小儿经外周静脉置入中心静脉导管照护者自护能力调查分析

Investigation of Caregivers' Self-nursing Ability for Children with Peripherally Inserted Central Catheter

目的 了解小儿经外周静脉置入中心静脉导管（PICC）照护者对 PICC 自我护理知识的掌握情况及需求,为住院患儿及带管出院患儿的健康教育提供依据。方法 选择 2013 年 12 月－ 2015 年 7 月住院期间 162例留置 PICC 患儿,采用自设问卷对其照护者共 364 名进行调查,内容为照护者一般资料收集、已掌握护理知识内容调查、照护者现有护理知识获得途径等内容。结果 留置 PICC 的小儿照护者主要以老年人居多,照护模式多为为家庭核心成员轮流照护;由老年人照护为主的家庭有 59 户（36.42%）,由患儿父母为主要照护者家庭 21 户（12.96%）,为父母、老年人轮流照护 82 户（50.62%）。调查住院期间照护者的自我护理知识测试总分在 5 ～ 29 分,平均（11.37±5.68）分。带管出院家长 19 名,单独填写测带管出院注意事项,成绩在 6 ～ 11 分,平均（8.41±4.33）分。所有照护者均接受了来自于护士口头指导（362 例）,其次是接受上一位陪护者的指导（313 例,86.65%）。结论 留置 PICC 的小儿照护者对 PICC 自我护理知识的知晓率普遍偏低,尤其是带管出院患儿。护理管理者应重视护士专科培训工作,提高护士对 PICC 健康教育知识点的掌握度,针对不同照护者人群特点采用不同形式的健康教育手段,不断改进健康教育模式,提高小儿 PICC 护理质量。

Objective To investigate the knowledge and need of caregivers who perform self-nursing for children with peripherally inserted central catheter （PICC）, in order to provide evidence for health education for children in-patients and children discharged from hospital with central venous catheter. Methods Self-designed questionnaire was used to investigate 364 caregivers who performed nursing for 162 PICC pediatric in-patients bwtween December 2013 and July 2015. The investigation was carried out on the general information, nursing knowledge, and the acquisition approach of caregivers＇ existing nursing knowledge. Results The majority of indwelling PICC pediatric caregivers were elderly people, and the common care model was alternate caring carried out by core family members. The children were cared by the elderly in 59 families （36.42%）. Twenty-one families had the parents of the children as the major caregivers （12.96%）, and alternate caring by parents and the elderly happened in 82 families （50.62%）. The total score of the investigation was ranged from 5 to 29 with an average of 11.37±5.68. Nineteen children were discharged with catheter, whose caregivers got a score from 6 to 11, averaging 8.41±4.33. Conclusions The ratio of self-nursing knowledge in caregivers for pediatric PICC patients is generally low, especially in those caregivers for patients discharged with central venous catheter. Nursing administrators should pay attention to training of the nurses, trying to improve the knowledge of nurses on PICC health education. Different forms of health education should be carried out for different caregivers. Finally, health education model should also be continuously improved to raise the quality of PICC pediatric nursing.