. Xiaodi Zhu: Design guidance and supervision. Fangfang Zhang: Data statistics, design guidance, and supervision. Acknowledgements ： This research is grateful for the collaboration of teachers from various departments of the First Affiliated Hospital of Anhui Medical University. Clinical Trial Number ： Not applicable. References Liu Y, Wang L, Liu J, Geng F, Li Y, Zheng L. The relationship between anal disease and quality of life: A bibliometric study. Ann Transl Med. 2022;10(8):484. Chinese Society of Integrative Medicine, Committee on Colorectal and Anal Diseases. Chinese Guidelines for the Diagnosis and Treatment of Hemorrhoids. (2020). Colorectal and Anal Surgery 2020;26(5):519 – 33. Rosser R, Harikrishnan A. Benign anorectal conditions: Perianal abscess, fistula in ano, haemorrhoids, fissures, and pilonidal sinus. Surg (oxf). 2020;38(6):322–8. Wald A, Bharucha AE, Limketkai B, Malcolm A, Remes-Troche JM, Whitehead WE, et al. ACG clinical guidelines: Management of benign anorectal disorders. 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Cai Weixin S, Weige Z, Ran S, Xue L, Nan D, Yue, et al. Evidence-Based Summary of Perioperative Health Education for Day Surgery Patients Undergoing Anorectal Procedures. J Nurs Adm Manag. 2023;23(12):894–900. Flink IL, Boersma K, Linton SJ. Pain catastrophizing as repetitive negative thinking: A development of the conceptualization. Cogn Behav Ther. 2013;42(3):215–23. Hampton SN, Nakonezny PA, Richard HM, Wells JE. Pain catastrophizing, anxiety, and depression in hip pathology. Bone Jt J 2019;101-B(7):800ཞ7. Buvanendran A, Sremac AC, Merriman PA, Della Valle CJ, Burns JW, McCarthy RJ. Preoperative cognitive-behavioral therapy for reducing pain catastrophizing and improving pain outcomes after total knee replacement: A randomized clinical trial. Reg Anesth Pain Med. 2021;46(4):313–21. Markfelder T, Pauli P. Fear of pain and pain intensity: Meta-analysis and systematic review. Psychol Bull. 2020;146(5):411–50. Jiang Weilian G, Xuan L, Ming T, Huijuan Z, Zhi L. The Current Status of Early Postoperative Pain Catastrophizing in Patients with Mixed Hemorrhoids and Its Influencing Factors. J PLA Nurs. 2021;38(9):79–81. Gong Y, Yonghua W, Wei W, Ling L, Yunming L, Jie S, et al. Correlation between Pain Psychological Resilience and Pain Catastrophizing in Elderly Patients with Chronic Musculoskeletal Pain. Geriatr Health Care. 2023;29(1):111–6. Jiang Weilian G, Xuan W, Ke L, Ming T, Huijuan Z, Zhi, et al. Development and Application of a Disaster Management Strategy for Postoperative Pain in Patients with Mixed Hemorrhoids. J PLA Nurs. 2022;39(3):95–8. Li R. Catastrophizing Levels of Early Postoperative Pain in Patients with Anal Fistula and Its Influencing Factors. Evid Based Nurs. 2025;11(9):1896–9. Charan J, Biswas T. How to calculate sample size for different study designs in medical research? Indian J Psychol Med. 2013;35(2):121–6. Xu Meijuan C, Li J, Lingfang Y, Qin. Development and Validation of a Predictive Model for Early Pain Catastrophizing in Patients After Mixed Hemorrhoid Surgery. Contemp Chin Med. 2025;32(10):19–24. Yap JC, Lau J, Chen PP, Gin T, Wong T, Chan I, et al. Validation of the Chinese pain catastrophizing scale (HK-PCS) in patients with chronic pain. Pain Med (malden Mass). 2008;9(2):186–95. Shafshak TS, Elnemr R. The visual analogue scale versus numerical rating scale in measuring pain severity and predicting disability in low back pain. J Clin Rheumatol: Pract Rep Rheum Musculoskelet Dis. 2021;27(7):282–5. Huang Li Y, Tingzhong J, Zhongmin. A Study on the Applicability of the Positive and Negative Affect Schedule in the Chinese Population. Chin J Mental Health 2003;(1):54–6. Wang X. Clinical Observation of Bletilla Powder Combined with Chitosan for Postoperative Wound Care in Low-Level Simple Anal Fistula Surgery[D]. Anhui University of Chinese Medicine; 2024. Chen PC, Kao YK, Yang PW, Chen CH, Chen CI. Ice packing versus warm sitz baths for post-hemorrhoidectomy pain management: A randomized controlled trial. Dis Colon Rectum. 2025;68(7):865. Lohsiriwat V. Anorectal emergencies. World J Gastroenterol. 2016;22(26):5867–78. Bharucha AE, Lacy BE. Mechanisms, evaluation, and management of chronic constipation. Gastroenterology. 2020;158(5):1232–e12493. Wiech K, Tracey I. The influence of negative emotions on pain: Behavioral effects and neural mechanisms. NeuroImage. 2009;47(3):987–94. Sakyi R, Boateng EA, Diji AKA, Afful KA, Nimoh VA, Ajanaba PA, et al. Pain expectations, experiences, and coping strategies used by post-operative patients: A descriptive phenomenological study. PLoS ONE. 2025;20(6):e0298780. Rogers AH, Farris SG. A meta-analysis of the associations of elements of the fear-avoidance model of chronic pain with negative affect, depression, anxiety, pain-related disability, and pain intensity. Eur J Pain. 2022;26(8):1611–35. Haythornthwaite JA, Campbell CM, Edwards RR. When thinking about how pain contributes to suffering: The example of pain catastrophizing. Pain. 2024;165(11 Suppl):S68–75. Landmark L, Sunde HF, Fors EA, Kennair LEO, Sayadian A, Backelin C, et al. Associations between pain intensity, psychosocial factors, and pain-related disability in 4285 patients with chronic pain. Sci Rep. 2024;14(1):1–12. Pan Qi. A Longitudinal Study on the Catastrophic Trajectory of Pain and Its Influencing Factors in Elderly Total Knee Arthroplasty Patients [D]. Zhengzhou University; 2022. Additional Declarations No competing interests reported. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-8431346","acceptedTermsAndConditions":true,"allowDirectSubmit":false,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":583559246,"identity":"5e21a219-b818-4063-843c-ed8ad0e6a82f","order_by":0,"name":"Xiaomei Chen","email":"","orcid":"","institution":"First Affiliated Hospital of Anhui Medical University","correspondingAuthor":false,"prefix":"","firstName":"Xiaomei","middleName":"","lastName":"Chen","suffix":""},{"id":583559250,"identity":"cf7b808f-0c4f-432a-a83f-e6c72db100d5","order_by":1,"name":"Xiaodi Zhu","email":"","orcid":"","institution":"First Affiliated Hospital of Anhui Medical 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2","display":"","copyAsset":false,"role":"figure","size":203436,"visible":true,"origin":"","legend":"\u003cp\u003e\u003cstrong\u003eTechnology Roadmap\u003c/strong\u003e\u003c/p\u003e","description":"","filename":"image2.jpeg","url":"https://assets-eu.researchsquare.com/files/rs-8431346/v1/5a267dee125e04a0d1195783.jpeg"},{"id":101634655,"identity":"7abefc22-f4f6-4db5-aeea-df0b0aeef71c","added_by":"auto","created_at":"2026-02-02 06:17:38","extension":"png","order_by":3,"title":"Figure 3","display":"","copyAsset":false,"role":"figure","size":88897,"visible":true,"origin":"","legend":"\u003cp\u003e\u003cstrong\u003eColumn Chart Prediction Model\u003c/strong\u003e\u003c/p\u003e","description":"","filename":"image3.png","url":"https://assets-eu.researchsquare.com/files/rs-8431346/v1/6b4d8af5e9f86f59109c8dd7.png"},{"id":101634657,"identity":"aa68c4f4-3607-484f-b7df-28319bf12e7e","added_by":"auto","created_at":"2026-02-02 06:17:38","extension":"png","order_by":4,"title":"Figure 4","display":"","copyAsset":false,"role":"figure","size":41207,"visible":true,"origin":"","legend":"\u003cp\u003e\u003cstrong\u003eROC Curve for Modeling Group\u003c/strong\u003e\u003c/p\u003e","description":"","filename":"image4.png","url":"https://assets-eu.researchsquare.com/files/rs-8431346/v1/0b5b13ee2d74475f32c53481.png"},{"id":101634658,"identity":"38dee288-8c51-417d-8b4f-63b224596074","added_by":"auto","created_at":"2026-02-02 06:17:38","extension":"jpeg","order_by":5,"title":"Figure 5","display":"","copyAsset":false,"role":"figure","size":1668003,"visible":true,"origin":"","legend":"\u003cp\u003e\u003cstrong\u003eROC Curve for Validation Group\u003c/strong\u003e\u003c/p\u003e","description":"","filename":"image5.jpeg","url":"https://assets-eu.researchsquare.com/files/rs-8431346/v1/3db584c323ac8fa82c6626e1.jpeg"},{"id":101634652,"identity":"8c2b997d-1130-4e0c-ad24-30553ee72700","added_by":"auto","created_at":"2026-02-02 06:17:38","extension":"jpeg","order_by":6,"title":"Figure 6","display":"","copyAsset":false,"role":"figure","size":14829,"visible":true,"origin":"","legend":"\u003cp\u003e\u003cstrong\u003eModeling Group Calibration Diagram\u003c/strong\u003e\u003c/p\u003e","description":"","filename":"image6.jpeg","url":"https://assets-eu.researchsquare.com/files/rs-8431346/v1/d646a3dfee0a5d9c0cb2656b.jpeg"},{"id":101634656,"identity":"b598f5c2-4d87-4df3-b52c-54f77e211a84","added_by":"auto","created_at":"2026-02-02 06:17:38","extension":"jpeg","order_by":7,"title":"Figure 7","display":"","copyAsset":false,"role":"figure","size":64469,"visible":true,"origin":"","legend":"\u003cp\u003e\u003cstrong\u003eValidation Group Calibration Diagram\u003c/strong\u003e\u003c/p\u003e","description":"","filename":"image7.jpeg","url":"https://assets-eu.researchsquare.com/files/rs-8431346/v1/6c04e4f8fc31f0560af97dc5.jpeg"},{"id":102294880,"identity":"e2d56e07-49ba-48ee-928a-aa5efac9daa2","added_by":"auto","created_at":"2026-02-10 10:02:59","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":3752113,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-8431346/v1/c65e8c1c-c5cd-4752-866d-435f27a6f311.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"\u003cp\u003e\u003cstrong\u003eDevelopment and Validation of a Disaster Risk Prediction Model for Postoperative Anal Pain in Patients\u003c/strong\u003e\u003c/p\u003e","fulltext":[{"header":"1. Introduction","content":"\u003cp\u003eGlobally, the prevalence of anal diseases remains persistently high. Research indicates in Western countries\u003csup\u003e[\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e]\u003c/sup\u003e, the prevalence of anal diseases such as hemorrhoids ranges from 4.4% to 36.4% among adults, constituting a significant proportion of both outpatient and inpatient cases. Epidemiological survey results in China indicate that 51.14% of adults (21,885 out of 42,792) suffer from anorectal diseases\u003csup\u003e[\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e]\u003c/sup\u003e. Anal diseases, such as hemorrhoids, anal fissures, anal fistulas, and perianal abscesses, are common general surgical conditions worldwide\u003csup\u003e[\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e, \u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e]\u003c/sup\u003e. Patients often experience symptoms such as rectal bleeding, prolapse, anal discomfort, and anal pain, which cause significant distress in their daily lives, work, and mental health, severely impacting their quality of life. Due to the high concentration of sensory nerve endings around the anus, which are extremely sensitive to pain, patients with anal diseases often experience heightened sensitivity to pain\u003csup\u003e[\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e]\u003c/sup\u003e. The anus is a relatively private part of the human body, leading to psychological anxiety in patients\u003csup\u003e[\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e]\u003c/sup\u003e. Colorectal diseases represent a significant public health issue, affecting numerous populations worldwide and imposing a substantial economic burden on society\u003csup\u003e[\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e]\u003c/sup\u003e.\u003c/p\u003e \u003cp\u003eSurgical intervention remains the fundamental solution for numerous anorectal conditions. However, due to the region's dense concentration of nerve endings and the typically open nature of postoperative wounds, postoperative pain presents as the primary challenge nearly all patients must confront\u003csup\u003e[\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e, \u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e]\u003c/sup\u003e. This pain is often severe and persistent\u003csup\u003e[\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e, \u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e]\u003c/sup\u003e, this causes significant inconvenience to patients' post-operative lives. Beyond the pain itself, postoperative complications such as constipation further exacerbate patients' suffering\u003csup\u003e[\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e]\u003c/sup\u003e. Constipation causes patients to fear pain during bowel movements, making them reluctant to strain\u003csup\u003e[\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e]\u003c/sup\u003e, this creates a vicious cycle of \"fear of pain \u0026rarr; holding stool \u0026rarr; constipation \u0026rarr; more painful bowel movements,\" resulting in patients experiencing extreme psychological distress due to post-operative pain.\u003c/p\u003e \u003cp\u003ePain catastrophizing encompasses three aspects: helplessness, rumination, and amplification of pain sensations. It refers to the exaggerated negative psychological attitude that arises during actual or anticipated painful experiences, representing a negative cognitive and emotional coping mechanism for pain\u003csup\u003e[\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e]\u003c/sup\u003e. Catastrophizing pain is a risk factor for persistent pain and impaired physical functioning in patients\u003csup\u003e[\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e]\u003c/sup\u003e. Buvanendran A et al.\u003csup\u003e[\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e]\u003c/sup\u003eresearch indicates that patients' cognitive levels can influence their levels of pain catastrophizing. Patients may exaggerate postoperative issues when they fail to understand symptoms that arise after surgery. Markfelder T et al.\u003csup\u003e[\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e]\u003c/sup\u003eresearch indicates that the intensity of pain directly exacerbates the level of pain catastrophizing. Patients undergoing anal surgery experience anal swelling and defecation, which directly exacerbates perianal distension and stabbing pain, thereby worsening the level of pain catastrophizing. Jiang Weilian et al.