三级甲等医院肿瘤患者PICC置管依从性的调查与分析

Investigation and analysis of compliance of PICC among patients with tumor in top first-class hospitals

目的查找分析影响三级甲等医院肿瘤患者外周静脉置入中心静脉导管(PICC)置管依从性的现状及其影响因素。方法使用自设问卷《三级甲等医院肿瘤患者PICC置管依从性调查问卷》,采用方便抽样对具备PICC置管适应证而尚未施行PICC的80例肿瘤化疗患者进行置管依从性调查,调查内容包括置管意愿、一般资料、基本医疗情况、患者对PICC的担心程度和认知程度。结果调查对象PICC置管依从性为72.5%,其中文化程度越高、有医疗保险支付(与自费者比较)、住院期间发生静脉情况不良、家庭支持度越好的患者,对PICC置管依从性越好(P<0.05);而性别、工作状况、婚姻状况和家庭月收入对PICC置管依从性的影响无统计学意义(P>0.05);48.7%患者主要通过医护人员了解PICC的置管技术和相关知识;患者对PICC各方面的担心程度越高则依从性越差,不愿意置管患者的担心程度得分与愿意置管患者的得分差异具有统计学意义[(24.88±6.02)分vs(19.14±3.30)分](P<0.01)。结论患者对PICC置管依从性具有很大的提高潜力。护理人员应当充分考虑影响依从性的因素,有针对地加强PICC置管前宣教,注意护患沟通技巧,逐步推广PICC。

Objective To investigate the status and influencing factors of compliance of peripherally inserted central catheterization(PICC) among patients with tumor in top first-class hospitals.Methods Self-designed questionnaire of compliance of PICC among patients with tumor in top first-class hospitals was adopted,and convenient sampling was used to investigate the compliance of PICC in 80 patients who were suited for PICC and were not performed PICC.The investigation included will of PICC,general data,basic medical condition,level of worry and awareness for PICC.Results The compliance of PICC in all the patients was 72.5%.Higher educational background,medical insurance coverage,poorer condition of vein during hospital stay and better support from family led to higher compliance of PICC(P<0.05),while gender,working condition,marital status and family monthly income had no significant impact on compliance of PICC(P>0.05).A total of 48.7% of patients learned the main knowledge of PICC from medical staff.Patients with higher level of worry had lower compliance of PICC,and patients who disagreed to perform PICC got higher score of worry(24.88±6.02) than those who agreed(19.14±3.30)(P<0.01).Conclusion There is much room for improvement for compliance of PICC in patients.Nurses should take influencing factors into full consideration,enhance introduction of PICC to patients,and promote PICC step by step.