基于Meleis转移理论的健康教育对肺癌化疗PICC带管患者出院准备度与自我管理能力的影响

Effect of health education based on Meleis transition theory on discharge readiness and self-management ability of patients with peripherally inserted central catheter during lung cancer chemotherapy

目的探究基于Meleis转移理论的健康教育对肺癌化疗留置经外周静脉穿刺中心静脉置管(PICC)患者出院准备度与自我管理能力的影响。方法便利抽样法选取2019年1~12月复旦大学附属华山北院收治的肺癌化疗留置PICC导管患者51例作为对照组,实施常规健康教育,2020年1~12月我院收治的肺癌化疗留置PICC导管患者52例作为研究组,于PICC置管后第2天开始实施基于Meleis转移理论的健康教育。比较两组患者干预后的出院准备度、出院指导质量、PICC置管并发症及置管时间,并采用中文版健康促进策略量表(SUPPH)评价两组患者干预前后的自我管理能力。结果出院当天,研究组患者出院准备度评分及出院指导质量评分分别为(176.82±28.73)分、(151.77±29.46)分,明显高于对照组的(163.60±31.04)分、(138.59±26.38)分,差异均有统计学意义(P<0.05);出院当天,研究组患者自我管理能力评价中的减轻压力评分、积极态度评分及总分分别为(26.26±5.89)分、(36.89±7.43)分、(70.61±9.25)分,明显高于对照组的(23.82±5.17)分、(33.45±6.71)分、(64.22±7.37)分,差异均有统计学意义(P<0.05);研究组患者的PICC导管平均留置时间为(115.13±6.32)d,明显长于对照组的(110.94±7.73)d,差异有统计学意义(P<0.05);研究组患者的并发症总发生率为8.33%,略低于对照组的21.74%,但差异无统计学意义(P>0.05)。结论基于Meleis转移理论的健康教育能够提高肺癌化疗PICC带管患者出院准备度与出院指导质量,增强自我管理能力,进而有效延长带管时间。

Objective To explore the effect of education based on Meleis transition theory on discharge readiness and self-management ability of patients with peripherally inserted central catheter(PICC)during lung cancer chemotherapy.Methods Using convenience sampling method,51 patients with PICC during lung cancer chemotherapy who were admitted to Huashan North Hospital Affiliated to Fudan University from January to December,2019 were selected as the control group,which received routine health education,and 52 patients with PICC during lung cancer chemotherapy who were admitted from January to December,2020,were enrolled as the study group,which received health education based on the Meleis transition theory on the 2ndday after the PICC catheterization.The readiness for hospital discharge,quality of discharge guidance,complications of PICC catheterization,and catheterization time were compared between the two groups after intervention.The Chinese version of Health Promotion Strategies(SUPPH)was used to compare the self-management ability of the two groups before and after intervention.Results On the day of discharge,the scores of readiness for discharge and quality of discharge guidance were(176.82±28.73)points and(151.77±29.46)points in the study group,which were significantly higher than(163.60±31.04)points and(138.59±26.38)points in the control group(P<0.05).On the day of discharge,the stress reduction score,positive attitude score,and total score in the self-management ability evaluation of the study group were(26.26±5.89)points,(36.89±7.43)points,and(70.61±9.25)points,respectively,which were significantly higher than(23.82±5.17)points,(33.45±6.71)points,(64.22±7.37)points in the control group(P<0.05).The average indwelling time of PICC in the study group was(115.13±6.32)d,which was significantly longer than(110.94±7.73)d in the control group(P<0.05).There was no significant difference in the total incidence of complications between the two groups(8.33%vs 21.74%,P>0.05).Conclusion Health education based on Meleis transition theory can improve the discharge readiness and discharge guidance quality of patients with peripherally inserted central catheter during lung cancer chemotherapy,enhance self-management ability,and effectively prolong the indwelling time of PICC.