自我效能干预在化疗间歇期留置PICC导管患者中的应用效果

Effects of self-effidency intervention for patients with PICC at chemotherapy intermission

目的探讨自我效能干预对留置PICC导管化疗间歇期患者的效果。方法选取2013年5月-2014年5月150例留置PICC导管化疗患者作为研究对象，按照住院日期先后分为观察组和对照组各75例。对照组采用常规护理措施，观察组采用自我效能护理干预方法，包括直接性经验、代替性经验、言语劝说及启用支持系统。采用一般自我效能量表在两组患者入院时及出院后6个月进行评价，并且比较出院6个月内两组患者PICC并发症发生率。结果观察组患者入院时自我效能得分与对照组比较，差异无统计学意义（P〉0．05）。出院6个月后观察组自我效能得分高于对照组，差异有统计学意义（P〈0．01）。出院6个月内观察组PICC并发症中，导管相关性感染、导管异位发生情况均优于对照组，差异有统计学意义（P〈0．05）。结论自我效能干预措施增强了留置PICC导管化疗间歇期患者的自我效能水平，增强信心，提升自我管理的能力，减少了PICC管并发症的发生。

Objective To explore the effect of self-efficiency intervention for patients with peripherally inserted central catheter （PICC） at the intermission of the chemotherapy. Methods A total of 150 chemotherapy patients with PICC were selected from May 2013 to May 2014 and divided into experimental group （n = 75 ） and control group （ n = 75 ） according to the date of admission. The patients of control group underwent conventional nursing, while the patients of experimental group received self-efficiency nursing including directed experience, vicarious experience, verbal persuasion, and support system. The genera/ self- efficacy scale （GSES） was evaluated in two groups at admission and six months after discharge. The PICC complication rates were compared between two groups at admission and six months after discharge. Results At admission, the scores of self-efficiency were no significantly different between the experimental group and the control group （ P 〉 0.05 ）. At six months after discharge, the self-efficiency score of experimental group was higher than that of the control group （P 〈 0.01 ）. Within six months after discharge, the complications of catheter-related infection, PICC ectopy in the experimental group were significantly lower than those of the control group （P 〈 0.05 ）. Conclusions The self-efficiency intervention can enhance the level of self-efficiency among patients with PICC during the period of chemotherapy intermission. It also can increase patient＇ s confidence, promote patient＇s ability of self-management, and decrease the PICC complications.