化疗间歇期PICC带管出院患者健康管理需求及影响因素调查

摘要

Objective To investigate health management needs of the patients with peripherally inserted cen-tral catheter (PICC) in intermittent chemotherapy and to analyze its influencing factors. Methods Cancer chemother-apy patients discharged with PICC were investigated with a self-designed questionnaire about health management needs. Results A total of 240 questionnaires were issued, but only 213 questionnaires were returned. Patients with PICC in intermittent chemotherapy had a strong need for PICC health management knowledge. The top three were catheter maintenance sites, complications of processing instruction, and notes with a pipe out of the hospital. There were respectively 78.9%, 34.3% and 32.9% patients, who hoped hospital adopt health management through regular telephone follow-up, QQ video guide and SMS alerts. 46.9%patients hoped health management platform web pages of hospital network regularly publish the information for the PICC health management knowledge for reading. Univar-iate analysis showed that the difference was statistically significant (P<0.05) in comparison of the scores of health management knowledge needs between different careers, marriage, the degree of culture, medical payment method, in-come, residence, number of catheter, whether to accept health education and patients undergoing health education with different frequency. Multiple factors analysis showed that the degree of culture, frequency of health education and pro-fession were the influence factors of patients' health management knowledge demand. Conclusion Medical staff should consider the patients' individualized, specific, rationalization of health management needs when developing health management plan and implementing health management education for PICC tube discharged patients in inter-mittent chemotherapy, in order to provide patients with a variety of health management service.%目的：了解化疗间歇期PICC带管患者健康管理需求并分析其影响因素，为临床制定健康管理计划提供参考。方法采用自行设计的化疗间歇期PICC患者健康管理需求问卷，采用分层随机抽样法对即将带管出院的患者进行问卷调查。结果共发放问卷240份，回收213份。化疗间歇期带管出院患者对PICC健康管理知识需求强烈，排在前三位的为导管维护地点的确定、并发症处理指导和出院后带管注意事项；分别有78.9%、34.3%和32.9%的患者希望医院采取定期电话随访、QQ视频指导和短信提醒的健康管理方式；46.9%的患者希望医院网络医疗健康管理平台网页定期发布有关PICC健康管理知识的信息以供阅览；单因素分析结果显示：不同职业、婚姻、文化程度、医疗付费方式、收入、居住地、置管次数、是否接受健康宣教和接受健康宣教不同频率的患者健康管理知识需求得分差异均有统计学意义(P<0.05)；采用多元逐步回归对患者管理需求进行多因素分析，结果显示：文化程度、接受健康宣教频率和职业是患者健康管理知识需求的影响因素。结论医护人员在为化疗间歇期PICC带管出院患者制定健康管理计划和实施健康管理宣教时应考虑患者的个体化具体化合理化的健康管理需求，从而为患者提供多样化的健康管理服务。