肿瘤患者PICC知信行现状及影响因素分析

Knowledge-Attitude-Practice and Associated Factors of Cancer Patients with Peripherally Inserted Central Catheter

目的了解肿瘤患者经外周静脉置入中心静脉导管（peripherally inserted central catheter,PICC）知信行现状并分析其影响因素。方法对2014年4月至2015年3月在四川大学华西医院肿瘤中心住院并置入PICC的650例肿瘤患者进行PICC知信行问卷调查,分析其影响因素。结果共发放650份问卷,其中有效问卷619份,其中男性258例,女性361例,年龄18~83岁,平均年龄为（51.4±12.2）岁。知信行各维度得分分别为：知识（9.28±2.04）分,态度（27.95±4.17）分,行为（25.67±4.00）分;单因素分析结果显示,有无合并其他慢性疾病（主要为糖尿病、高血压和冠心病）对患者置入PICC的态度有影响（P=0.040）;性别（P=0.015）和导管置入部位（P=0.023）对患者PICC维护行为有影响。多元回归分析得出文化程度对PICC相关知识（标准偏回归系数=0.125,P=0.017）评分有影响,性别（标准偏回归系数=-0.097,P=0.024）对PICC维护行为评分有影响,即文化程度越高的患者在知识部分得分越高,女性较男性在行为部分的得分更高。结论肿瘤患者PICC知信行的总体水平较高,但男性患者、文化程度低的患者的PICC知信行水平有待进一步提高。

Objective To investigate the Knowledge-Attitude-Practice（KAP）of cancer patients with peripherally inserted central catheter（PICC）and its associated factors.Methods A cross-sectional study was undertaken in 650 cancer patients with PICC in the West China Hospital,Sichuan University,from April 2014 to March 2015.Data were collected through a self-designed questionnaire in relation to KAP and its associated factors.Results A total of 619 valid questionnaires were returned.The participants had an average score of 9.28±2.04 in knowledge,27.95±4.17 in attitude,and 25.67±4.00 in practice.Occupation was associated with catheter-related knowledge.Comorbidity（with diabetes,hypertension and coronary heart disease）was associated with catheterrelated attitudes（P=0.040）.Gender（P=0.015）and catheter insertion site（P=0.023）were associated with PICC practice.The multivariable linear regression model showed that female patients（standardized partial regression coefficient =-0.097,P=0.024）and those with a higher level of education（standardized partial regression coefficient=0.125,P=0.017）had a higher score in PICC practice.Conclusion Overall,a high level of KAP was found in cancer patients with PICC.Clinical nursesshould provide personalized catheter-related education for patients according to their gender and level of education.Special attention should be paid to those with comorbidities such as diabetes mellitus,hypertension,coronary heart disease and other chronic diseases.