程序教学模型干预对肿瘤外周静脉置入中心静脉导管置管患者预后的影响

Effect of Skinner's theory health education in prognosis of cancer patients with peripheral venous puncture central venous catheter

目的:建立以程序教学理论为基础的教学模型,探讨其在肿瘤经外周中心静脉置管(PICC)患者健康教育中的应用效果。方法:选取肿瘤科首次进行PICC置管的165例患者,按照随机数表法将其分为观察组(81例)与对照组(84例)。观察组采用程序教学模型对患者进行健康教育,对照组沿用常规健康教育方式,两组均干预4个化疗周期。干预结束后应用生活质量核心量表及焦虑自评量表进行问卷调查并统计学分析,比较两组患者PICC导管相关并发症发生情况及导管维护情况。结果:干预后两组肿瘤留置PICC患者生活质量核心量表得分比较,其躯体功能、角色功能、情绪功能及总健康得分均有显著差异(t=11.62,t=13.59,t=17.02,t=6.98;P<0.01);两组认知功能和社会功能得分差异显著(t=2.16,t=2.25;P<0.05);症状维度中疲乏得分有差异(t=-2.44,P<0.05);其他症状得分均无差异(t=-1.92,t=-1.35;P>0.05);两组患者干预后焦虑程度及发生率比较差异显著(F=22.99,P<0.01)。结论:程序教学模型在肿瘤PICC置管患者健康教育中的应用,有利于提高患者的生活质量,改善患者的心理状态。

Objective To discuss effect of Skinner＇s program education and reinforced theoryin education of cancer patients with PICC and improve nursing quality. Methods： Patients admitted into a 3rd levelhospital of Cangzhou city with PICC was selected. They were divided into 2 groups, 84 case in control group and 81cases in observation group. Traditional health education method was applied in control group, whereas Skinner＇s programeducation and reinforced theory was applied in observation group, both for 4 chemotherapy cycles. Complicationsassociated with PICC and condition of catheter maintenance was compared after that. Results： Comparison of Core lifequality schedule score, there were significant differences in physical function, role function, emotional function and totalhealth condition score in statistics（P〈0.01）, differences in cognitive function and social function were also significantin statistics （P〈0.05）, so did in tired score in symptom dimension（P〈0.05）. There was no significant difference in othersymptom scores （P〉0.05）. After implementing intervention, differences of rate and level of anxiety between groups wasstatistically different （P〈0.01）. Conclusions： Application of Skinner＇s program education and reinforced theory in cancerpatients with PICC can improve patient life quality and psychological status.