护患双方对经外周静脉的中心静脉置管带管出院患者健康教育认知差异性的调查

Differences Investigation of Health Education Cognition for Discharged with PICC between Nurses and Patients

目的探讨护患双方在外周静脉的中心静脉置管(peripherally inserted central catheters,PICC)带管出院患者健康教育认知上的差异。方法便利抽样法选择2012年5-10月在上海某三级甲等医院PICC门诊维护患者50例和普外科、血液科、肿瘤科具有PICC维护证书的护士26名为研究对象。采用自行设计的问卷对其进行调查。结果 PICC带管出院患者主要为肘正中静脉置管,占42.0%。出现的不适状况主要以手臂肿胀为主,占30.0%。患者对PICC健康教育项目重要性认知与实际了解程度呈正相关(r=0.637,P<0.05)。护士对PICC健康教育项目重要性认识与实际强调程度呈正相关(r=0.775,P<0.05)。两者在PICC置管最重要的3项健康教育项目认知上有差异,患者注重自身生活、活动的影响及定时维护的要求,而护士更关注PICC穿刺处观察、导管维护、换药等方面。影响健康教育实施成效的原因,主要包括患者的年龄、文化程度、护士PICC相关知识、健康教育的认知和态度及护士工作的繁忙程度等。结论对PICC带管出院患者的健康教育要以患者的需求为出发点。

Objective To explore the difference of health education cognition for discharged with PICC between nurses and patients. Methods By convenience sampling, 50 patients with PICC from May to October in 2012 in outpatient department in Shanghai and 26 nurses with PICC maintenance certification from department of general surgery, department of hematology and department of oncology were randomly selected and surveyed by using self-designed questionnaire. Results Most of the patients discharged with PICC were using median cubital vein catheter, which accounted for 42.0%.The main discomfort was the arm swollen mostly, which accounted for 30.0.The patient＇s cognitive level of the importance of PICC health education project was positively correlated with the actual emphasis level （r =0.637,P〈0.05）. The nurse＇s cognitive level of the importance of PICC health education proj ect was positively correlated with the actual emphasis level（r=0.775, P 〈0.05）. Nurses and patients had some different opinions on the health education cognition with PICC. Patients focused on the effects of PICC for their life, activities and requirement of timely maintenance, while nurses concerned with the observation for puncture point, catheters maintenance and dressing change etc. Factors influencing the implementation of health education contained patient＇s age and educational level, nurse＇s PICC knowledge, health education cognition for patients and degree of busyness work.Conclusion Health education for patients with PICC should meet with the patient＇s needs.