The Contruction And Application Study Of Self-management Model In Cancer Patients With PICC During The Period Indwelling

ObjectiveTo investigate and analyze the status quo and influencing factors of self-management and self-efficacy in cancer patients with PICC.We constructed the self-management model on cancer patients with PICC during the period indwelling through literature analysis and revision and certification by expert meeting method,and then evaluate the effect of clinical application.It is reference to provide a basis for the self-management in patients with PICC.Methods(1)A total of 119 cancer patients with PICC were investigated by using the general information questionnaire,the PICC Self-Management Capability Questionnaire(CPPSM)and the General Self-Efficacy Scale(GSES).To understand the status quo of the self-management ability and self-efficacy level in cancer patients with PICC.(2)To investigate and analyze the status quo and influencing factors of self-management and self-efficacy in cancer patients with PICC.We initially constructed the self-management model in cancer patients with PICC during the period indwelling through literature analysis to determine the point of implementation of self-management content,form,and intervention time.The expert meeting method was used to revise and certify the initial selfmanagement model.(3)The cancer patients with PICC treated by intravenous chemotherapy at a tertiary level A hospital in Hengyang City were selected as the subjects.According to random number table,a total of 75 cancer patients with PICC were divided into intervention group(n=38)and control group(n=37).The patients of the intervention group received 4 months of the selfmanagement education of PICC on the basic of regular health education,and the patients of the control group accepted regular health education.The general information,the self-management capability and the level of selfefficacy among cancer patients with PICC were assessed by the general information questionnaire,the PICC Self-Management Capability Questionnaire(CPPSM)and the General Self-Efficacy Scale(GSES).All data were analyzed by IBM SPSS 18.0 software.Descriptive statistics were carried out with Mean±standard deviation and constituent ratio(%).Person correlationcoefficient,one-way analysis of variance,multiple linear regression,chi-square test,Mann-Whitney U test,two-sample t-test,matched t-test and repeated measures ANOVA were used to analyze the of data descriptive survey and self-management intervention.Results(1)The level of self-efficacy was at the upper middle level with a total score of(28.91±6.67),the self-management capability of cancer patients with PICC scored(146.17±13.40),63.9% of which was good.Person correlation coefficient showed that there was a positive correlation between self-efficacy and self-management ability's total score in cancer patients with PICC,and one-way analysis of variance of self-efficacy level of cancer patients was age,educational level,marital status,occupation,economic status and place of residence.The results of one-way analysis of variance of self-management ability in cancer patients with PICC were age,educational level,type of neoplasms,occupation,economic status and place of residence,and multiple linear regression showed that the influencing factors of self-efficacy level of cancer patients were age and economic status,and the influencing factors of PICC self-management ability were educational level,self-efficacy and type of neoplasms.(2)After four months of catheterization,the total self-efficacy score of cancer patients with PICC in the two groups was statistically significant(P<0.05).The repeated measures ANOVA was used to compare the data in the group.The results showed that the self-efficacy scores of PICC patients in the intervention group after one month of catheterization was higher than that before catheterization,and the difference was statistically significant(P<0.05).After four months of catheterization,the score of self-efficacy of PICC patients in intervention group was significantly different from that before catheterization and after one month of catheterization(P<0.05).The scores of self-efficacy of PICC patients in the control group were significantly different from those before catheterization and after one month of catheterization(P<0.05).(3)There was no significant difference in the total score of PICC self-management ability and the scores of all dimensions(except for information acquisition)between the two groups after one month of catheterization(P>0.05).After four months of catheterization,the total scores of PICC self-management ability and the scores of catheter daily observation,catheter management confidence,information acquisition and daily activities with tube were significantly different between the two groups(P<0.05).The results of one month and four months after catheterization in the intervention group showed that the total average score of PICC self-management ability and confidence in catheter management,information access and exercises with catheters were significantly different(P<0.05).(4)After One month of catheterization,the incidence of PICC-related complications was 7.89% in the intervention group and 29.73% in the control group.There was significant difference between the two groups(P<0.05).Conclusions(1)The level of self-efficacy was at the upper middle level.The age and economic status played an important role in the level of self-efficacy.(2)The PICC self-management ability of cancer patients is on the middle level.According to the results,it was suggested that the Self-efficacy,education and Type of neoplasms had impact on PICC self-management capability.(3)In this study,the self-management model of cancer patients during PICC retention.This model can improve the level of self-efficacy and the self-management behavior of PICC patients,and reduce PICC Catheterrelated complications through clinical practice.