School of Nursing, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
Ministry of Health and Medical Services, Chinese Academy of Medical Sciences and Peking Union Medical College, Peking Union Medical College Hospital, Beijing, China.
Support Care Cancer. 2024 Sep 5;32(10):635. doi: 10.1007/s00520-024-08827-2.
To explore the behavioral intention of breast cancer patients undergoing chemotherapy to prevent PICC-related thrombosis based on the theory of planned behavior (TPB).
This qualitative study employed purposive sampling and conducted semi-structured interviews with 14 breast cancer patients undergoing chemotherapy in the outpatient chemotherapy ward of a tertiary A-level comprehensive hospital in Beijing from July to August 2023. Data were analyzed using Colaizzi's descriptive analysis framework.
Data analysis identified 10 themes that were derived from 4 aspects. Regarding behavioral attitude, three themes were condensed: (1) Considering the benefits of preventive measures, (2) Simple and easy preventive measures, and (3) Underestimating the importance of PICC-related thrombosis prophylaxis. Subjective norms yielded two main themes and five sub-themes: (1) Support from those close to the patient motivates adherence to prophylaxis (support from the patient's family, healthcare professionals, and other patients) and (2) Patients are influenced by personal factors to form an internal driving force (physical symptoms, fear of PICC-related thrombosis). Regarding perceived behavioral control, three main themes and four sub-themes were extracted: (1) Obstacles before actual prevention exercise (prevention information, hard-to-remember information), (2) Forgetfulness is the main obstacle factor, and (3) Wanting to overcome barriers to adhere to regular prevention (confidence to overcome obstacles, hope to get support).
The impediments and facilitators identified in this study may provide a scientific foundation for subsequent targeted non-pharmacological preventive interventions for PICC-related thrombosis based on TPB in breast cancer patients undergoing chemotherapy. Special interventions should be designed for the patients in three areas: the patients themselves, the supporters around the patient, and the healthcare professionals.
基于计划行为理论（TPB）探讨行化疗的乳腺癌患者预防经外周静脉置入中心静脉导管（PICC）相关血栓的行为意愿。
本质性研究采用目的抽样法，于 2023 年 7-8 月，选取北京市某三级甲等综合医院门诊化疗病房 14 例行化疗的乳腺癌患者进行半结构式访谈。采用 Colaizzi 现象学描述分析法对资料进行分析。
共提炼出 10 个主题，来源于 4 个方面。行为态度方面，凝练出 3 个主题：（1）考虑预防措施的获益，（2）预防措施简单易行，（3）低估 PICC 相关血栓预防的重要性。主观规范方面，提炼出 2 个主主题和 5 个亚主题：（1）来自患者亲近的人的支持促进预防措施的实施（来自患者家属、医护人员和其他患者的支持），（2）患者受个人因素影响形成内在驱动力（身体症状、对 PICC 相关血栓的恐惧）。感知行为控制方面，凝练出 3 个主主题和 4 个亚主题：（1）实际预防锻炼前的障碍（预防信息、难记的信息），（2）遗忘是主要障碍因素，（3）想要克服障碍坚持规律预防（有信心克服障碍、希望获得支持）。
本研究确定的阻碍和促进因素可为基于 TPB 为行化疗的乳腺癌患者预防 PICC 相关血栓的后续有针对性的非药物预防干预提供科学依据。应针对患者自身、患者周围的支持者和医护人员 3 个方面设计特殊干预措施。
