Application Of LEARNS Health Education Model In PICC Cancer Chemotherapy Patients

ObjectivesTo explore the intervention effect of LEARNS health education model on PICC self-management,self-efficacy,catheter-related complications,and PICC health education satisfaction in patients with PICC cancer chemotherapy,and provide a reference basis for health education of PICC cancer chemotherapy patients.MethodsThis study consists of two parts: the construction of evidence-based health education content for PICC chemotherapy patients and the quasi-experimental study.1.Evidence-based health education content construction: Comprehensive search of PICC health education content related guidelines,expert consensus,evidence summary,systematic review,meta-analysis and original literature of cancer chemotherapy patients,quality evaluation,evidence extraction,collation and summary and expert demonstration rating of literature that meets the inclusion criteria to form PICC health education content for cancer chemotherapy patients.The health education content received by the subjects in the second part of this study was based on this standard.2.Experimental research: The convenient sampling method was used to select the cancer chemotherapy patients who were first placed in PICC in April2022～December 2022 in a tertiary hospital in Gansu Province as the research objects,and the experimental group and control group were determined according to the time order of catheterization,the experimental group(n=40 cases)implemented education according to the LEARNS health education model,and the control group(n=40 cases)carried out education according to the conventional education model.Before intervention: collection of general data,general self-efficacy scale scores;When one chemotherapy cycle was intervened,the PICC self-management ability scale score,general self-efficacy scale score,and catheter-related complications were collected.PICC self-management scale scores,general self-efficacy scale scores,catheterrelated complications,and PICC health education satisfaction questionnaire scores were collected for four cycles of chemotherapy.Using SPSS26.0 software,statistical methods such as chi-square test and independent sample t-test were used to analyze the application effect of LEARNS health education model in PICC tumor chemotherapy patients.Results1.Construction of evidence-based health education content: 14 relevant literatures were finally included,including 6 guidelines,4 expert consensus,2evidence summaries,and 2 randomized controlled studies,and 31 PICC health education content items for tumor chemotherapy patients were formed in 8dimensions: health education before catheterization,health education during catheterization,precautions within 24 hours after catheterization,observation and treatment of PICC-related complications,catheter maintenance,daily life guidance,functional exercise,and precautions for catheter removal.2.Class experimental research:(1)A total of 80 patients with PICC chemotherapy were included in this study,40 cases in the experimental group and 40 cases in the control group,and after 4cycles of chemotherapy intervention,6 cases were shed in the experimental group and5 cases were dropped in the control group,and a total of 69 patients with PICC chemotherapy were finally included and completed the intervention.(2)Comparison of baseline data: Before the intervention,there was no significant difference in the scores of general demographic data,disease and PICC related data,and general self-efficacy scale between the two groups(P>0.05),and the baseline data were balanced and comparable.(3)Comparison of PICC Self-Management Scale scores: The total scores and differences in each dimension of the PICC Self-Management Scale were statistically significant between the two groups after one chemotherapy cycle(P<0.05),and the total scores and differences in each dimension of the PICC Self-Management Ability Scale were statistically significant in addition to the catheter maintenance compliance dimension for four chemotherapy cycles(P<0.05).After the intervention from 1 cycle of chemotherapy to 4 cycles of chemotherapy,except for the dimension of daily life management,the total score of the scale and the scores of other dimensions were improved,and the other scores were statistically significant except for the tube exercise dimension(P<0.05).(4)Comparison of general self-efficacy scale scores: Before the intervention,there was no significant difference between the two groups(P>0.05).The results of repeated measures of ANOVA showed that there was an interaction effect between groups and time between the general self-efficacy scale scores of PICC cancer chemotherapy patients in the experimental group and the control group(F interaction=22.939,P<0.05),and the main effect between groups(F groups=54.522,P<0.05),and the difference in scale scores at different time points was statistically significant(F time=352.783,P<0.05).With the implementation of the intervention,the scores of the general self-efficacy scale of both the experimental group and the control group tended to increase,but the experimental group scored higher than the control group at the same time point.(5)Comparison of catheter-related complications: After 4 cycles of chemotherapy intervention,the incidence of PICC catheter-related complications in the experimental group was lower than that in the control group,and the difference between the groups was statistically significant(P<0.05).(6)Comparison of PICC health education satisfaction: After 4 cycles of intervention,the PICC health education satisfaction of the experimental group was better than that of the control group,and the difference between the groups was statistically significant(P<0.05).ConclusionsThe LEARNS health education model can promote the catheter self-management ability of PICC cancer chemotherapy patients,improve general self-efficacy,reduce the incidence of PICC catheter-related complications,and improve patients’ satisfaction with PICC health education.Therefore,this health education model is worth promoting and applying in the health education of PICC cancer chemotherapy patients.