\u003csup\u003e[\u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e]\u003c/sup\u003eresearch indicates that negative emotions can exacerbate the level of pain catastrophizing. Gong Yan et \u003csup\u003e[\u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e]\u003c/sup\u003eresearch indicates that patients with chronic illnesses lack confidence in achieving favorable treatment outcomes and prognosis, experience heightened feelings of helplessness, and consequently exhibit increased levels of pain catastrophizing. Jiang Weilian et al.\u003csup\u003e[\u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e]\u003c/sup\u003eresearch indicates that postoperative constipation exacerbates patients' levels of pain catastrophizing. The catastrophic perception of pain can delay treatment cycles, compromise surgical outcomes, and adversely affect patients' post-operative quality of life. It also discourages other patients with anorectal conditions from undergoing surgery\u003csup\u003e[\u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e]\u003c/sup\u003e.\u003c/p\u003e \u003cp\u003eRisk prediction models can more accurately forecast disease occurrence probabilities or adverse event risks by analyzing patient clinical data. Currently, research both domestically and internationally primarily focuses on the current state of pain catastrophizing among patients following anorectal surgery, with relatively few studies addressing this topic\u003csup\u003e[\u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e, \u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e]\u003c/sup\u003e. No relevant studies have been identified regarding predictive models for catastrophic pain risk in patients following anorectal surgery. Therefore, this study employs regression analysis to identify factors influencing catastrophic pain in post-surgical patients, constructs and validates a risk prediction model, and aims to provide clinical healthcare professionals with an assessment tool for early identification of catastrophic pain risk. This enables the timely implementation of preventive measures to reduce the occurrence of catastrophic pain.\u003c/p\u003e"},{"header":"2. Method","content":"\u003cdiv id=\"Sec3\" class=\"Section2\"\u003e \u003ch2\u003e2.1 Research Subjects\u003c/h2\u003e \u003cp\u003eUsing convenience sampling, patients who underwent anorectal surgery and were admitted to the Anorectal Surgery Department of a Grade III Class A hospital in Hefei from October 31 to December 10, 2025, were selected as the study subjects during their 3rd to 4th postoperative days. Patient Inclusion Criteria:(1) Patient age\u0026thinsp;\u0026ge;\u0026thinsp;18 years. (2)Diagnosed as per the ACG clinical guidelines\u003csup\u003e[\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e]\u003c/sup\u003e: mixed hemorrhoids, anal fistula, perianal abscess, anal fissure. (3) The patient is fully conscious, communicates effectively, and can understand and cooperate in completing the questionnaire assessment. (4) Voluntary participation in this study. Exclusion Criteria: (1) Concurrent colorectal tumors or other anorectal diseases. (2) Concurrent severe cardiac, hepatic, or renal disease; immune system disorders; or psychiatric conditions. (3) Severe postoperative complications such as major hemorrhage or serious infection. Formula for Calculating the Sample Size of the Modeling Group and Verification Group\u003csup\u003e[\u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e]\u003c/sup\u003e: N=༈tα/2༉\u003csup\u003e2\u003c/sup\u003e\u0026middot;p\u0026middot;(1\u0026thinsp;\u0026minus;\u0026thinsp;p)/d\u0026sup2;, N\u0026thinsp;=\u0026thinsp;Sample size、a\u0026thinsp;=\u0026thinsp;0.05、tα/2\u0026thinsp;=\u0026thinsp;1.96、d\u0026thinsp;=\u0026thinsp;0.05, reviewing the literature reveals the prevalence rate\u003csup\u003e[\u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e]\u003c/sup\u003e (\u003cem\u003ep\u003c/em\u003e\u0026thinsp;=\u0026thinsp;26.47%), with a margin of error of d\u0026thinsp;=\u0026thinsp;0.05 and accounting for a 10% sample loss rate, the calculated sample size was 333 cases. This study collected 423 questionnaires, with 412 valid responses, see Fig.\u0026nbsp;\u003cspan refid=\"Fig1\" class=\"InternalRef\"\u003e1\u003c/span\u003e. Research Technology Roadmap, see Fig.\u0026nbsp;2。\u003c/p\u003e \u003cp\u003e \u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"No\" id=\"Taba\" border=\"1\"\u003e \u003ccolgroup cols=\"1\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eFigure 2: Technology Roadmap\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec4\" class=\"Section2\"\u003e \u003ch2\u003e2.2 Ethical Considerations\u003c/h2\u003e \u003cp\u003e This study was approved by the Medical Ethics Committee of the First Affiliated Hospital of Anhui Medical University (Clinical Research Ethics Review PJ-2025-09-22). All patients understood the procedures, voluntarily participated, and signed informed consent forms. This study complies with the Declaration of Helsinki.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec5\" class=\"Section2\"\u003e \u003ch2\u003e2.3 Research Tools\u003c/h2\u003e \u003cdiv id=\"Sec6\" class=\"Section3\"\u003e \u003ch2\u003e2.3.1 General Information Questionnaire\u003c/h2\u003e \u003cp\u003eSelf-designed after reviewing literature, including gender, age, education level, occupation type, marital status, monthly personal income, method of medical expense payment, place of residence, primary caregiver during hospitalization, nighttime sleep patterns during hospitalization, regular exercise habits, and whether preoperative knowledge of postoperative pain was obtained from healthcare providers/online sources/other channels. Clinical data were extracted from hospital electronic medical records, including disease type, whether it was the first anal surgery, postoperative use of an analgesic pump, occurrence of postoperative complications (including constipation and urinary retention), and presence of chronic pain (lasting more than one week) before surgery.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec7\" class=\"Section3\"\u003e \u003ch2\u003e2.3.2 Pain Catastrophizing Scale, PCS\u003c/h2\u003e \u003cp\u003eAdopted by scholars from Hong Kong, China, including Yap et al.\u003csup\u003e[\u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e22\u003c/span\u003e]\u003c/sup\u003e, the Pain Catastrophizing Scale, translated into Chinese and validated for reliability and validity in 2008. The scale comprises three dimensions: helplessness (items 1, 2, 3, 4, 5, 12), grandiosity (items 6, 7, 13), and rumination (items 8, 9, 10, 11), totaling 13 items. Likert5 Rating scale: options range from \"Never\" to \"Always,\" scored as 0\u0026ndash;4 points respectively, with a total score of 0\u0026ndash;52 points. The higher the score, the more severe the patient's catastrophic pain. A score of 30 or higher indicates catastrophic levels. In this study, scores\u0026thinsp;\u0026ge;\u0026thinsp;30 were classified as pain catastrophizing, while scores 30 were classified as no pain catastrophizing. Cronbach's αThe coefficient was 0.927, demonstrating good reliability. In this study, the Cronbach's α coefficient for the scale was 0.976, while the Cronbach's α coefficients for each dimension were 0.957, 0.907, and 0.934.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec8\" class=\"Section3\"\u003e \u003ch2\u003e2.3.3 Visual Analog Scale, VAS\u003c/h2\u003e \u003cp\u003eTo assess the severity of anal pain in patients, a 10-centimeter straight line is marked and precisely measured by the evaluator to quantify subjective pain intensity. A score of 0 indicates no pain, 1\u0026ndash;3 indicates mild pain, 4\u0026ndash;6 indicates moderate pain, and 7\u0026ndash;10 indicates severe pain\u003csup\u003e[\u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e23\u003c/span\u003e]\u003c/sup\u003e.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec9\" class=\"Section3\"\u003e \u003ch2\u003e2.3.4 The Positive and Negative Affect Scale, PANAS\u003c/h2\u003e \u003cp\u003eAdopted by Huang Li et al.\u003csup\u003e[\u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e24\u003c/span\u003e]\u003c/sup\u003e, The Positive and Negative Affect Schedule, translated into Chinese and validated for reliability and validity in 2003, is used to assess patients' emotional states and their intensity. The scale comprises two dimensions: positive affect and negative affect, each containing 10 items, totaling 20 items. The Likert 5-point scale yields a total score ranging from 20 to 100 points. The Cronbach's α coefficient for this scale is 0.82. Possesses good reliability this study, the Cronbach's α coefficient for the scale was 0.627, while the Cronbach's α coefficients for the individual dimensions were 0.898 and 0.941.\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv id=\"Sec10\" class=\"Section2\"\u003e \u003ch2\u003e2.3 Data Collection and Quality Control Methods\u003c/h2\u003e \u003cp\u003eQuestionnaires will be administered uniformly by researchers postoperatively 3-4days Conduct the survey. Before collecting questionnaires, inform participants about the purpose, significance, and content of this study, as well as their rights and obligations in participating. After obtaining informed consent, proceed to formal questionnaire completion. For participants experiencing difficulty understanding the questionnaire, researchers provided explanations, inquired about responses, completed entries on their behalf, and confirmed accuracy. Completed questionnaires were collected and verified on-site; any missing or incomplete sections were supplemented immediately. Data collection and entry were jointly conducted by the principal investigator and one trained study team member holding the title of nurse practitioner or higher with at least three years of experience in proctology. A third member performed final verification.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec11\" class=\"Section2\"\u003e \u003ch2\u003e2.4 Statistical Methods\u003c/h2\u003e \u003cp\u003eStatistical analysis was performed using SPSS 29.0 software. Quantitative data meeting normal distribution requirements were expressed as mean\u0026thinsp;\u0026plusmn;\u0026thinsp;standard deviation (\u003cem\u003ex\u0026macr;\u0026plusmn;s\u003c/em\u003e) and analyzed using the independent samples \u003cem\u003et\u003c/em\u003e-test. Qualitative data were expressed as frequencies and percentages (\u003cem\u003e%\u003c/em\u003e) and analyzed using the \u003cem\u003eχ\u003c/em\u003e\u003csup\u003e\u003cem\u003e\u0026sup2;\u003c/em\u003e\u003c/sup\u003e test. Variables showing statistical significance in univariate analysis were incorporated into a multivariate logistic regression model. After variable selection, a predictive model was established using the rms package in R software, and a column chart was generated. Model fit and predictive performance were assessed using the Hosmer-Lemeshow test, receiver operating characteristic (ROC) curves, and calibration curves. \u003cem\u003eP\u003c/em\u003e\u0026lt;0.05 was considered statistically significant.\u003c/p\u003e \u003c/div\u003e"},{"header":"3. Results","content":"\u003cp\u003e\u003cstrong\u003e3.1 Baseline Data\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe modeling group comprised 288 patients with a mean age of 39.57\u0026plusmn;12.37 years, including 196 males and 92 females. The mean PCS score was 35.71\u0026plusmn;13.81 points, as shown in Table 1。\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTable 1\u003c/strong\u003e\u003cstrong\u003e：\u003c/strong\u003e\u003cstrong\u003eBaseline Characteristics of 288 Patients in the Modeling Cohort\u003c/strong\u003e\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\" width=\"548\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 48.3577%;\"\u003e\n \u003cp\u003eVariable\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 27.5547%;\"\u003e\n \u003cp\u003e\u003cem\u003en\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 24.0876%;\"\u003e\n \u003cp\u003e\u003cem\u003e%/x\u0026macr;\u0026plusmn;s\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 48.3577%;\"\u003e\n \u003cp\u003eAge（years）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 27.5547%;\"\u003e\n \u003cp\u003e288\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 24.0876%;\"\u003e\n \u003cp\u003e39.57\u0026plusmn;12.37\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 48.3577%;\"\u003e\n \u003cp\u003eGender\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 27.5547%;\"\u003e\u0026nbsp;\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 24.0876%;\"\u003e\u0026nbsp;\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 48.3577%;\"\u003e\n \u003cp\u003eMale\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 27.5547%;\"\u003e\n \u003cp\u003e196\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 24.0876%;\"\u003e\n \u003cp\u003e68.1\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 48.3577%;\"\u003e\n \u003cp\u003eFemale\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 27.5547%;\"\u003e\n \u003cp\u003e92\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 24.0876%;\"\u003e\n \u003cp\u003e31.9\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 48.3577%;\"\u003e\n \u003cp\u003eEducation level\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 27.5547%;\"\u003e\u0026nbsp;\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 24.0876%;\"\u003e\u0026nbsp;\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 48.3577%;\"\u003e\n \u003cp\u003eElementary school and below\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 27.5547%;\"\u003e\n \u003cp\u003e37\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 24.0876%;\"\u003e\n \u003cp\u003e12.8\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 48.3577%;\"\u003e\n \u003cp\u003eJunior high school\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 27.5547%;\"\u003e\n \u003cp\u003e58\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 24.0876%;\"\u003e\n \u003cp\u003e20.2\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 48.3577%;\"\u003e\n \u003cp\u003eHigh school/Vocational school\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 27.5547%;\"\u003e\n \u003cp\u003e59\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 24.0876%;\"\u003e\n \u003cp\u003e20.5\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 48.3577%;\"\u003e\n \u003cp\u003eAssociate degree or higher\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 