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白血病患者外周中心静脉置管护理的障碍:一项定性研究。

Hindrances of peripherally inserted central catheter care of leukemia patients: a qualitative study.

机构信息

School of Nursing, Hubei University of Chinese Medicine, Wuhan, China.

Research Support Center, Brigham Young University, Provo, USA.

出版信息

Support Care Cancer. 2021 Aug;29(8):4339-4347. doi: 10.1007/s00520-020-05941-9. Epub 2021 Jan 7.

Abstract

OBJECTIVE

A peripherally inserted central catheter (PICC) needs regular care. However, clinical observations found that some discharged leukemia patients in mainland China had not complied with the requirement of regular care. Our study aims to explore the facilitators and hindrances of regular cares of PICC in leukemia patients with the Colaizzi phenomenon analysis.

METHODS

This qualitative report used the descriptive phenomenological method to collect information and was conducted in accordance with the COREQ checklist. By purposive sampling, 11 leukemia patients with PICC were selected and interviewed in the Department of Hematology of a first-class hospital in Wuhan (central China). The interviews were conducted from March 2016 to May 2017.

RESULTS

Two facilitators for PICC care were extracted through interviews, including fear of nosocomial infection and convenience for treatment. Eleven hindrances were summarized, including high costs, unavailability of local services, worries about affecting family members, a lack of health awareness, inconvenient transportations, fluke minds, physical discomfort, fears of leukemia and chemotherapy, short chemotherapy intervals, damage to appearance, and no insurance coverage of costs.

CONCLUSION

Leukemia patients' compliance with PICC care was hindered by several factors. The improvement of PICC care may need joint efforts of patients, nursing professionals, hospitals' managerial staff, and governments.

摘要

目的

经外周静脉置入中心静脉导管(PICC)需要定期护理。然而,临床观察发现,中国大陆一些出院的白血病患者未遵循定期护理的要求。本研究旨在通过 Colaizzi 现象分析探讨白血病患者 PICC 定期护理的促进因素和阻碍因素。

方法

本定性报告采用描述现象学方法收集信息,并按照 COREQ 清单进行。通过目的抽样,在华中地区一家一流医院的血液科选择了 11 名携带 PICC 的白血病患者进行访谈。访谈于 2016 年 3 月至 2017 年 5 月进行。

结果

通过访谈提取出 PICC 护理的两个促进因素,包括害怕医院感染和治疗方便。总结出 11 个阻碍因素,包括费用高、当地服务不可用、担心影响家庭成员、健康意识不足、交通不便、侥幸心理、身体不适、对白血病和化疗的恐惧、化疗间隔短、外观受损以及费用无保险覆盖。

结论

白血病患者对 PICC 护理的依从性受到多种因素的阻碍。改善 PICC 护理可能需要患者、护理专业人员、医院管理人员和政府的共同努力。

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