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赋能教育在PICC置管肿瘤患者健康教育中的效果研究

发布时间:2019-01-07 17:46  文章来源:笔耕文化传播
【摘要】:目的:将赋能教育应用于PICC置管前后的健康教育中,探讨赋能教育对PICC置管肿瘤患者三个方面的影响,包括PICC置管患者自我效能感、PICC自我管理能力、PICC相关并发症的影响。方法:采用完全随机对照研究设计,严格按照纳入标准和排除标准选取2015年11月至2016年4月贵州肿瘤医院首次进行PICC置管治疗的101例肿瘤患者,通过随机分组为对照组(n=51)和实验组(n=50),对照组实施常规教育,包括置管前、置管后的健康宣教及出院指导,实验组为在常规健康教育的基础上实施赋能教育,实施干预时间为1个月。干预后比较两组干预前后自我效能感评分、干预后PICC自我管理能力评分及干预期间的并发症发生率。其中,自我效能感评分采用《中文版癌症患者自我管理效能感量表》进行评估,PICC自我管理能力评分采用《肿瘤患者PICC自我管理能力评分量表》进行评估。应用SPSS19.0软件进行数据双人录入及分析:1.两组基线资料采用例数、百分比或均数±标准差描述,采用卡方检验、Fisher’s精确检验或t检验;2.两组患者自我效能感评分前后组间比较采用计量资料以均数±标准差描述,采用t检验,两组患者自我效能感评分前后差值比较的计量资料以均数±标准差描述,采用配对t检验;3.两组患者干预后自我管理能力评分的计量资料以均数±标准差描述,采用t检验;4.两组患者PICC导管相关并发症发生情况采用例数和百分比描述,采用卡方检验或Fisher’s精确检验。结果:1.实验组置管前后患者自我效能感及各维度评分(104.08±22.07、110.26±21.17)提高程度优于对照组(100.76±17.58、100.29±20.65)(P0.05);2.实验组患者PICC自我管理能力及各维度评分(149.10±14.063)高于对照组(124.22±17.966)(P0.05);3.实验组患者导管相关并发症总发生率(10%)低于对照组(66%)(P0.05),其中,实验组的静脉炎和导管移位发生率(8%、0)低于对照组(29%、14%)(P0.05),实验组导管异位(2%)、导管脱出(10%)、穿刺点感染(6%)、非计划拔管(4%)发生率低于对照组(0),但是差异没有统计学意义(P0.05),两组穿刺点渗血发生率一样(2%),差异没有统计学意义(P0.05)。结论:1.赋能教育能提高肿瘤患者自我效能感;2.赋能教育能提高肿瘤患者对PICC自我管理能力;3.赋能教育能减少PICC导管相关并发症的发生,特别是能减少静脉炎和导管移位两种并发症的发生。
[Abstract]:Objective: to apply empowerment education to health education before and after PICC catheterization, and to explore the effects of empowerment education on PICC patients with tumor, including self-efficacy, PICC self-management and PICC related complications. Methods: totally randomized controlled study design was used to select 101 cancer patients who were treated with PICC tube for the first time from November 2015 to April 2016 in Guizhou Cancer Hospital according to the inclusion criteria and exclusion criteria. The control group was randomly divided into two groups: control group (NX51) and experimental group (NC50). The control group was given routine education, including health education before and after catheterization and discharge guidance, while the experimental group was given empowerment education on the basis of routine health education. The time of intervention was 1 month. After intervention, the scores of self-efficacy, PICC self-management ability and the incidence of complications during intervention were compared between the two groups. The Chinese version of the scale for self-management efficacy of cancer patients was used to evaluate the self-efficacy, and the PICC scale for self-management ability of cancer patients was used to evaluate the self-management ability of cancer patients. Application of SPSS19.0 software for data double input and analysis: 1. The two groups of baseline data were described by case number, percentage or mean 卤standard deviation, chi-square test, Fisher's accurate test or t test; 2. The mean 卤standard deviation was used in the comparison between the two groups before and after the self-efficacy score, and the mean 卤standard deviation was used in the measurement data of the difference between the two groups before and after the self-efficacy score. Paired t test was used. 3. The measurement data of self-management ability score after intervention in both groups were described by mean 卤standard deviation, and t test was used. The incidence of PICC catheter-related complications in both groups was described by the number and percentage of cases, chi-square test or Fisher's accurate test. Results: 1. The scores of self-efficacy and each dimension in the experimental group (104.08 卤22.07 110.26 卤21.17) were better than those in the control group (100.76 卤17.58100.29 卤20.65) (P0.05). The scores of PICC self-management ability and each dimension in the experimental group (149.10 卤14.063) were higher than that in the control group (124.22 卤17.966) (P0.05). The total incidence of catheter-related complications in the experimental group (10%) was lower than that in the control group (66%) (P0.05). The incidence of phlebitis and catheter displacement in the experimental group (8%) was lower than that in the control group (29%) (P0.05). The incidence of ectopic catheter (2%), catheter prolapse (10%), puncture point infection (6%) and unplanned extubation (4%) in the experimental group was lower than that in the control group (0%), but the difference was not statistically significant (P0.05). The incidence of bleeding at puncture point was the same (2%), the difference was not statistically significant (P0.05). Conclusion: 1. Empowerment education can improve the sense of self-efficacy of cancer patients; 2. Empowerment education can improve the ability of cancer patients to manage themselves to PICC. Enabling education can reduce the incidence of complications associated with PICC catheter, especially phlebitis and catheter displacement.
【学位授予单位】:贵州医科大学
【学位级别】:硕士
【学位授予年份】:2017
【分类号】:R473.73

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