27.5547%;\"\u003e\n \u003cp\u003e134\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 24.0876%;\"\u003e\n \u003cp\u003e46.5\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 48.3577%;\"\u003e\n \u003cp\u003eOccupation\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 27.5547%;\"\u003e\u0026nbsp;\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 24.0876%;\"\u003e\u0026nbsp;\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 48.3577%;\"\u003e\n \u003cp\u003eNo job\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 27.5547%;\"\u003e\n \u003cp\u003e58\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 24.0876%;\"\u003e\n \u003cp\u003e20.2\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 48.3577%;\"\u003e\n \u003cp\u003ePhysical labor\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 27.5547%;\"\u003e\n \u003cp\u003e73\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 24.0876%;\"\u003e\n \u003cp\u003e25.3\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 48.3577%;\"\u003e\n \u003cp\u003eMental work\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 27.5547%;\"\u003e\n \u003cp\u003e157\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 24.0876%;\"\u003e\n \u003cp\u003e54.5\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 48.3577%;\"\u003e\n \u003cp\u003eMarital status\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 27.5547%;\"\u003e\u0026nbsp;\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 24.0876%;\"\u003e\u0026nbsp;\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 48.3577%;\"\u003e\n \u003cp\u003eMarried\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 27.5547%;\"\u003e\n \u003cp\u003e216\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 24.0876%;\"\u003e\n \u003cp\u003e75.0\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 48.3577%;\"\u003e\n \u003cp\u003eUnmarried\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 27.5547%;\"\u003e\n \u003cp\u003e62\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 24.0876%;\"\u003e\n \u003cp\u003e21.5\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 48.3577%;\"\u003e\n \u003cp\u003eDivorced/Widowed\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 27.5547%;\"\u003e\n \u003cp\u003e10\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 24.0876%;\"\u003e\n \u003cp\u003e3.5\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 48.3577%;\"\u003e\n \u003cp\u003eMonthly personal income（RMB）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 27.5547%;\"\u003e\u0026nbsp;\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 24.0876%;\"\u003e\u0026nbsp;\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 48.3577%;\"\u003e\n \u003cp\u003e＜1000\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 27.5547%;\"\u003e\n \u003cp\u003e59\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 24.0876%;\"\u003e\n \u003cp\u003e20.5\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 48.3577%;\"\u003e\n \u003cp\u003e1000-3000\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 27.5547%;\"\u003e\n \u003cp\u003e54\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 24.0876%;\"\u003e\n \u003cp\u003e18.8\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 48.3577%;\"\u003e\n \u003cp\u003e3000-5000\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 27.5547%;\"\u003e\n \u003cp\u003e88\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 24.0876%;\"\u003e\n \u003cp\u003e30.5\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 48.3577%;\"\u003e\n \u003cp\u003e＞5000\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 27.5547%;\"\u003e\n \u003cp\u003e87\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 24.0876%;\"\u003e\n \u003cp\u003e30.2\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 48.3577%;\"\u003e\n \u003cp\u003eMedical expense payment methods\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 27.5547%;\"\u003e\u0026nbsp;\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 24.0876%;\"\u003e\u0026nbsp;\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 48.3577%;\"\u003e\n \u003cp\u003eHealth insurance\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 27.5547%;\"\u003e\n \u003cp\u003e273\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 24.0876%;\"\u003e\n \u003cp\u003e94.8\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 48.3577%;\"\u003e\n \u003cp\u003eNo health insurance\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 27.5547%;\"\u003e\n \u003cp\u003e15\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 24.0876%;\"\u003e\n \u003cp\u003e5.2\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 48.3577%;\"\u003e\n \u003cp\u003ePlace of residence\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 27.5547%;\"\u003e\u0026nbsp;\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 24.0876%;\"\u003e\u0026nbsp;\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 48.3577%;\"\u003e\n \u003cp\u003eRural\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 27.5547%;\"\u003e\n \u003cp\u003e85\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 24.0876%;\"\u003e\n \u003cp\u003e29.5\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 48.3577%;\"\u003e\n \u003cp\u003eUrban\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 27.5547%;\"\u003e\n \u003cp\u003e203\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 24.0876%;\"\u003e\n \u003cp\u003e70.5\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 48.3577%;\"\u003e\n \u003cp\u003ePrimary caregiver during hospitalization\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 27.5547%;\"\u003e\u0026nbsp;\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 24.0876%;\"\u003e\u0026nbsp;\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 48.3577%;\"\u003e\n \u003cp\u003eChildren\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 27.5547%;\"\u003e\n \u003cp\u003e33\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 24.0876%;\"\u003e\n \u003cp\u003e11.5\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 48.3577%;\"\u003e\n \u003cp\u003eParents\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 27.5547%;\"\u003e\n \u003cp\u003e54\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 24.0876%;\"\u003e\n \u003cp\u003e18.8\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 48.3577%;\"\u003e\n \u003cp\u003eSpouse\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 27.5547%;\"\u003e\n \u003cp\u003e142\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 24.0876%;\"\u003e\n \u003cp\u003e49.2\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 48.3577%;\"\u003e\n \u003cp\u003eOthers\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 27.5547%;\"\u003e\n \u003cp\u003e59\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 24.0876%;\"\u003e\n \u003cp\u003e20.5\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 48.3577%;\"\u003e\n \u003cp\u003eSleep quality during nighttime hours while hospitalized\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 27.5547%;\"\u003e\u0026nbsp;\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 24.0876%;\"\u003e\u0026nbsp;\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 48.3577%;\"\u003e\n \u003cp\u003eGood\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 27.5547%;\"\u003e\n \u003cp\u003e99\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 24.0876%;\"\u003e\n \u003cp\u003e34.4\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 48.3577%;\"\u003e\n \u003cp\u003eGeneral\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 27.5547%;\"\u003e\n \u003cp\u003e155\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 24.0876%;\"\u003e\n \u003cp\u003e53.8\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 48.3577%;\"\u003e\n \u003cp\u003ePoor/Bad\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 27.5547%;\"\u003e\n \u003cp\u003e34\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 24.0876%;\"\u003e\n \u003cp\u003e11.8\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 48.3577%;\"\u003e\n \u003cp\u003eExercise（%）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 27.5547%;\"\u003e\u0026nbsp;\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 24.0876%;\"\u003e\u0026nbsp;\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 48.3577%;\"\u003e\n \u003cp\u003eAt least 3 times per week\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 27.5547%;\"\u003e\n \u003cp\u003e23\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 24.0876%;\"\u003e\n \u003cp\u003e8.0\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 48.3577%;\"\u003e\n \u003cp\u003eOccasionally\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 27.5547%;\"\u003e\n \u003cp\u003e101\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 24.0876%;\"\u003e\n \u003cp\u003e35.1\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 48.3577%;\"\u003e\n \u003cp\u003eHardly any\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 27.5547%;\"\u003e\n \u003cp\u003e164\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 24.0876%;\"\u003e\n \u003cp\u003e56.9\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 48.3577%;\"\u003e\n \u003cp\u003eUnderstanding postoperative pain before surgery\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 27.5547%;\"\u003e\u0026nbsp;\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 24.0876%;\"\u003e\u0026nbsp;\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 48.3577%;\"\u003e\n \u003cp\u003eFully understand\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 27.5547%;\"\u003e\n \u003cp\u003e49\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 24.0876%;\"\u003e\n \u003cp\u003e17.0\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 48.3577%;\"\u003e\n \u003cp\u003ePartial understanding\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 27.5547%;\"\u003e\n \u003cp\u003e131\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 24.0876%;\"\u003e\n \u003cp\u003e45.5\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 48.3577%;\"\u003e\n \u003cp\u003eRarely understand\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 27.5547%;\"\u003e\n \u003cp\u003e108\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 24.0876%;\"\u003e\n \u003cp\u003e37.5\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 48.3577%;\"\u003e\n \u003cp\u003eDiagnosis（%）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 27.5547%;\"\u003e\u0026nbsp;\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 24.0876%;\"\u003e\u0026nbsp;\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 48.3577%;\"\u003e\n \u003cp\u003eMixed hemorrhoids\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 27.5547%;\"\u003e\n \u003cp\u003e102\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 24.0876%;\"\u003e\n \u003cp\u003e35.4\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 48.3577%;\"\u003e\n \u003cp\u003eFistula\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 27.5547%;\"\u003e\n \u003cp\u003e18\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 24.0876%;\"\u003e\n \u003cp\u003e6.3\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 48.3577%;\"\u003e\n \u003cp\u003ePerianal abscess\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 27.5547%;\"\u003e\n \u003cp\u003e28\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 24.0876%;\"\u003e\n \u003cp\u003e9.7\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 48.3577%;\"\u003e\n \u003cp\u003eMixed hemorrhoids and anal fissure\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 27.5547%;\"\u003e\n \u003cp\u003e60\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 24.0876%;\"\u003e\n \u003cp\u003e20.8\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 48.3577%;\"\u003e\n \u003cp\u003eMixed hemorrhoids and perianal abscess\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 27.5547%;\"\u003e\n \u003cp\u003e34\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 24.0876%;\"\u003e\n \u003cp\u003e11.8\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 48.3577%;\"\u003e\n \u003cp\u003eMixed hemorrhoids and anal fistula\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 27.5547%;\"\u003e\n \u003cp\u003e35\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 24.0876%;\"\u003e\n \u003cp\u003e12.2\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 48.3577%;\"\u003e\n \u003cp\u003eMixed hemorrhoids and anal fistula\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 27.5547%;\"\u003e\n \u003cp\u003e11\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 24.0876%;\"\u003e\n \u003cp\u003e3.8\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 48.3577%;\"\u003e\n \u003cp\u003eFirst anal surgery\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 27.5547%;\"\u003e\u0026nbsp;\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 24.0876%;\"\u003e\u0026nbsp;\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 48.3577%;\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 27.5547%;\"\u003e\n \u003cp\u003e261\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 24.0876%;\"\u003e\n \u003cp\u003e90.4\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 48.3577%;\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 27.5547%;\"\u003e\n \u003cp\u003e27\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 24.0876%;\"\u003e\n \u003cp\u003e9.6\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 48.3577%;\"\u003e\n \u003cp\u003ePostoperative use of an analgesic pump\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 27.5547%;\"\u003e\u0026nbsp;\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 24.0876%;\"\u003e\u0026nbsp;\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 48.3577%;\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 27.5547%;\"\u003e\n \u003cp\u003e168\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 24.0876%;\"\u003e\n \u003cp\u003e58.3\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 48.3577%;\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 27.5547%;\"\u003e\n \u003cp\u003e120\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 24.0876%;\"\u003e\n \u003cp\u003e41.7\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 48.3577%;\"\u003e\n \u003cp\u003eCombined Chronic Diseases\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 27.5547%;\"\u003e\u0026nbsp;\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 