以信念为基础的健康教育对乳腺癌患者选择PICC化疗的影响

Influence of education basing on health belief model on breast cancer patients choosing PICC for chemotherapy

目的 探讨以健康信念模式为基础的健康教育对乳腺癌化疗患者选择超声下PICC置管化疗的影响.方法 选择在本科室住院的76例患者,开展以健康信念模式为基础的健康教育,向患者讲解静脉化疗相关知识,包括化疗药物的作用与副作用,化疗途径及各途径化疗的优劣,特别是超声引导下PICC置管化疗的优劣,帮助患者了解超声下PICC置管术、并在知情同意后选择它.健康教育前发放问卷调查表,评估患者对化疗相关情况的了解,并针对存在问题进行至少2次的健康信念教育,5～7天后再次发放此问卷对患者进行教育后的评估.结果 健康教育后患者对化疗相关知识、选择化疗途径的态度及行为得分明显改变,经配对t检验,差异有统计学意义（P＜0.001）;健康教育后选择超声下PICC置管化疗的人数逐月比较,经卡方检验有意义（P＜0.01）.结论 应用以健康信念模式为基础的健康教育有助于患者选择超声下PICC置管术,有效保护了外周血管、减少了穿刺次数,提高化疗期间的生命质量.

Objective To investigate the influence of the education basing on health belief model on breast cancer patients choosing ultrasound-guided PICC for chemotherapy. Methods 76 breast cancer patients were enrolled into this study. All these patients received the education basing on health belief model which included the knowledge about the effects and side effects caused by chemotherapy drugs, the pathway to receive these drugs, and the advantages and disadvantages of these pathways（especially that of ultrasound- guided PICC） so that they would have some knowledge of ultrasound-guided PICC and chose it after signing the medical informed consent. Before the health education, the investigation papers were given out to the patients to investigate their knowledge about chemotherapy. According to the specific and personal questions of the patients, education basing on the health belief were performed at least twice. 5-7 days from then, the same investigation papers were given out to re-evaluate the patients. Results After the education, the attitude and behavior about chemotherapy and the pathway to receive these drugs in these patients were significantly improved, with statistical differences （P〈0.001）; more breast cancer patients chose PICC for chemotherapy, with a statistical difference （P〈0.01）. Conclusions The education basing on health belief model can help breast cancer patients choose ultrasound-guided PICC which can protect their peripheral blood vessel, decrease venipuncture times. This eduction model can improve their life quality during chemotherapy.