Objective:

To examine factors associated with unmet psychological care needs in hepatocellular carcinoma (HCC) patients and develop a risk prediction model using the Neuman Systems Model.

Approach:

• Study Design: Single-center retrospective study involving 345 adults with HCC admitted between January 2020 and December 2024.
• Definition of Unmet Needs: Unmet psychological care needs were defined as a score of ≥3 on any item in the psychological domain of the SCNS-SF34 within 24–48 h after admission.
• Data Analysis: Used multiple imputation, LASSO selection, and multivariable logistic regression to develop a nomogram, with evaluation of discrimination, calibration, and internal validation.

Key Findings:

• Unmet psychological care needs were identified in 205 patients (59.4%).
• Key predictors included pain NRS score, sleep disturbance, PHQ-9 score, GAD-7 score, family support, cooperation in physician-patient communication, and perceived economic burden.
• The nomogram demonstrated AUCs of 0.851 in the training set and 0.829 in the validation set.

Interpretation:

The model requires external validation before clinical implementation.

Limitations:

• Single-center study may limit generalizability.
• External validation of the nomogram is necessary.

Conclusion:

Unmet psychological care needs are prevalent in HCC patients shortly after admission, and a validated nomogram could enhance early nursing assessment and support.