24.0876%;\"\u003e\u0026nbsp;\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 48.3577%;\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 27.5547%;\"\u003e\n \u003cp\u003e247\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 24.0876%;\"\u003e\n \u003cp\u003e85.8\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 48.3577%;\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 27.5547%;\"\u003e\n \u003cp\u003e41\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 24.0876%;\"\u003e\n \u003cp\u003e14.2\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 48.3577%;\"\u003e\n \u003cp\u003eChronic pain before surgery\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 27.5547%;\"\u003e\u0026nbsp;\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 24.0876%;\"\u003e\u0026nbsp;\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 48.3577%;\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 27.5547%;\"\u003e\n \u003cp\u003e66\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 24.0876%;\"\u003e\n \u003cp\u003e22.9\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 48.3577%;\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 27.5547%;\"\u003e\n \u003cp\u003e222\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 24.0876%;\"\u003e\n \u003cp\u003e77.1\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 48.3577%;\"\u003e\n \u003cp\u003ePostoperative urinary retention\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 27.5547%;\"\u003e\u0026nbsp;\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 24.0876%;\"\u003e\u0026nbsp;\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 48.3577%;\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 27.5547%;\"\u003e\n \u003cp\u003e240\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 24.0876%;\"\u003e\n \u003cp\u003e83.3\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 48.3577%;\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 27.5547%;\"\u003e\n \u003cp\u003e48\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 24.0876%;\"\u003e\n \u003cp\u003e16.7\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 48.3577%;\"\u003e\n \u003cp\u003ePostoperative constipation\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 27.5547%;\"\u003e\u0026nbsp;\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 24.0876%;\"\u003e\u0026nbsp;\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 48.3577%;\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 27.5547%;\"\u003e\n \u003cp\u003e82\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 24.0876%;\"\u003e\n \u003cp\u003e28.5\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 48.3577%;\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 27.5547%;\"\u003e\n \u003cp\u003e\u003cem\u003e206\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 24.0876%;\"\u003e\n \u003cp\u003e71.5\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 48.3577%;\"\u003e\n \u003cp\u003eVAS（score）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 27.5547%;\"\u003e\n \u003cp\u003e288\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 24.0876%;\"\u003e\n \u003cp\u003e4.52\u0026plusmn;1.62\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 48.3577%;\"\u003e\n \u003cp\u003ePositive emotions（score）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 27.5547%;\"\u003e\n \u003cp\u003e288\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 24.0876%;\"\u003e\n \u003cp\u003e25.45\u0026plusmn;6.07\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 48.3577%;\"\u003e\n \u003cp\u003eNegative emotions（score）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 27.5547%;\"\u003e\n \u003cp\u003e288\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 24.0876%;\"\u003e\n \u003cp\u003e17.94\u0026plusmn;7.95\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003eAbbreviation: VAS， visual analog scale；s， Sample standard deviation; x̄, Sample mean;%， Variable proportion.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e3.2Univariate Analysis of Risk Factors for Catastrophic Pain in Patients Following Anal Sphincter Reconstruction Surgery\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe modeling group was divided into no pain catastrophizing161 cases, and pain catastrophizing in 127 cases, with a 44.1% incidence of pain catastrophizing risk. Univariate analysis was conducted using the occurrence of pain catastrophizing as the dependent variable， Results indicate that age, gender, place of residence, sleep during hospitalization, preoperative knowledge of postoperative pain, presence of chronic comorbidities, postoperative complications (urinary retention, constipation), VAS score, positive affect score, and negative affect score are factors influencing the risk of pain catastrophizing（\u003cem\u003eP\u003c/em\u003e＜0. 05）, See Table 2.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTable 2\u003c/strong\u003e\u003cstrong\u003e：\u003c/strong\u003e\u003cstrong\u003eResults of the Single-Factor Analysis for the Modeling Module\u003c/strong\u003e\u003cstrong\u003e（\u003c/strong\u003e\u003cstrong\u003en=288\u003c/strong\u003e\u003cstrong\u003e）\u003c/strong\u003e\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\" width=\"554\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 34.1772%;\"\u003e\n \u003cp\u003eVariable\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 18.8065%;\"\u003e\n \u003cp\u003eNo PCS\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e(\u003cem\u003en\u003c/em\u003e=161)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 20.434%;\"\u003e\n \u003cp\u003ePCS\u003c/p\u003e\n \u003cp\u003e(\u003cem\u003en\u003c/em\u003e=127)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 15.3707%;\"\u003e\n \u003cp\u003e\u003cem\u003et/x\u003csup\u003e2\u003c/sup\u003e\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11.2116%;\"\u003e\n \u003cp\u003e\u003cem\u003ep\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 34.1772%;\"\u003e\n \u003cp\u003eAge（years，x\u0026macr;\u0026plusmn;s）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 18.8065%;\"\u003e\n \u003cp\u003e38.01\u0026plusmn;12.35\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 20.434%;\"\u003e\n \u003cp\u003e41.55\u0026plusmn;12.16\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 15.3707%;\"\u003e\n \u003cp\u003e-2.431\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11.2116%;\"\u003e\n \u003cp\u003e0.016\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 34.1772%;\"\u003e\n \u003cp\u003eGender（%）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 18.8065%;\"\u003e\u0026nbsp;\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 20.434%;\"\u003e\u0026nbsp;\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 15.3707%;\"\u003e\n \u003cp\u003e7.049\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11.2116%;\"\u003e\n \u003cp\u003e0.008\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 34.1772%;\"\u003e\n \u003cp\u003eMale\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 18.8065%;\"\u003e\n \u003cp\u003e120(74.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 20.434%;\"\u003e\n \u003cp\u003e76(59.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 15.3707%;\"\u003e\u0026nbsp;\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11.2116%;\"\u003e\u0026nbsp;\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 34.1772%;\"\u003e\n \u003cp\u003eFemale\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 18.8065%;\"\u003e\n \u003cp\u003e41(25.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 20.434%;\"\u003e\n \u003cp\u003e51(40.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 15.3707%;\"\u003e\u0026nbsp;\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11.2116%;\"\u003e\u0026nbsp;\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 34.1772%;\"\u003e\n \u003cp\u003eEducation level（%）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 18.8065%;\"\u003e\u0026nbsp;\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 20.434%;\"\u003e\u0026nbsp;\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 15.3707%;\"\u003e\n \u003cp\u003e5.668\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11.2116%;\"\u003e\n \u003cp\u003e0.129\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 34.1772%;\"\u003e\n \u003cp\u003eElementary school and below\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 18.8065%;\"\u003e\n \u003cp\u003e16(9.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 20.434%;\"\u003e\n \u003cp\u003e21(16.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 15.3707%;\"\u003e\u0026nbsp;\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11.2116%;\"\u003e\u0026nbsp;\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 34.1772%;\"\u003e\n \u003cp\u003eJunior high school\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 18.8065%;\"\u003e\n \u003cp\u003e28(17.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 20.434%;\"\u003e\n \u003cp\u003e30(23.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 15.3707%;\"\u003e\u0026nbsp;\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11.2116%;\"\u003e\u0026nbsp;\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 34.1772%;\"\u003e\n \u003cp\u003eHigh school/Vocational school\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 18.8065%;\"\u003e\n \u003cp\u003e37(23.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 20.434%;\"\u003e\n \u003cp\u003e22(17.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 15.3707%;\"\u003e\u0026nbsp;\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11.2116%;\"\u003e\u0026nbsp;\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 34.1772%;\"\u003e\n \u003cp\u003eAssociate degree or higher\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 18.8065%;\"\u003e\n \u003cp\u003e80(49.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 20.434%;\"\u003e\n \u003cp\u003e54(42.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 15.3707%;\"\u003e\u0026nbsp;\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11.2116%;\"\u003e\u0026nbsp;\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 34.1772%;\"\u003e\n \u003cp\u003eOccupation（%）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 18.8065%;\"\u003e\u0026nbsp;\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 20.434%;\"\u003e\u0026nbsp;\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 15.3707%;\"\u003e\n \u003cp\u003e3.073\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11.2116%;\"\u003e\n \u003cp\u003e0.215\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 34.1772%;\"\u003e\n \u003cp\u003eNo job\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 18.8065%;\"\u003e\n \u003cp\u003e27(16.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 20.434%;\"\u003e\n \u003cp\u003e31(24.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 15.3707%;\"\u003e\u0026nbsp;\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11.2116%;\"\u003e\u0026nbsp;\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 34.1772%;\"\u003e\n \u003cp\u003ePhysical labor\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 18.8065%;\"\u003e\n \u003cp\u003e45(28.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 20.434%;\"\u003e\n \u003cp\u003e28(22.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 15.3707%;\"\u003e\u0026nbsp;\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11.2116%;\"\u003e\u0026nbsp;\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 34.1772%;\"\u003e\n \u003cp\u003eMental work\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 18.8065%;\"\u003e\n \u003cp\u003e89(55.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 20.434%;\"\u003e\n \u003cp\u003e68(53.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 15.3707%;\"\u003e\u0026nbsp;\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11.2116%;\"\u003e\u0026nbsp;\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 34.1772%;\"\u003e\n \u003cp\u003eMarital status（%）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 18.8065%;\"\u003e\u0026nbsp;\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 20.434%;\"\u003e\u0026nbsp;\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 15.3707%;\"\u003e\n \u003cp\u003e5.769\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11.2116%;\"\u003e\n \u003cp\u003e0.056\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 34.1772%;\"\u003e\n \u003cp\u003eMarried\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 18.8065%;\"\u003e\n \u003cp\u003e112(69.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 20.434%;\"\u003e\n \u003cp\u003e104(81.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 15.3707%;\"\u003e\u0026nbsp;\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11.2116%;\"\u003e\u0026nbsp;\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 34.1772%;\"\u003e\n \u003cp\u003eUnmarried\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 18.8065%;\"\u003e\n \u003cp\u003e42(26.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 20.434%;\"\u003e\n \u003cp\u003e20 (15.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 15.3707%;\"\u003e\u0026nbsp;\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11.2116%;\"\u003e\u0026nbsp;\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 34.1772%;\"\u003e\n \u003cp\u003eDivorced/Widowed\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 18.8065%;\"\u003e\n \u003cp\u003e7(4.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 20.434%;\"\u003e\n \u003cp\u003e3(2.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 15.3707%;\"\u003e\u0026nbsp;\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11.2116%;\"\u003e\u0026nbsp;\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 34.1772%;\"\u003e\n \u003cp\u003eMonthly personal income（RMB，%）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 18.8065%;\"\u003e\u0026nbsp;\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 20.434%;\"\u003e\u0026nbsp;\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 15.3707%;\"\u003e\n \u003cp\u003e7.138\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11.2116%;\"\u003e\n \u003cp\u003e0.068\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 34.1772%;\"\u003e\n \u003cp\u003e＜1000\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 18.8065%;\"\u003e\n \u003cp\u003e34 (21.