新疆地区肿瘤化疗患者PICC自我管理能力及影响因素分析

Investigation of the catheter self-management level of patients with PICC during tumor ehemotherapg and its influencing factors

目的：调查新疆地区肿瘤化疗患者PICC导管自我管理能力现况，分析其影响因素及与患者家庭功能和健康行为的关系。方法于2013年10月—2014年6月采用便利抽样法对276例肿瘤化疗即将带管出院患者应用一般资料调查表、肿瘤患者PICC自我管理能力问卷、家庭功能量表、健康促进生活方式量表进行问卷调查。结果肿瘤患者PICC导管自我管理能力较差者88例（31.9%），中等水平者112例（40.6%），较好者76例（27.5%），整体处于中等水平。 Pearson相关分析显示，患者导管管理能力总分与健康行为总分及各维度呈正相关，与家庭功能总分及各维度呈负相关（P〈0.01）。单因素分析结果显示，不同年龄、性别、职业、婚姻、文化、医疗付费方式、个人月均收入、居住地和居住情况的患者导管管理能力水平的差异有统计学意义（P〈0.05）。多元逐步回归分析结果显示，文化程度、年龄、民族、医疗付费方式及心理健康、情感介入、情感反应、角色、沟通和行为控制是肿瘤化疗间歇期患者PICC导管管理能力的影响因素。结论肿瘤化疗患者家庭支持系统越高，选择的生活方式越健康，患者的导管自我管理能力越强。提高家庭成员对肿瘤患者的关爱，促进患者健康行为的改变，对于新疆地区的少数民族、高龄、低文化程度和低收入的患者，更应加强健康干预，提高其导管自我管理能力。

Objective To investigate the catheter self-management level of patients with PICC during tumor chemotherapy intermission in Xinjiang, and analyze the family function and health behavior impacted on catheter self-management ability. Methods A survey was conducted with convenience sampling method on 276 tumor patients who were going to discharge from hospital with PICC and investigated by general information questionnaire, tumor patients with PICC catheter self-management ability questionnaire, family functional scales and health promotion lifestyle scales. Results There were 88 of them with a poor ability of catheter self-management, accounted for 31. 9%, and 112 patients with a medium ability, accounted for 40. 6%,76 patients with a better ability of catheter self-management than others, accounted for 27. 5%, and the whole patients were in a medium level. By Pearson analysis, the score of catheter self-management ability was positively correlated with that of health behavior and each dimension, and was negatively correlated with that of family function and each dimension （P 〈0. 01）. Single-factor analysis showed that patients with differences of age, gender, occupation, marriage, culture, way of medical payment, average monthly personal income, domicile and different living condition had different level of self-management ability （ P 〈 0. 05 ）. Multiple step-wise regression analysis represented that the education background, age, nation, way of medical payment, mental health, emotional involvement, emotional reactions, roles, communication and behavior control were the factors affected catheter self-management ability of patient with PICC during tumor chemotherapy intermission. Conclusions The increasing of advanced family support system and healthy way of life style can lead to a strong catheter self-management ability of the patients during tumor chemotherapy intermission. We should improve the family members′attention for the tumor patients and promote the patients′health behavior change, especially we should strengthen the health intervention to the patients of minorities, the elderly, low-income, low degree of education for the improvement of their catheter self-management ability.