賦能教育在PICC置管腫瘤患者健康教育中的效果研究
發(fā)布時間：2019-01-07 17:46
【摘要】：目的:將賦能教育應(yīng)用于PICC置管前后的健康教育中,探討賦能教育對PICC置管腫瘤患者三個方面的影響,包括PICC置管患者自我效能感、PICC自我管理能力、PICC相關(guān)并發(fā)癥的影響。方法:采用完全隨機(jī)對照研究設(shè)計,嚴(yán)格按照納入標(biāo)準(zhǔn)和排除標(biāo)準(zhǔn)選取2015年11月至2016年4月貴州腫瘤醫(yī)院首次進(jìn)行PICC置管治療的101例腫瘤患者,通過隨機(jī)分組為對照組(n=51)和實(shí)驗(yàn)組(n=50),對照組實(shí)施常規(guī)教育,包括置管前、置管后的健康宣教及出院指導(dǎo),實(shí)驗(yàn)組為在常規(guī)健康教育的基礎(chǔ)上實(shí)施賦能教育,實(shí)施干預(yù)時間為1個月。干預(yù)后比較兩組干預(yù)前后自我效能感評分、干預(yù)后PICC自我管理能力評分及干預(yù)期間的并發(fā)癥發(fā)生率。其中,自我效能感評分采用《中文版癌癥患者自我管理效能感量表》進(jìn)行評估,PICC自我管理能力評分采用《腫瘤患者PICC自我管理能力評分量表》進(jìn)行評估。應(yīng)用SPSS19.0軟件進(jìn)行數(shù)據(jù)雙人錄入及分析:1.兩組基線資料采用例數(shù)、百分比或均數(shù)±標(biāo)準(zhǔn)差描述,采用卡方檢驗(yàn)、Fisher’s精確檢驗(yàn)或t檢驗(yàn);2.兩組患者自我效能感評分前后組間比較采用計量資料以均數(shù)±標(biāo)準(zhǔn)差描述,采用t檢驗(yàn),兩組患者自我效能感評分前后差值比較的計量資料以均數(shù)±標(biāo)準(zhǔn)差描述,采用配對t檢驗(yàn);3.兩組患者干預(yù)后自我管理能力評分的計量資料以均數(shù)±標(biāo)準(zhǔn)差描述,采用t檢驗(yàn);4.兩組患者PICC導(dǎo)管相關(guān)并發(fā)癥發(fā)生情況采用例數(shù)和百分比描述,采用卡方檢驗(yàn)或Fisher’s精確檢驗(yàn)。結(jié)果:1.實(shí)驗(yàn)組置管前后患者自我效能感及各維度評分(104.08±22.07、110.26±21.17)提高程度優(yōu)于對照組(100.76±17.58、100.29±20.65)(P0.05);2.實(shí)驗(yàn)組患者PICC自我管理能力及各維度評分(149.10±14.063)高于對照組(124.22±17.966)(P0.05);3.實(shí)驗(yàn)組患者導(dǎo)管相關(guān)并發(fā)癥總發(fā)生率(10%)低于對照組(66%)(P0.05),其中,實(shí)驗(yàn)組的靜脈炎和導(dǎo)管移位發(fā)生率(8%、0)低于對照組(29%、14%)(P0.05),實(shí)驗(yàn)組導(dǎo)管異位(2%)、導(dǎo)管脫出(10%)、穿刺點(diǎn)感染(6%)、非計劃拔管(4%)發(fā)生率低于對照組(0),但是差異沒有統(tǒng)計學(xué)意義(P0.05),兩組穿刺點(diǎn)滲血發(fā)生率一樣(2%),差異沒有統(tǒng)計學(xué)意義(P0.05)。結(jié)論:1.賦能教育能提高腫瘤患者自我效能感;2.賦能教育能提高腫瘤患者對PICC自我管理能力;3.賦能教育能減少PICC導(dǎo)管相關(guān)并發(fā)癥的發(fā)生,特別是能減少靜脈炎和導(dǎo)管移位兩種并發(fā)癥的發(fā)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 鹵standard deviation, chi-square test, Fisher's accurate test or t test; 2. The mean 鹵standard deviation was used in the comparison between the two groups before and after the self-efficacy score, and the mean 鹵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 鹵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 鹵22.07 110.26 鹵21.17) were better than those in the control group (100.76 鹵17.58100.29 鹵20.65) (P0.05). The scores of PICC self-management ability and each dimension in the experimental group (149.10 鹵14.063) were higher than that in the control group (124.22 鹵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.
【學(xué)位授予單位】：貴州醫(yī)科大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R473.73
本文編號：2403949
[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 鹵standard deviation, chi-square test, Fisher's accurate test or t test; 2. The mean 鹵standard deviation was used in the comparison between the two groups before and after the self-efficacy score, and the mean 鹵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 鹵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 鹵22.07 110.26 鹵21.17) were better than those in the control group (100.76 鹵17.58100.29 鹵20.65) (P0.05). The scores of PICC self-management ability and each dimension in the experimental group (149.10 鹵14.063) were higher than that in the control group (124.22 鹵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.
【學(xué)位授予單位】：貴州醫(yī)科大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R473.73
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