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 20.434%;\"\u003e\n \u003cp\u003e25(19.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 15.3707%;\"\u003e\u0026nbsp;\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11.2116%;\"\u003e\u0026nbsp;\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 34.1772%;\"\u003e\n \u003cp\u003e1000-3000\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 18.8065%;\"\u003e\n \u003cp\u003e24(14.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 20.434%;\"\u003e\n \u003cp\u003e30(23.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 15.3707%;\"\u003e\u0026nbsp;\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11.2116%;\"\u003e\u0026nbsp;\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 34.1772%;\"\u003e\n \u003cp\u003e3000-5000\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 18.8065%;\"\u003e\n \u003cp\u003e58(36.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 20.434%;\"\u003e\n \u003cp\u003e30(23.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 15.3707%;\"\u003e\u0026nbsp;\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11.2116%;\"\u003e\u0026nbsp;\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 34.1772%;\"\u003e\n \u003cp\u003e＞5000\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 18.8065%;\"\u003e\n \u003cp\u003e45(28.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 20.434%;\"\u003e\n \u003cp\u003e42(33.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 15.3707%;\"\u003e\u0026nbsp;\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11.2116%;\"\u003e\u0026nbsp;\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 34.1772%;\"\u003e\n \u003cp\u003eMedical expense payment methods（%）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 18.8065%;\"\u003e\u0026nbsp;\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 20.434%;\"\u003e\u0026nbsp;\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 15.3707%;\"\u003e\n \u003cp\u003e0.042\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11.2116%;\"\u003e\n \u003cp\u003e0.837\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 34.1772%;\"\u003e\n \u003cp\u003eHealth insurance\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 18.8065%;\"\u003e\n \u003cp\u003e153(95.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 20.434%;\"\u003e\n \u003cp\u003e120(94.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 15.3707%;\"\u003e\u0026nbsp;\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11.2116%;\"\u003e\u0026nbsp;\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 34.1772%;\"\u003e\n \u003cp\u003eNo health insurance\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 18.8065%;\"\u003e\n \u003cp\u003e8(5.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 20.434%;\"\u003e\n \u003cp\u003e7(5.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 15.3707%;\"\u003e\u0026nbsp;\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11.2116%;\"\u003e\u0026nbsp;\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 34.1772%;\"\u003e\n \u003cp\u003ePlace of residence（%）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 18.8065%;\"\u003e\u0026nbsp;\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 20.434%;\"\u003e\u0026nbsp;\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 15.3707%;\"\u003e\n \u003cp\u003e6.133\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11.2116%;\"\u003e\n \u003cp\u003e0.013\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 34.1772%;\"\u003e\n \u003cp\u003eRural\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 18.8065%;\"\u003e\n \u003cp\u003e38(23.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 20.434%;\"\u003e\n \u003cp\u003e47(37.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 15.3707%;\"\u003e\u0026nbsp;\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11.2116%;\"\u003e\u0026nbsp;\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 34.1772%;\"\u003e\n \u003cp\u003eUrban\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 18.8065%;\"\u003e\n \u003cp\u003e123(76.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 20.434%;\"\u003e\n \u003cp\u003e80(63.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 15.3707%;\"\u003e\u0026nbsp;\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11.2116%;\"\u003e\u0026nbsp;\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 34.1772%;\"\u003e\n \u003cp\u003ePrimary caregiver during hospitalization（%）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 18.8065%;\"\u003e\u0026nbsp;\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 20.434%;\"\u003e\u0026nbsp;\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 15.3707%;\"\u003e\n \u003cp\u003e1.678\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11.2116%;\"\u003e\n \u003cp\u003e0.642\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 34.1772%;\"\u003e\n \u003cp\u003eChildren\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 18.8065%;\"\u003e\n \u003cp\u003e19(11.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 20.434%;\"\u003e\n \u003cp\u003e14(11.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 15.3707%;\"\u003e\u0026nbsp;\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11.2116%;\"\u003e\u0026nbsp;\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 34.1772%;\"\u003e\n \u003cp\u003eParents\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 18.8065%;\"\u003e\n \u003cp\u003e34(21.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 20.434%;\"\u003e\n \u003cp\u003e20 (15.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 15.3707%;\"\u003e\u0026nbsp;\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11.2116%;\"\u003e\u0026nbsp;\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 34.1772%;\"\u003e\n \u003cp\u003eSpouse\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 18.8065%;\"\u003e\n \u003cp\u003e75(46.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 20.434%;\"\u003e\n \u003cp\u003e67(52.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 15.3707%;\"\u003e\u0026nbsp;\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11.2116%;\"\u003e\u0026nbsp;\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 34.1772%;\"\u003e\n \u003cp\u003eOthers\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 18.8065%;\"\u003e\n \u003cp\u003e33(20.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 20.434%;\"\u003e\n \u003cp\u003e26(20.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 15.3707%;\"\u003e\u0026nbsp;\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11.2116%;\"\u003e\u0026nbsp;\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 34.1772%;\"\u003e\n \u003cp\u003eSleep quality during nighttime hours while hospitalized（%）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 18.8065%;\"\u003e\u0026nbsp;\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 20.434%;\"\u003e\u0026nbsp;\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 15.3707%;\"\u003e\n \u003cp\u003e13.511\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11.2116%;\"\u003e\n \u003cp\u003e0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 34.1772%;\"\u003e\n \u003cp\u003eGood\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 18.8065%;\"\u003e\n \u003cp\u003e65(40.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 20.434%;\"\u003e\n \u003cp\u003e34(26.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 15.3707%;\"\u003e\u0026nbsp;\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11.2116%;\"\u003e\u0026nbsp;\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 34.1772%;\"\u003e\n \u003cp\u003eGeneral\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 18.8065%;\"\u003e\n \u003cp\u003e86(53.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 20.434%;\"\u003e\n \u003cp\u003e69(54.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 15.3707%;\"\u003e\u0026nbsp;\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11.2116%;\"\u003e\u0026nbsp;\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 34.1772%;\"\u003e\n \u003cp\u003ePoor/Bad\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 18.8065%;\"\u003e\n \u003cp\u003e10(6.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 20.434%;\"\u003e\n \u003cp\u003e24(18.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 15.3707%;\"\u003e\u0026nbsp;\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11.2116%;\"\u003e\u0026nbsp;\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 34.1772%;\"\u003e\n \u003cp\u003eExercise（%）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 18.8065%;\"\u003e\u0026nbsp;\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 20.434%;\"\u003e\u0026nbsp;\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 15.3707%;\"\u003e\n \u003cp\u003e2.008\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11.2116%;\"\u003e\n \u003cp\u003e0.352\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 34.1772%;\"\u003e\n \u003cp\u003eAt least 3 times per week\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 18.8065%;\"\u003e\n \u003cp\u003e16(9.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 20.434%;\"\u003e\n \u003cp\u003e7(5.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 15.3707%;\"\u003e\u0026nbsp;\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11.2116%;\"\u003e\u0026nbsp;\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 34.1772%;\"\u003e\n \u003cp\u003eOccasionally\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 18.8065%;\"\u003e\n \u003cp\u003e57(35.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 20.434%;\"\u003e\n \u003cp\u003e44(34.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 15.3707%;\"\u003e\u0026nbsp;\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11.2116%;\"\u003e\u0026nbsp;\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 34.1772%;\"\u003e\n \u003cp\u003eHardly any\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 18.8065%;\"\u003e\n \u003cp\u003e88(54.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 20.434%;\"\u003e\n \u003cp\u003e76(59.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 15.3707%;\"\u003e\u0026nbsp;\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11.2116%;\"\u003e\u0026nbsp;\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 34.1772%;\"\u003e\n \u003cp\u003eUnderstanding postoperative pain before surgery（%）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 18.8065%;\"\u003e\u0026nbsp;\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 20.434%;\"\u003e\u0026nbsp;\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 15.3707%;\"\u003e\n \u003cp\u003e10.274\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11.2116%;\"\u003e\n \u003cp\u003e0.006\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 34.1772%;\"\u003e\n \u003cp\u003eFully understand\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 18.8065%;\"\u003e\n \u003cp\u003e36(22.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 20.434%;\"\u003e\n \u003cp\u003e13(10.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 15.3707%;\"\u003e\u0026nbsp;\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11.2116%;\"\u003e\u0026nbsp;\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 34.1772%;\"\u003e\n \u003cp\u003ePartial understanding\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 18.8065%;\"\u003e\n \u003cp\u003e75(46.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 20.434%;\"\u003e\n \u003cp\u003e56(44.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 15.3707%;\"\u003e\u0026nbsp;\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11.2116%;\"\u003e\u0026nbsp;\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 34.1772%;\"\u003e\n \u003cp\u003eRarely understand\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 18.8065%;\"\u003e\n \u003cp\u003e50(31.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 20.434%;\"\u003e\n \u003cp\u003e58(45.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 15.3707%;\"\u003e\u0026nbsp;\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11.2116%;\"\u003e\u0026nbsp;\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 34.1772%;\"\u003e\n \u003cp\u003eDiagnosis（%）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 18.8065%;\"\u003e\u0026nbsp;\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 20.434%;\"\u003e\u0026nbsp;\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 15.3707%;\"\u003e\n \u003cp\u003e5.986\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11.2116%;\"\u003e\n \u003cp\u003e0.541\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 34.1772%;\"\u003e\n \u003cp\u003eMixed hemorrhoids\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 18.8065%;\"\u003e\n \u003cp\u003e60(37.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 20.434%;\"\u003e\n \u003cp\u003e42(33.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 15.3707%;\"\u003e\u0026nbsp;\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11.2116%;\"\u003e\u0026nbsp;\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 34.1772%;\"\u003e\n \u003cp\u003eFistula\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 18.8065%;\"\u003e\n \u003cp\u003e12(7.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 20.434%;\"\u003e\n \u003cp\u003e12(9.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 15.3707%;\"\u003e\u0026nbsp;\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11.2116%;\"\u003e\u0026nbsp;\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 34.1772%;\"\u003e\n \u003cp\u003ePerianal abscess\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 18.8065%;\"\u003e\n \u003cp\u003e17(10.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 20.434%;\"\u003e\n \u003cp\u003e17(13.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 15.3707%;\"\u003e\u0026nbsp;\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11.2116%;\"\u003e\u0026nbsp;\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 34.1772%;\"\u003e\n \u003cp\u003eMixed hemorrhoids and anal fissure\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 18.8065%;\"\u003e\n \u003cp\u003e29(18.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 20.434%;\"\u003e\n \u003cp\u003e31(24.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 15.3707%;\"\u003e\u0026nbsp;\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11.2116%;\"\u003e\u0026nbsp;\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 34.1772%;\"\u003e\n \u003cp\u003eMixed hemorrhoids and perianal abscess\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 18.8065%;\"\u003e\n \u003cp\u003e17(10.