乳腺癌PICC化疗患者CDSMP实施效果评价

Evaluation of the effect of CDSMP implementation among the patients with breast cancer during PICC chemotherapy

目的:评价乳腺癌经外周静脉置入中心静脉导管(PICC)化疗患者CDSMP(慢性病自我管理健康教育项目)实施后的效果。方法:采用历史性对照试验研究设计,将2010年11月～2011年10月88例乳腺癌PICC化疗患者实施CDSMP作为干预组,将2010年2～11月90例乳腺癌PICC化疗患者作为对照组,比较两组患者化疗结束后PICC拔管前疾病自我管理行为、PICC自我管理能力、自我效能、健康状况和并发症发生率等方面的变化。结果:与对照组比较,干预组在健康状况的7个方面(整体健康自评、健康担忧、精力指标、疲劳、气短、疼痛、PICC对患者生活影响)明显好于对照组(P均<0.05),干预组在自我管理行为方面、PICC导管自我管理能力方面明显提高,机械性静脉炎、导管堵塞、管腔回血、导管感染、导管脱出等并发症发生率明显低于对照组(P均<0.05)。结论:CDSMP可改善乳腺癌PICC化疗患者的健康状况、自我管理行为、PICC导管自我管理能力、自我效能,可降低机械性静脉炎等并发症的发生率。

Objective： To evaluate the effect of implementation of Chronic Disease Self - Management Program （CDSMP） among the patients with breast cancer during periptlerally inserted central catheter （PICC） chemotherapy. Methods ： A historical case - control study was conducted, eighty- eight patients with breast cancer receiving PICC chemotherapy and CDSMP from November 2010 to October 2011 were selected as intervention group, ninety patients with breast cancer receiving PICC chemotherapy from February to November in 2010 were selected as control group ; the changes of disease self - management ability, PICC self - management ability, self - efficacy, ,health status, and complications after chemotherapy and before removing catheter of PICC in the two groups were compared. Results： The seven aspects of health status （ self - evaluation of whole health, health concern, energy index, fatigue, shortness of breath, pain, and effect of P1CC on life of the patients） of the patients in intervention group were better than those in control group （P 〈 0. 05）, self - management behavior and self - management ability of PICC catheter in intervention group were improved significantly, the incidences of complications including mechanical phlebitis, obstruction of catheter, blood returning, catheter infection, and pull away of catheter in intervention group were significantly lower than those in control group （ P 〈 0.05） . Conclusion ： CDSMP can improve the health status, self - management behavior, self - management ability of PICC catheter, and self - efficacy of the patients with breast cancer during PICC chemotherapy, and reduce the incidences of complications, such as mechanical phlebitis.