Sharp Rebecca, Grech Carol, Fielder Andrea, Mikocka-Walus Antonina, Cummings Melita, Esterman Adrian
School of Nursing and Midwifery, University of South Australia, Adelaide, SA, Australia.
Contemp Nurse. 2014;48(1):26-35. doi: 10.1080/10376178.2014.11081923. Epub 2014 Jul 19.
To investigate the patient experience of Peripherally Inserted Central Catheter (PICC) insertion, the significance of arm choice and the impact of the device on activities of daily living.
Arm choice for PICC insertion is often determined by PICC nurses with little input from consumers. There are few studies that have investigated the patient experience of living with a PICC and none that have examined the impact of arm choice from the consumer's perspective.
Participants were recruited in a hospital whilst they waited for PICC insertion. A purposeful sampling approach was used to select participants based on diagnosis types. Semi-structured telephone interviews were conducted November 2012-August 2013. Transcripts of the interviews were analysed using thematic analysis.
Ten participants were interviewed. Four themes were identified: (i) apprehension/adaptation/acceptance, (ii) impact of treatment, (iii) asking questions (trusting doctors) and (iv) freedom. Although initially apprehensive, participants adapted to the PICC and came to accept that the device allowed convenient access for treatment. This allowed them the freedom to receive treatment at home. The use of the dominant or non-dominant arm for PICC insertion had marginal impact on activities of daily living for participants. Auxiliary factors such as the infusion pump had a significant impact for those who received outpatient treatment. For those participants who did not understand the procedure, many did not seek clarification and trusted medical and nursing staff to make decisions for them.
Nurses should involve consumers in clinical decision-making and provide individualised information and support that facilitates adaptation for patients living with a PICC.
探讨经外周静脉穿刺中心静脉置管（PICC）患者的置管体验、手臂选择的重要性以及该装置对日常生活活动的影响。
PICC置管的手臂选择通常由PICC护士决定，很少有患者参与意见。很少有研究调查过PICC患者的生活体验，也没有从患者角度研究过手臂选择的影响。
在医院招募等待PICC置管的患者。采用目的抽样法根据诊断类型选择参与者。于2012年11月至2013年8月进行半结构化电话访谈。使用主题分析法对访谈记录进行分析。
对10名参与者进行了访谈。确定了四个主题：（i）担忧/适应/接受，（ii）治疗的影响，（iii）提问（信任医生）和（iv）自由。尽管最初感到担忧，但参与者逐渐适应了PICC，并开始接受该装置便于治疗的优点。这使他们能够在家中接受治疗。PICC置管选择优势手臂或非优势手臂对参与者的日常生活活动影响不大。输液泵等辅助因素对接受门诊治疗的患者有重大影响。对于那些不了解操作过程的参与者，许多人没有寻求解释，而是信任医护人员为他们做决定。
护士应让患者参与临床决策，并提供个性化信息和支持，以帮助PICC患者适应。