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 20.434%;\"\u003e\n \u003cp\u003e17(13.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 15.3707%;\"\u003e\u0026nbsp;\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11.2116%;\"\u003e\u0026nbsp;\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 34.1772%;\"\u003e\n \u003cp\u003eMixed hemorrhoids and anal fistula\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 18.8065%;\"\u003e\n \u003cp\u003e18(11.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 20.434%;\"\u003e\n \u003cp\u003e17(13.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 15.3707%;\"\u003e\u0026nbsp;\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11.2116%;\"\u003e\u0026nbsp;\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 34.1772%;\"\u003e\n \u003cp\u003eMixed hemorrhoids and anal fistula\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 18.8065%;\"\u003e\n \u003cp\u003e8(5.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 20.434%;\"\u003e\n \u003cp\u003e3(2.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 15.3707%;\"\u003e\u0026nbsp;\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11.2116%;\"\u003e\u0026nbsp;\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 34.1772%;\"\u003e\n \u003cp\u003eFirst anal surgery（%）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 18.8065%;\"\u003e\u0026nbsp;\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 20.434%;\"\u003e\u0026nbsp;\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 15.3707%;\"\u003e\n \u003cp\u003e2.623\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11.2116%;\"\u003e\n \u003cp\u003e0.269\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 34.1772%;\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 18.8065%;\"\u003e\n \u003cp\u003e147(91.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 20.434%;\"\u003e\n \u003cp\u003e114(89.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 15.3707%;\"\u003e\u0026nbsp;\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11.2116%;\"\u003e\u0026nbsp;\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 34.1772%;\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 18.8065%;\"\u003e\n \u003cp\u003e14(8.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 20.434%;\"\u003e\n \u003cp\u003e13(10.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 15.3707%;\"\u003e\u0026nbsp;\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11.2116%;\"\u003e\u0026nbsp;\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 34.1772%;\"\u003e\n \u003cp\u003ePostoperative use of an analgesic pump（%）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 18.8065%;\"\u003e\u0026nbsp;\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 20.434%;\"\u003e\u0026nbsp;\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 15.3707%;\"\u003e\n \u003cp\u003e2.145\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11.2116%;\"\u003e\n \u003cp\u003e0.143\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 34.1772%;\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 18.8065%;\"\u003e\n \u003cp\u003e100()\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 20.434%;\"\u003e\n \u003cp\u003e68(53.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 15.3707%;\"\u003e\u0026nbsp;\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11.2116%;\"\u003e\u0026nbsp;\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 34.1772%;\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 18.8065%;\"\u003e\n \u003cp\u003e61()\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 20.434%;\"\u003e\n \u003cp\u003e59(46.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 15.3707%;\"\u003e\u0026nbsp;\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11.2116%;\"\u003e\u0026nbsp;\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 34.1772%;\"\u003e\n \u003cp\u003eCombined Chronic Diseases（%）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 18.8065%;\"\u003e\u0026nbsp;\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 20.434%;\"\u003e\u0026nbsp;\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 15.3707%;\"\u003e\n \u003cp\u003e7.237\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11.2116%;\"\u003e\n \u003cp\u003e0.007\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 34.1772%;\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 18.8065%;\"\u003e\n \u003cp\u003e15(9.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 20.434%;\"\u003e\n \u003cp\u003e26(20.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 15.3707%;\"\u003e\u0026nbsp;\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11.2116%;\"\u003e\u0026nbsp;\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 34.1772%;\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 18.8065%;\"\u003e\n \u003cp\u003e146(90.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 20.434%;\"\u003e\n \u003cp\u003e101(79.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 15.3707%;\"\u003e\u0026nbsp;\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11.2116%;\"\u003e\u0026nbsp;\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 34.1772%;\"\u003e\n \u003cp\u003eChronic pain before surgery（%）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 18.8065%;\"\u003e\u0026nbsp;\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 20.434%;\"\u003e\u0026nbsp;\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 15.3707%;\"\u003e\n \u003cp\u003e0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11.2116%;\"\u003e\n \u003cp\u003e0.977\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 34.1772%;\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 18.8065%;\"\u003e\n \u003cp\u003e37(23.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 20.434%;\"\u003e\n \u003cp\u003e29(22.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 15.3707%;\"\u003e\u0026nbsp;\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11.2116%;\"\u003e\u0026nbsp;\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 34.1772%;\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 18.8065%;\"\u003e\n \u003cp\u003e124(77.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 20.434%;\"\u003e\n \u003cp\u003e98(77.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 15.3707%;\"\u003e\u0026nbsp;\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11.2116%;\"\u003e\u0026nbsp;\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 34.1772%;\"\u003e\n \u003cp\u003ePostoperative urinary retention（%）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 18.8065%;\"\u003e\u0026nbsp;\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 20.434%;\"\u003e\u0026nbsp;\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 15.3707%;\"\u003e\n \u003cp\u003e16.702\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11.2116%;\"\u003e\n \u003cp\u003e＜0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 34.1772%;\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 18.8065%;\"\u003e\n \u003cp\u003e14(8.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 20.434%;\"\u003e\n \u003cp\u003e34(26.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 15.3707%;\"\u003e\u0026nbsp;\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11.2116%;\"\u003e\u0026nbsp;\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 34.1772%;\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 18.8065%;\"\u003e\n \u003cp\u003e147(91.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 20.434%;\"\u003e\n \u003cp\u003e93(73.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 15.3707%;\"\u003e\u0026nbsp;\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11.2116%;\"\u003e\u0026nbsp;\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 34.1772%;\"\u003e\n \u003cp\u003ePostoperative constipation（%）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 18.8065%;\"\u003e\u0026nbsp;\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 20.434%;\"\u003e\u0026nbsp;\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 15.3707%;\"\u003e\n \u003cp\u003e70.117\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11.2116%;\"\u003e\n \u003cp\u003e＜0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 34.1772%;\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 18.8065%;\"\u003e\n \u003cp\u003e14(8.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 20.434%;\"\u003e\n \u003cp\u003e68(53.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 15.3707%;\"\u003e\u0026nbsp;\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11.2116%;\"\u003e\u0026nbsp;\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 34.1772%;\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 18.8065%;\"\u003e\n \u003cp\u003e147(91.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 20.434%;\"\u003e\n \u003cp\u003e59(46.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 15.3707%;\"\u003e\u0026nbsp;\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11.2116%;\"\u003e\u0026nbsp;\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 34.1772%;\"\u003e\n \u003cp\u003eVAS（score，x\u0026macr;\u0026plusmn;s）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 18.8065%;\"\u003e\n \u003cp\u003e3.60\u0026plusmn;1.20\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 20.434%;\"\u003e\n \u003cp\u003e5.69\u0026plusmn;1.31\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 15.3707%;\"\u003e\n \u003cp\u003e-14.091\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11.2116%;\"\u003e\n \u003cp\u003e＜0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 34.1772%;\"\u003e\n \u003cp\u003ePositive emotions（score，x\u0026macr;\u0026plusmn;s）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 18.8065%;\"\u003e\n \u003cp\u003e128.38\u0026plusmn;5.53\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 20.434%;\"\u003e\n \u003cp\u003e21.57\u0026plusmn;4.51\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 15.3707%;\"\u003e\n \u003cp\u003e10.944\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11.2116%;\"\u003e\n \u003cp\u003e＜0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 34.1772%;\"\u003e\n \u003cp\u003eNegative emotions（score，x\u0026macr;\u0026plusmn;s）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 18.8065%;\"\u003e\n \u003cp\u003e13.52\u0026plusmn;3.85\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 20.434%;\"\u003e\n \u003cp\u003e23.56\u0026plusmn;8.26\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 15.3707%;\"\u003e\n \u003cp\u003e-12.667\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11.2116%;\"\u003e\n \u003cp\u003e＜0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003eAbbreviation: PCS， Pain Catastrophizing Scale； VAS， Visual Analog Scale；\u003cem\u003es\u003c/em\u003e， Sample standard deviation; \u003cem\u003e\u0026chi;\u0026sup2;\u003c/em\u003e, Chi-Square Test；\u003cem\u003ex̄\u003c/em\u003e, Sample mean; t， Independent samples test. %， Variable proportion.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e3.3 Screening of Risk Factors for Pain Catastrophizing and Development of a Predictive Model\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eUsing the occurrence of pain catastrophizing risk as the dependent variable (No=0, Yes=1), and incorporating observation indicators with clinically significant differences in univariate analysis (\u003cem\u003eP\u0026lt;\u003c/em\u003e0.05) as independent variables, ultimately, 11 variables were included in the multivariate logistic regression analysis. The variable assignment methods are shown in Table 3. Results indicated that patients with chronic comorbidities, minimal preoperative knowledge of postoperative pain management, postoperative complications (urinary retention, constipation), anal visual analog scale scores, and negative emotional scores were independent risk factors for pain catastrophizing (\u003cem\u003eP\u003c/em\u003e\u0026lt;0.05), entering the predictive model as shown in Table 4. Column plots were generated using the \u0026quot;rms\u0026quot; package in RStudio, as depicted in Figure 3.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTable 3: Modeling Module Assignment Method for Independent Variables\u003c/strong\u003e\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\" width=\"561\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 32.4421%;\"\u003e\n \u003cp\u003eVariable\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 67.5579%;\"\u003e\n \u003cp\u003eAssign a value\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 32.4421%;\"\u003e\n \u003cp\u003eGender\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 67.5579%;\"\u003e\n \u003cp\u003eMale=0，woman=1\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 32.4421%;\"\u003e\n \u003cp\u003eAge (years)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 67.5579%;\"\u003e\n \u003cp\u003eOriginal value input\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 32.4421%;\"\u003e\n \u003cp\u003ePlace of residence\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 67.5579%;\"\u003e\n \u003cp\u003eRural=0, Urban=1\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 32.4421%;\"\u003e\n \u003cp\u003eSleep quality during nighttime hours while hospitalized\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 67.5579%;\"\u003e\n \u003cp\u003eGood=0, General =1，Poor/Bad =2\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 32.4421%;\"\u003e\n \u003cp\u003eUnderstanding postoperative pain before surgery\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 67.5579%;\"\u003e\n \u003cp\u003eFully understand =0，Partial understanding =1，Rarely understand =2\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 32.4421%;\"\u003e\n \u003cp\u003eCombined Chronic Diseases\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 67.5579%;\"\u003e\n \u003cp\u003eNo=0，Yes=1\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 32.4421%;\"\u003e\n \u003cp\u003ePostoperative urinary retention\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 67.5579%;\"\u003e\n \u003cp\u003eNo=0，Yes=1\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 32.4421%;\"\u003e\n \u003cp\u003ePostoperative constipation\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 67.5579%;\"\u003e\n \u003cp\u003eNo=0，Yes=1\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 32.4421%;\"\u003e\n \u003cp\u003eVAS\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 67.5579%;\"\u003e\n \u003cp\u003eOriginal value input\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 32.4421%;\"\u003e\n \u003cp\u003ePositive emotions\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 67.5579%;\"\u003e\n \u003cp\u003eOriginal value input\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 32.4421%;\"\u003e\n \u003cp\u003enegative emotions\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 67.5579%;\"\u003e\n \u003cp\u003eOriginal value input\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003eAbbreviation: PCS，\u0026nbsp;Pain Catastrophizing Scale；\u0026nbsp;VAS，\u0026nbsp;Visual Analog Scale.