癌症患者PICC置管期间自我护理能力及影响因素研究

发布时间：2018-06-25 19:18

本文选题：癌症 + PICC置管　；参考：《山东大学》2017年硕士论文

【摘要】：研究背景众所周知,癌症已成为威胁全世界人民生命健康的一种严重疾病,近几年来其发病率呈逐年上升趋势,在治疗过程中多数患者采用化学药物进行治疗。因化疗药物有刺激性强、易外渗等特点,所以在应用过程中极易出现各种严重的并发症。而经PICC置管化疗是目前临床当中最常采用的给药方式,置管期间患者的自我护理能力水平的高低会直接影响治疗效果,甚至直接影响预后水平,因此对置管期间患者自护能力进行研究是目前临床医务工作者极为关注的重点。研究目的调查影响癌症患者PICC置管期间自我护理能力的相关因素,为临床护理及健康教育提供科学指导,帮助护理人员采取针对性的措施,进而提升患者的自我护理能力水平,避免置管期间并发症的发生,保证治疗的顺利进行,进一步提升临床治疗效果。资料与方法采用便利抽样的方法,选取2016年1月～6月在某三甲医院进行PICC导管维护的395例癌症患者为研究对象,采用现场调查的方法,逐一对研究对象发放问卷调查表,调查表共包含5部分内容:(1)采用自行编制的一般资料调查表调查患者的性别、年龄、婚姻状况等一般人口学资料;(2)采用自我护理能力测定量表(ESCA)调查癌症患者PICC置管期间的自我护理能力;(3)采用健康促进生活方式量表(HPLP-Ⅱ)调查癌症患者的健康促进生活方式;(4)采用社会支持评定量表(SSRS)调查癌症患者的社会支持状况;(5)采用抑郁自评量表(SDS)调查患者在置管期间的抑郁程度以了解患者的心理状态。用SPSS21.0统计学软件对数据进行统计分析,计数单位和计量单位分别使用率(%)和均数±标准差(x±SD)表示,以P0.05表示差异具有统计学意义。研究结果1.患者年龄在20岁～76岁之间,平均年龄为(54.12±5.68)岁,90.65%的患者已婚,居住地分布在市区、城镇、农村不一,文化水平、主要照护者、职业、月收入、付费方式、疾病及治疗状况各不相同。2.本研究中395例患者的整体自我护理能力评分水平(112.97± 12.05)分,处于中等水平,其中有42.03%的患者处于高等水平,55.19%的患者处于中等水平,2.78%处于低水平。其中健康责任感这一指标的评分水平最高,自我护理技能指标的评分水平最低,健康责任感自我概念健康知识自我护理技能。3.患者的性别、居住地、文化程度、职业、月收入、付费方式、PICC置管留置时间、并发症发生情况、健康促进生活方式、社会支持、抑郁都是影响自我护理能力的单因素,具有统计学差异(P0.05)。而年龄、工作状态、主要照护者、疾病类型、置管部位、导管品牌、穿刺点位置、置管次数、穿刺时机、置管用处不会对患者PICC置管期间自我护理能力造成影响,无统计学差异,(P0.05)。通过对11个单因素进行多元线性回归分析发现性别、居住地、职业、月收入、留置时间、健康促进生活方式、社会支持、抑郁都是影响癌症患者PICC置管期间自我护理能力的重要因素。结论与建议患者的性别、居住地、职业、月收入、留置时间、健康促进生活方式、社会支持、抑郁都会对PICC置管期间癌症患者的自我护理能力产生影响。护理人员要对癌症患者社会人口学资料、病情资料、生活方式、社会支持情况及抑郁情绪状况等进行全面分析,根据实际情况予以针对性护理、个性化护理,提升癌症患者PICC置管期间自我护理能力水平。
[Abstract]:It is well known that cancer has become a serious disease that threatens the life and health of the people all over the world. In recent years, the incidence of cancer has been increasing year by year. In the course of treatment, most patients are treated with chemical drugs. Because of the strong irritation and extravasation of chemotherapeutic drugs, it is very easy to appear in the process of application. PICC catheterization is the most commonly used way of administration in clinical practice. The level of self-care ability of patients during catheterization will directly affect the effect of treatment and even directly affect the level of prognosis. Therefore, research on the self-care ability of patients during the catheterization is the most important concern of clinical medical workers. Objective to investigate the related factors affecting the self-care ability of cancer patients during PICC catheterization, provide scientific guidance for clinical nursing and health education, help nurses take pertinent measures, improve the level of self-care ability of the patients, avoid complications during the management, and ensure the smooth progress of the treatment. Step up the effect of clinical treatment. Materials and methods adopt a convenient sampling method, select 395 cases of cancer patients maintained by PICC catheter in a three a hospital from January 2016 to June as the research object. Using the method of field investigation, the questionnaire survey table is issued one by one, and the survey table includes 5 parts: (1) the self-made method is adopted. General data questionnaire survey of patients' gender, age, marital status and other general demographic data; (2) the self-care ability measurement scale (ESCA) was used to investigate the self-care ability of cancer patients during PICC catheterization; (3) the Health Promotion Lifestyle Scale (HPLP- II) was used to investigate the health promoting lifestyle of cancer patients; (4) use the society. The support assessment scale (SSRS) was used to investigate the social support status of cancer patients; (5) the depression degree of the patients was investigated by the self rating Depression Scale (SDS) to understand the psychological state of the patients. The data were statistically analyzed with the SPSS21.0 statistics software, and the rate of use (%) and the mean standard deviation (x + SD) table of the counting unit and measurement unit (x + SD) The difference was statistically significant by P0.05. The results of the 1. patients were between the ages of 20 and 76 years, the average age was (54.12 + 5.68) years and 90.65% of the patients were married. The residential areas were distributed in urban areas, towns, rural areas, cultural level, major caregivers, occupation, monthly income, payment methods, disease and treatment conditions were different in the.2. study. The overall self-care ability score (112.97 + 12.05) score of the 395 patients was in the middle level, of which 42.03% of the patients were at the higher level, 55.19% of the patients were at the middle level and 2.78% at the low level. Among them, the level of health responsibility was the highest, and the score of self nursing skill index was the lowest. Responsibility self-concept health knowledge self-care skills.3. patients' gender, residence, education level, occupation, monthly income, payment method, PICC set up time, complications, health promotion lifestyle, social support, depression are the single factors affecting self-care ability, with statistical difference (P0.05). And age, work State, the main caregivers, the type of disease, the location of the tube, the brand of the catheter, the location of the puncture point, the times of insertion, the timing of the puncture, and the use of the catheterization will not affect the self-care ability of the patients during the PICC catheterization, and there is no statistical difference (P0.05). By the multiple linear regression analysis of 11 single factors, the sex, residence, occupation, and monthly income are found. Entry, retention time, health promotion lifestyle, social support, depression are all important factors affecting the self-care ability of cancer patients during PICC catheterization. Conclusions and suggested patients' gender, residence, occupation, monthly income, retention time, health promotion lifestyle, social support, depression are all self-protection of cancer patients during PICC catheterization. The nursing staff should make a comprehensive analysis of the social demographic data, the condition data, the lifestyle, the social support and the depression of the cancer patients. According to the actual situation, the nursing staff should give specific nursing, individualized nursing and improve the level of self-care ability of cancer patients during PICC management.
【学位授予单位】：山东大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R473.73

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