阶段变化理论健康宣教在肺癌经外周静脉穿刺置入中心静脉导管置管化疗间歇期的应用

Application of Health Education of Trans-theoretical Model in Patients with Lung Cancer During Intermission of PICC Catheterization Chemotherapy

目的探讨阶段变化理论(TTM)的健康宣教对肺癌经外周静脉穿刺置入中心静脉导管(PICC)置管化疗间歇期患者的影响。方法选取2019年12月至2020年12月新乡市中心医院收治的95例肺癌PICC置管化疗间歇期患者为研究对象,依据护理方案分为对照组(47例)和观察组(48例)。对照组接受常规健康宣教;观察组接受TTM的健康宣教。比较两组患者干预前后应对方式、自我管理能力(AHSMSRS)、心理状态(焦虑HAMA、抑郁HAMD)及PICC置管化疗管理认知度。结果干预后观察组积极应对评分、AHSMSRS评分高于对照组,消极应对评分低于对照组(P<0.05);干预后观察组HAMA评分、HAMD评分低于对照组(P<0.05);观察组PICC置管化疗管理认知度[93.75%(45/48)]高于对照组[76.60%(36/47)](P<0.05)。结论基于TTM的健康宣教可缓解肺癌PICC置管化疗间歇期患者的负性心理,提升患者自我管理能力和认知水平,激发患者治疗积极性。

Objective To investigate the application of health education of trans-theoretical model(TTM)in patients with lung cancer during intermission of peripherally inserted central catheter(PICC)catheterization chemotherapy.Methods A total of 95 patients with lung cancer who accepted PICC catheterization chemotherapy in Xinxiang Central Hospital from December 2019 to December 2020 were collected,and they were divided into control group(47 cases)and observation group(48 cases).The control group accepted routine health education,and the observation group accepted TTM health education.Coping style,the rating scale of health self-management skill for adults(AHSMSRS),the score of Hamilton anxiety scale(HAMA)and Hamilton depression scale(HAMD)and management awareness of PICC catheterization and chemotherapy were compared between the two groups before and after intervention.Results After intervention,the scores of positive coping and AHSMSRS in the observation group were higher than those of the control group,while the score of negative coping was lower than that of the control group(P<0.05).After intervention,the scores of HAMA and HAMD of the observation group were lower than those of the control group(P<0.05).The management awareness of PICC catheterization of the observation group was[93.75%(45/48)]higher than that of the control group[76.60%(36/47)](P<0.05).Conclusion Health education of TTM can improve the negative psychology of lung cancer patients with PICC catheterization and intermittent chemotherapy,improve their self-management ability and cognitive level,and stimulate the enthusiasm of patients for treatment.