\u003c/p\u003e\n\u003cp\u003e\u003cbr\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTable 4:Multivariate linear regression analysis of the modeling group (n=288)\u003c/strong\u003e\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 23.689%;\"\u003e\n \u003cp\u003eVariable\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11.3924%;\"\u003e\n \u003cp\u003e\u003cimg width=\"7\" height=\"14\" src=\"data:image/jpeg;base64,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\" alt=\"image\"\u003e\u003c/p\u003e\n \u003cp\u003evalue\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9.58409%;\"\u003e\n \u003cp\u003e\u003cem\u003eSE\u003c/em\u003e Value\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 13.2007%;\"\u003e\n \u003cp\u003e\u003cem\u003eWaldx\u003csup\u003e2\u003c/sup\u003e\u0026nbsp;\u003c/em\u003eValue\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 12.2966%;\"\u003e\n \u003cp\u003e\u003cem\u003eP\u003c/em\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003eValue\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10.4882%;\"\u003e\n \u003cp\u003e\u003cem\u003eOR\u003c/em\u003e Value\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 19.349%;\"\u003e\n \u003cp\u003e95%\u003cem\u003eCI\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 23.689%;\"\u003e\n \u003cp\u003eConstant\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11.3924%;\"\u003e\n \u003cp\u003e-8.907\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9.58409%;\"\u003e\n \u003cp\u003e8.824\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 13.2007%;\"\u003e\n \u003cp\u003e9.905\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 12.2966%;\"\u003e\n \u003cp\u003e0.002\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10.4882%;\"\u003e\n \u003cp\u003e0.000\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 19.349%;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 23.689%;\"\u003e\n \u003cp\u003eVAS\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11.3924%;\"\u003e\n \u003cp\u003e1.393\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9.58409%;\"\u003e\n \u003cp\u003e0.285\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 13.2007%;\"\u003e\n \u003cp\u003e29.137\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 12.2966%;\"\u003e\n \u003cp\u003e＜0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10.4882%;\"\u003e\n \u003cp\u003e4.028\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 19.349%;\"\u003e\n \u003cp\u003e2.429-6.679\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 23.689%;\"\u003e\n \u003cp\u003eNegative emotions\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 11.3924%;\"\u003e\n \u003cp\u003e0.180\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 9.58409%;\"\u003e\n \u003cp\u003e0.05\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 13.2007%;\"\u003e\n \u003cp\u003e13.098\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 12.2966%;\"\u003e\n \u003cp\u003e＜0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10.4882%;\"\u003e\n \u003cp\u003e1.197\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 19.349%;\"\u003e\n \u003cp\u003e1.068-1.320\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 23.689%;\"\u003e\n \u003cp\u003eUnderstanding postoperative pain before surgery\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 11.3924%;\"\u003e\n \u003cp\u003e0.901\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 9.58409%;\"\u003e\n \u003cp\u003e0.372\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 13.2007%;\"\u003e\n \u003cp\u003e5.861\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 12.2966%;\"\u003e\n \u003cp\u003e0.015\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10.4882%;\"\u003e\n \u003cp\u003e2.462\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 19.349%;\"\u003e\n \u003cp\u003e1.187-5.108\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 23.689%;\"\u003e\n \u003cp\u003ePostoperative constipation\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 11.3924%;\"\u003e\n \u003cp\u003e2.585\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 9.58409%;\"\u003e\n \u003cp\u003e0.602\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 13.2007%;\"\u003e\n \u003cp\u003e18.41\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 12.2966%;\"\u003e\n \u003cp\u003e＜0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10.4882%;\"\u003e\n \u003cp\u003e13.262\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 19.349%;\"\u003e\n \u003cp\u003e4.072-43.195\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 23.689%;\"\u003e\n \u003cp\u003eCombined Chronic Diseases\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 11.3924%;\"\u003e\n \u003cp\u003e1.751\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 9.58409%;\"\u003e\n \u003cp\u003e0.718\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 13.2007%;\"\u003e\n \u003cp\u003e5.939\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 12.2966%;\"\u003e\n \u003cp\u003e0.015\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10.4882%;\"\u003e\n \u003cp\u003e5.759\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 19.349%;\"\u003e\n \u003cp\u003e1.409-23.546\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003eAbbreviation: VAS， Visual Analog Scale. SE, standard error; \u003cem\u003e\u0026beta;\u003c/em\u003e, regression coefficient; \u003cem\u003eOR\u003c/em\u003e, Odds Ratio； \u003cem\u003eCI\u003c/em\u003e, Confidence interval； \u003cem\u003eWald \u0026chi;\u0026sup2;\u003c/em\u003e，\u0026nbsp;the statistic used for hypothesis testing of a single regression coefficient\u003cem\u003e\u0026beta;\u003c/em\u003ein logistic regression.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e3.4 Performance Evaluation of Predictive Models\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe area under the ROC curve (AUC) for the modeling group was 0.957 [95%\u003cem\u003eCI\u003c/em\u003e(0.937, 0.977)], with a J statistic of 0.763, sensitivity of 82.6%, specificity of 93.7%, and an optimal cutoff value of 0.277，\u0026nbsp;see\u0026nbsp;Figure 4.\u0026nbsp;The ROC curve area under the curve (AUC) for the validation cohort was 0.985 [95% \u003cem\u003eCI\u003c/em\u003e(0.970, 1.000)], with a Yordens index of 0.871, sensitivity of 92.3%, specificity of 94.9%, and optimal cutoff value of 0.315, see\u0026nbsp;Figure 5.The Hosmer-Lemeshow goodness-of-fit test yielded\u0026nbsp;\u003cem\u003e\u0026chi;\u003csup\u003e\u0026sup2;\u003c/sup\u003e\u003c/em\u003e=4.965 (\u003cem\u003eP\u003c/em\u003e=0.790). Calibration curves for the modeling cohort demonstrated good agreement between model predictions and observed outcomes, as shown in\u0026nbsp;Figure 6.\u0026nbsp;The Hosmer-Lemeshow goodness-of-fit test for the validation cohort yielded \u003cem\u003e\u0026chi;\u003csup\u003e\u0026sup2;\u003c/sup\u003e\u003c/em\u003e= 1.594 \u003cem\u003e(P\u003c/em\u003e=0.991). Calibration curves consistently demonstrated good agreement between model predictions and observed outcomes in the validation cohort, as shown in Figure 7.\u003c/p\u003e"},{"header":"4. Discussion","content":"\u003cp\u003e\u003cstrong\u003e4.1 Patients undergoing anorectal surgery have a relatively high incidence of catastrophic pain.\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eIn this study, 127 out of 288 patients in the modeling group experienced pain catastrophizing, yielding an incidence rate of 44.1%, consistent with the findings of Jiang et al.\u003csup\u003e[16]\u003c/sup\u003e, the incidence of catastrophic pain in patients with mixed hemorrhoids is 42.15%. The perianal region contains a high concentration of sensory nerve endings, making it extremely sensitive to pain. Patients often experience severe pain following anal surgery, which directly exacerbates the level of pain catastrophizing. Due to the private nature of the anal region, dressing changes and wound care after surgery frequently require exposing intimate areas, leading to negative emotions in patients\u003csup\u003e[5]\u003c/sup\u003e, thereby increasing the risk of pain becoming catastrophic.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e4.2 Visual Anal Scale\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThis study indicates that the visual analog scale (VAS) for anal pain is the strongest predictor of pain catastrophizing. The findings reveal a small to moderate positive correlation between fear of pain and pain intensity\u003csup\u003e[15]\u003c/sup\u003e， consistent with the findings of this study.\u0026nbsp;Patients undergoing anal surgery experience intense pain, which can cause both physical suffering and psychological distress, potentially leading to negative coping mechanisms. This indicates that high-intensity pain serves as a direct and powerful physiological basis for triggering catastrophic thinking. As the key site controlling fundamental excretory functions, pain in the anus directly induces a profound sense of loss of control and a threat to vital survival functions; At the same time, due to the highly private and shameful nature of this area, patients often find themselves trapped in a negative psychological state of loneliness and helplessness\u003csup\u003e[25]\u003c/sup\u003e, due to fear of pain, individuals may avoid bowel movements, which exacerbates constipation and intensifies discomfort. This cycle of pain-fear-avoidance-exacerbated pain, coupled with inevitable triggers in daily activities, continually reinforces the patient\u0026apos;s catastrophic thinking.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e4.3\u003c/strong\u003e\u003cstrong\u003e\u0026nbsp;Constipation\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eWithin 7 days after anal surgery, the patient\u0026apos;s wound remains in the edema phase, and bowel movements may exacerbate anal pain\u0026nbsp;\u003csup\u003e[26]\u003c/sup\u003e. Patients often refuse to defecate due to fear of pain, which further hardens and dries the stool. Each straining episode directly pulls and compresses the unhealed anal wound, causing mechanical pain impulses to multiply\u003csup\u003e[27]\u003c/sup\u003e. Following anal surgery, anal edema increases resistance during bowel movements, leading to elevated resting anal pressure and exacerbating anal pain\u003csup\u003e[28]\u003c/sup\u003e. As pain intensifies, it exacerbates patients\u0026apos; negative emotions, providing an objective sensory basis for catastrophic thinking\u003csup\u003e[29]\u003c/sup\u003e. Postoperative constipation following anorectal surgery exacerbates pain and increases its catastrophic level, consistent with the findings of Jiang Weilian et al.\u003csup\u003e[18]\u003c/sup\u003e.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e4.4 Preoperative Understanding of Pain Knowledge and Awareness of Chronic Conditions\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThis study reveals the pivotal role of psychological factors in the catastrophizing of pain. Lack of knowledge about postoperative pain and the presence of chronic comorbidities are significant risk factors.\u0026nbsp;Research indicates that thorough preoperative health education about the disease helps alleviate patients\u0026apos; psychological burden\u003csup\u003e[11]\u003c/sup\u003e,\u0026nbsp;Similar to the findings of this study. Patients who lack understanding of the nature, duration, and relief methods for postoperative pain may misinterpret every instance of normal postoperative discomfort as \u0026quot;surgical failure\u0026quot; or \u0026quot;wound dehiscence\u0026quot;. Patients\u0026apos; preoperative pain expectations influence their actual postoperative pain experience\u003csup\u003e[30]\u003c/sup\u003e. Healthcare providers should ensure that surgical patients receive comprehensive information about postoperative pain before surgery research indicates that patients with chronic illnesses exhibit heightened levels of pain catastrophizing\u003csup\u003e[17]\u003c/sup\u003e, consistent with the findings of this study. For patients with long-term chronic conditions, concerns about elevated blood sugar and blood pressure post-surgery may affect wound healing. When experiencing normal postoperative pain, these patients often attribute worsening perianal discomfort to their chronic illness. When patients cannot explain their pain through medical reasoning, their attention repeatedly focuses on the pain sensation, generating anxiety that elevates the level of pain catastrophizing\u003csup\u003e[31]\u003c/sup\u003e.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e4.5 Negative Emotions\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eAt the emotional level, the findings of this study indicate that negative emotions exacerbate the risk of pain catastrophizing. Research shows that negative cognitive emotions intensify the level of pain catastrophizing\u003csup\u003e[32]\u003c/sup\u003e, consistent with the findings of this study. The reason may be that patients with negative emotions often experience psychological distress when facing postoperative pain and various complications, thereby amplifying their actual perception of pain\u003csup\u003e[29,33]\u003c/sup\u003e. This aligns with the findings of Wei Lian et al.\u0026nbsp;\u003csup\u003e[16]\u003c/sup\u003eand Pan Qi et al.\u003csup\u003e[34]\u003c/sup\u003e, indicating that negative emotions exacerbate the level of pain catastrophizing. Emotional states are not merely responses to pain but also serve as crucial regulatory variables that directly influence an individual\u0026apos;s perception of events.