患者对PICC的态度及其留置选择性的相关因素

Attitude of patients for the PICC and its relevant factors for patients＇ indwelling selection

目的了解患者对PICC的态度，分析患者留置PICC导管选择性的相关因素，为临床护士宣教、推广PICC提供依据。方法以方便抽样的方法抽取有PICC置管适应证的108例患者，将接受置管的50例患者为接受组，拒绝留置的58例患者为拒绝组。对两组患者采用自制问卷进行调查。结果两组患者在性别、科室、从家至医院所需时间、医疗付费方式方面差异有统计学意义（P〈0．05）；两组患者对PICC导管作用的态度差异均有统计学意义（P〈0．01或P〈0．05）；两组在对留置PICC导管可以减少穿刺次数、减轻疼痛、是治疗的必要条件的态度上差异有统计学意义（P〈0．05）；在对留置PICC管有发生感染、脱出、形成血栓、异位、断裂的危险及对技术安全的态度方面差异有统计学意义（P〈0．05），对PICC置管过程存在危险的态度上差异无统计学意义（P〉0．05）；对PICC导管的经济负担及对日常生活影响的态度方面差异均有统计学意义（P〈0．05）。结论对于有留置PICC适应证的患者而言，大多数患者认同使用PICC可以减轻长期输液带来的痛苦但是留置PICC费用过高，对留置PICC的危险性及其影响日常生活的态度不一。患者大多信赖医务人员，认为留置PICC影响心理状态及自我形象的较少。患者对留置PICC的选择性与置管危险性、对日常生活的影响、经济负担、心理、社会等因素相关。

Objective To study the attitude of patients for the PICC and analyse its relevant factors for patients＇ indwelling selection, so as to provide evidence for the promotion of PICC and health educations for clinical nurse. Methods The questionnaire survey was used and108 patients that had indwelling indications in Beijing Chao-Yang Hospital, between April and May in 2010 were recruited. They were divided into acceptance group （ n = 50） and refuse group（ n = 58 ） and were investigated with self-designed questionnaire. Results Both of two groups had significantly differences in terms of gender, payment method for health care, potential risk of it, financial burden from it, impacts on daily life, and the trust from the medical personnel（ P 〈 0.05 ）. The absolutely right percent of can avoid needling during transfusion period for the attitude on the PICC function, maybe pipe block of PICC for the attitude on the danger of PICC, such needle is very expensive for the attitude on the financial burden of PICC, influencing eating for the attitude on the influencing daily life of PICC of the refuse group respectively was 46.6% , 50.0% , 44.8% , 22.4% , and that of acceptance group was 86.0% , 12.0% ,28.0% ,6.0% , and the difference was statistically significant （ P 〈 0.01 or P 〈 0.05 ）. There was significantly difference in the attitude of PICC can reducing the puncture times, alleviating pain was the necessary therapy condition between two groups （ P 〈 0.05 ）, as well as in the attitude of the PICC has the danger of infection,taking off, forming thrombus , catheter misplacement, fracture, and the operation safety （ P 〈 0.05 ）. there was no significantly difference on the attitude of existing dangerous in the PICC installing（ P 〉 0.05 ）, while the difference in the attitude of the financial burden influence of PICC on the daily life between two groups was significantly（ P 〈 0.05 ）. Conclusions From the view of patients with indwelling PICC indications, most patients agree that PICC can reduce the pain suffered from long-term infusion, but they comment that fees are high, and they have different attitude towards the risk of indwelling PICC and the influences of their daily lives. Most patients trust medical staff and not believe that indwelling PICC affect their psychological status and themselves image. Therefore, patients indwelling selection is correlate with the potential risk of indwelling, the impact of daily life, relevant economic burden, psychological and social factors.