Application Of Gold’s Achievement Theory In Health Education Of PICC For Tumor Patients

Objectives:To understand the daily knowledge of the catheter management,the ability of catheter self-management,and the quality of life status of peripherally inserted central catheter（PICC）tumor patients in peripherally inserted central catheter（PICC）tumors,and analyze their correlations;explore the theory of gold’s compliance to indwelling PICC The impact of the knowledge and practice level of catheter management,the ability of catheter self-management,and quality of life in patients with cancer can provide a basis for clinical nursing staff to improve PICC health education strategies.Methods:（1）Investigative study:141 cases of cancer patients who were placed with PICC catheters in a tertiary hospital in Inner Mongolia from December 2018 to March 2019 were selected according to the inclusion and exclusion criteria using a convenient sampling method.The PICC daily management know-how questionnaire,Cancer Patients PICC Self-management Scale and Functional Assessment of Cancer Therapy were evaluated to understand the PICC daily management knowledge,trustworthiness and level of PICC self-management ability and quality of life status,and to analyze their correlation.（2）King’s theoretical intervention study:76 cases of cancer patients who met all the inclusion and exclusion criteria with PICC catheters placed in a department of oncology in a tertiary hospital in Inner Mongolia from June 2019 to November 2019 were selected and divided into 2 groups by random number table method,38 cases in each group.The control group was given routine missions.In addition to the routine missions,the experimental group was given a health missionary method based on the Golden Reaching Standards theory.The daily management level of PICC,self-management ability of PICC,quality of life,patients’satisfaction with catheter and the occurrence of PICC related complications were compared between the two groups.Results:（1）Results of current survey:PICC daily management know-how level total score（84.60±7.77）,knowledge score（25.05±2.57）,behavior score（34.38±2.99）,attitude score（25.16±2.55）;PICC self-management ability Total score（108.01±10.7）,daily catheter observation score（21.43±2.61）,maintenance compliance score（15.72±1.62）,catheter management confidence score（14.29±2.28）,abnormal situation processing score（11.95±1.32）,information acquisition Score（9.04±0.79）,tube exercise score（13.43±1.63）,daily activity score with tube（22.16±2.32）;total quality of life score for cancer patients（56.87±7.79）,physical condition score（14.11±1.65）,social/Family status score（15.95±2.3）,emotional status score（13.03±2.07）,functional status score（13.78±2.19）;PICC daily management knowing and trusting level,PICC self-management ability and quality of life of cancer patients were positively correlated(P_All<0.05),and the three are affected by age,education,occupation,monthly income,and medical payment methods.（2）Effect of Nursing Intervention Based on Gold’s Achievement Theory:Comparison of the levels of knowledge,belief,and practice in daily management of PICC in the two groups:the total score of the control group and the scores of knowledge,behavior,and attitude at the three levels after the intervention were（92.66±7.48）and（27.29±2.36）,（37.13±2.98）,（28.24±2.53）;the experimental group was（110.11±8.02）,（35.66±2.77）,（43.97±3.66）,（30.47±2.02）.Comparison of PICC self-management capabilities between the two groups:the total scores of the control group and the scores at the end of the intervention in the seven levels of daily catheter observation,maintenance compliance,catheter management confidence,abnormal situation handling,information acquisition,tube exercise,and tube daily activities（121.18±10.4）,（24.11±3.04）,（17.11±1.37）,（16.55±2.29）,（13.39±1.1）,（9.74±0.72）,（15.92±1.5）,（24.37±2.25）;experiments The groups were（142.32±10.53）,（28.29±1.84）,（21.55±1.35）,（19.47±1.61）,（16.61±1.88）,（11.39±1.22）,（16.05±1.31）,（28.95±1.64）.Comparison of the quality of life scores between the two groups:the total scores of the control group and the physical,social/family,emotional,and functional levels at the end of the intervention were（63.53±7.05）,（15.97±2.21）,and（16.32）±1.42),（15.5±1.54）,（15.74±2.3）.The experimental group was（78.84±8.17）,（21.34±1.94）,（19.29±1.81）,（18.39±2.4）,and（19.82±2.19）.Comparison of satisfaction scores with tube in the two groups:the control group score（30.89±1.69）and the experimental group score（41.13±1.80）,P<0.001.The incidence of PICC complications in the two groups was 5.2%in the experimental group and 23.7%in the control group,and the difference was statistically significant（P<0.05）,The difference was statistically significant.The differences in intervention time and intervention methods between the groups were statistically significant.Conclusion:（1）In this study,the patient’s PICC level of daily management,knowledge,practice,and self-management capabilities of PICC and quality of life needed to be improved.In addition,there was a positive correlation between the level of PICC daily management and the quality of life of cancer patients（P<0.05）,and there was a positive correlation between PICC self-management ability and quality of life of cancer patients（P<0.05）.The scores of the three are affected by age,education,occupation,monthly income,and payment methods for medical expenses.（2）Nursing intervention based on the theory of achieving the standard of gold can effectively improve the level of PICC management,PICC self-management ability,PICC self-management ability,effectively reduce the incidence of PICC complications,improve the quality of life and increase patient satisfaction with tube.