健康教育对中心静脉导管胸腔置管患者的影响

Effect of health education in patients with peripherally inserted central catheter chest tube

目的探讨健康教育对中心静脉导管(PICC)胸腔置管患者自护能力、自我效能及PICC相关并发症的影响。方法收集晚期肿瘤伴恶性胸腔积液的患者100例,2012年5月前纳入的47例患者作为对照组,2012年5月及以后纳入的53例患者作为观察组,对照组给予常规护理及健康教育,观察组实施以提高患者自我护理能力和自我效能为目的的健康教育方案。结果出院前观察组自我护理能力明显优于对照组,ESCA表的自护技能、责任感、自我概念、疾病健康知识得分及总分均高于对照组,差异有统计学意义(P<0.05)。观察组置管期间自我效能量表不适症状管理、自我护理任务管理得分及总分均高于对照组,差异有统计学意义(P<0.05),观察组PICC依从性问卷调查得分高于对照组,差异有统计学意义(P<0.05)。观察组置管期间导管最大流速变化值、月均非计划性导管维护次数PICC相关并发症发生率低于对照组,差异有统计学意义(P<0.05)。结论以认知行为干预、互动自我护理指导为主的健康教育有助于提高患者PICC置管期间自我护理技能、自我效能,降低导管阻塞及并发症发生率。

Objective To investigate the effect of health education on self-care ability, self-efficacy and impact of PICC related complications in patients with peripherally inserted central catheter chest tube. Methods Collected 100 cases of advanced cancer with malignant pleura1 effusion May 2012 ago included 47 cases in the control group, after May 2012 included 53 cases in the observation group. The control group received routine care and health education, and the observation group were taught to improve patient self-care and self-efficacy for the purpose of health education programs. Results The observation group before discharge self-care than the control group, self-care skills ESCA table, responsibility, self-concept, disease health knowledge score and total score were higher, the differences were statistically significant （P〈0.05）. During the observation group self-efficacy scale symptoms catheter management, self-care task management score and total score were statistically higher （P〈0.05）, observation group＇s PICC compliance question- naires scored were statistically higher （P〈0.05）. Changes in the value of the maximum flow rate during the catheter tube in the observation group , the average monthly number of unplanned maintenance PICC catheter-related complication rate were statistically lower than the control group （P〈0.05）. Conclusion Coguitive-behavioral interventions, self-care guidance based interactive health education can help improve patient PICC catheter during self-care skills, self-efficacy, reduce the incidence of catheter occlusion and complications .