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e4.6 Predictive Model Analysis\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThis study constructed and internally validated a predictive model for catastrophic postoperative anal pain risk, demonstrating exceptional discriminatory performance and calibration (AUC=0.957 in the modeling cohort, AUC=0.985 in the validation cohort). This model integrates five core factors: postoperative pain intensity, negative emotions, insufficient preoperative pain knowledge, comorbid chronic diseases, and postoperative constipation, into an intuitive nomogram tool, enabling early, quantitative assessment of patient risk. Its high sensitivity and specificity ensure clinical identification accuracy, while each predictor targets specific, modifiable factors. This provides critical evidence for implementing precision intervention strategies centered on pain management optimization, psychological counseling, constipation prevention, and personalized health education.\u003c/p\u003e"},{"header":"5. Conclusion","content":"\u003cp\u003eThe incidence of pain catastrophizing among patients after anorectal surgery is 44.1%, influenced by comorbid chronic diseases, preoperative knowledge of postoperative pain, postoperative constipation, anal visual analog scale scores, and negative emotion scores. The risk prediction model for pain catastrophizing was developed based on these factors and demonstrated good validation results, providing healthcare professionals with a reference for early identification and intervention of pain catastrophizing risk in anorectal surgery patients. This study has the following limitations: First, it did not include potential predictors such as psychological factors; future research should incorporate additional predictive variables. Second, due to the lack of external validation, the generalizability and reliability of these findings remain to be confirmed. Future studies should validate the model using external datasets to enhance its external validity.\u0026nbsp;\u003c/p\u003e"},{"header":"Abbreviations","content":"\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\" class=\"fr-table-selection-hover\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 50.0904%;\"\u003e\n \u003cp\u003eEnglish full name\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 49.9096%;\"\u003e\n \u003cp\u003eAbbreviation\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 50.0904%;\"\u003e\n \u003cp\u003ePain Catastrophizing Scale\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 49.9096%;\"\u003e\n \u003cp\u003ePCS\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 50.0904%;\"\u003e\n \u003cp\u003eVisual Analog Scale\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 49.9096%;\"\u003e\n \u003cp\u003eVAS\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 50.0904%;\"\u003e\n \u003cp\u003eThe Positive and Negative Affect Scale\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 49.9096%;\"\u003e\n \u003cp\u003ePANAS\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 50.0904%;\"\u003e\n \u003cp\u003eSample standard deviation\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 49.9096%;\"\u003e\n \u003cp\u003e\u003cem\u003es\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 50.0904%;\"\u003e\n \u003cp\u003eSample mean\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 49.9096%;\"\u003e\n \u003cp\u003e\u003cem\u003ex̄\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 50.0904%;\"\u003e\n \u003cp\u003eChi-Square Test\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 49.9096%;\"\u003e\n \u003cp\u003e\u003cem\u003e\u0026chi;\u0026sup2;\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 50.0904%;\"\u003e\n \u003cp\u003eIndependent samples test\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 49.9096%;\"\u003e\n \u003cp\u003e\u003cem\u003et\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 50.0904%;\"\u003e\n \u003cp\u003eregression coefficient\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 49.9096%;\"\u003e\n \u003cp\u003e\u003cem\u003e\u0026beta;\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 50.0904%;\"\u003e\n \u003cp\u003eOdds Ratio\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 49.9096%;\"\u003e\n \u003cp\u003e\u003cem\u003eOR\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 50.0904%;\"\u003e\n \u003cp\u003eConfidence interval\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 49.9096%;\"\u003e\n \u003cp\u003e\u003cem\u003eCI\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 50.0904%;\"\u003e\n \u003cp\u003ethe statistic used for hypothesis testing of a single regression coefficient\u0026beta;in logistic regression.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 49.9096%;\"\u003e\n \u003cp\u003e\u003cem\u003eWald \u0026chi;\u0026sup2;\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eEthics approval and consent to participate\u003c/strong\u003e\u003cstrong\u003e：\u003c/strong\u003eThis study was approved by the Medical Ethics Committee of the First Affiliated Hospital of Anhui Medical University (Clinical Research Ethics Review PJ-2025-09-22), and all stages of the study were conducted in accordance with the established research ethics principles. Informed consent has been obtained from all participants. This study complies with the Declaration of Helsinki.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConsent for publication\u003c/strong\u003e\u003cstrong\u003e：\u003c/strong\u003eThe manuscript contains personal data in any form (including personal details, images, or videos)，approved for publication.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAvailability of data and materials\u003c/strong\u003e\u003cstrong\u003e：\u003c/strong\u003eThe datasets generated and analyzed by this research are not publicly available to ensure patient privacy and comply with ethical guidelines regarding informed consent for online raw data. However, interested researchers may request access to the data from the corresponding author, subject to reasonable requirements.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eCompeting Interests\u003c/strong\u003e\u003cstrong\u003e：\u003c/strong\u003eThe authors declare no conflicts of interest.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFunding:\u0026nbsp;\u003c/strong\u003eThis research was supported by the Provincial Quality Engineering Program of Anhui Higher Education Institutions（Number:2024：jyxm0753）.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAuthors\u0026rsquo; Contributions:\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eXiaomei Chen: Questionnaire design, data collection, data statistics, article writing.\u003c/p\u003e\n\u003cp\u003eXiaodi Zhu: Design guidance and supervision.\u003c/p\u003e\n\u003cp\u003eFangfang Zhang: Data statistics, design guidance, and supervision.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAcknowledgements\u003c/strong\u003e\u003cstrong\u003e：\u003c/strong\u003eThis research is grateful for the collaboration of teachers from various departments of the First Affiliated Hospital of Anhui Medical University.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eClinical Trial Number\u003c/strong\u003e\u003cstrong\u003e：\u003c/strong\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003eNot applicable.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\u003cli\u003e\u003cspan\u003eLiu Y, Wang L, Liu J, Geng F, Li Y, Zheng L. The relationship between anal disease and quality of life: A bibliometric study. Ann Transl Med. 2022;10(8):484.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eChinese Society of Integrative Medicine, Committee on Colorectal and Anal Diseases. Chinese Guidelines for the Diagnosis and Treatment of Hemorrhoids. (2020). Colorectal and Anal Surgery 2020;26(5):519\u0026thinsp;\u0026ndash;\u0026thinsp;33.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eRosser R, Harikrishnan A. Benign anorectal conditions: Perianal abscess, fistula in ano, haemorrhoids, fissures, and pilonidal sinus. Surg (oxf). 2020;38(6):322\u0026ndash;8.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eWald A, Bharucha AE, Limketkai B, Malcolm A, Remes-Troche JM, Whitehead WE, et al. ACG clinical guidelines: Management of benign anorectal disorders. Am J Gastroenterol. 2021;116(10):1987\u0026ndash;2008.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eZhao Xiaomin Z. 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Zhengzhou University; 2022.\u003c/span\u003e\u003c/li\u003e\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":false,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"bmc-surgery","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"bsur","sideBox":"Learn more about [BMC Surgery](http://bmcsurg.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/bsur/default.aspx","title":"BMC Surgery","twitterHandle":"@BMC_series","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true},"keywords":"anal surgery, anorectal diseases, pain catastrophizing, predictive model, nomogram","lastPublishedDoi":"10.21203/rs.3.rs-8431346/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-8431346/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003ch2\u003eBackground\u003c/h2\u003e \u003cp\u003eAnorectal surgery frequently induces significant postoperative pain, which can precipitate pain catastrophizing, a maladaptive cognitive pattern that exacerbates suffering and delays recovery. The absence of validated tools for early identification of at-risk patients impedes targeted interventions. This study aimed to develop and internally validate a clinical prediction model for postoperative pain catastrophizing in this patient group.\u003c/p\u003e\u003ch2\u003eMethods\u003c/h2\u003e \u003cp\u003eWe conducted a single-center study of 412 patients assessed 3\u0026ndash;4 days after anorectal surgery (October\u0026ndash;December 2025). Participants were randomly divided into a modeling group (n\u0026thinsp;=\u0026thinsp;288) for model development and a validation group (n\u0026thinsp;=\u0026thinsp;124) for internal validation. Data collected via structured questionnaires (demographics, Pain Catastrophizing Scale, Visual Analogue Scale for pain, Positive and Negative Affect Schedule). This study employed a multivariate logistic regression approach to analyze independent factors influencing catastrophic pain in patients following anorectal surgery. Using R software, we constructed a risk prediction model and a nomogram model for catastrophic pain in patients after anorectal surgery. The predictive efficacy of these models was validated through the area under the receiver operating characteristic curve (AUC) and the Hosmer-Lemeshow goodness-of-fit test.\u003c/p\u003e\u003ch2\u003eResult\u003c/h2\u003e \u003cp\u003eIn the modeling group (n\u0026thinsp;=\u0026thinsp;288), 127 patients (44.1%) experienced pain catastrophizing. Logistic regression identified Visual Analogue Scale (VAS) score, negative emotions, lack of preoperative pain cognition, chronic comorbidities, and postoperative constipation as predictors (P\u0026thinsp;\u0026lt;\u0026thinsp;0.05). The model demonstrated excellent discriminative ability in the modeling group [area under the curve (AUC)\u0026thinsp;=\u0026thinsp;0.957, 95% CI: 0.937\u0026ndash;0.977; Youden index\u0026thinsp;=\u0026thinsp;0.763], with a sensitivity of 82.6%, specificity of 93.7%, optimal cutoff value of 0.277, and good fit (Hosmer-Lemeshow test, P\u0026thinsp;=\u0026thinsp;0.790). In the validation group (n\u0026thinsp;=\u0026thinsp;124, 47.7% experiencing pain catastrophizing), model performance remained outstanding (AUC\u0026thinsp;=\u0026thinsp;0.985, 95% CI: 0.970\u0026ndash;1.000; Youden index\u0026thinsp;=\u0026thinsp;0.871; sensitivity 92.3%, specificity 94.9%; optimal cutoff value 0.315; Hosmer-Lemeshow test P\u0026thinsp;=\u0026thinsp;0.991). Calibration curves for both groups indicated good agreement between predicted and observed outcomes.\u003c/p\u003e\u003ch2\u003eConclusion\u003c/h2\u003e \u003cp\u003eWe developed and validated a practical nomogram using five clinical variables to effectively identify patients at high risk for post-anorectal surgery pain catastrophizing. This tool facilitates early targeted intervention. The main limitation is the single-center design.\u003c/p\u003e","manuscriptTitle":"Development and Validation of a Disaster Risk Prediction Model for Postoperative Anal Pain in Patients","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2026-02-02 06:17:33","doi":"10.21203/rs.3.rs-8431346/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"editorInvitedReview","content":"","date":"2026-02-06T00:29:37+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"282672238410875582409100964007808318220","date":"2026-02-03T13:42:55+00:00","index":"hide","fulltext":""},{"type":"reviewersInvited","content":"","date":"2026-01-29T12:34:01+00:00","index":"","fulltext":""},{"type":"editorInvited","content":"","date":"2026-01-07T09:30:23+00:00","index":"","fulltext":""},{"type":"editorAssigned","content":"","date":"2026-01-07T09:11:51+00:00","index":"","fulltext":""},{"type":"checksComplete","content":"","date":"2026-01-02T13:16:55+00:00","index":"","fulltext":""},{"type":"submitted","content":"BMC Surgery","date":"2026-01-02T13:08:42+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"bmc-surgery","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"bsur","sideBox":"Learn more about [BMC Surgery](http://bmcsurg.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/bsur/default.aspx","title":"BMC Surgery","twitterHandle":"@BMC_series","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"fda45013-282b-41fc-81d1-f21df4018c8b","owner":[],"postedDate":"February 2nd, 2026","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"under-review","subjectAreas":[],"tags":[],"updatedAt":"2026-02-02T06:17:33+00:00","versionOfRecord":[],"versionCreatedAt":"2026-02-02 06:17:33","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-8431346","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-8431346","identity":"rs-8431346","version":["v1"]},"buildId":"XKTyCvWXoU3ODBz1xrDgd","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}