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针对外周静脉穿刺中心静脉置管癌症患者的居家护理教育：一项系统评价与荟萃分析。

Home care-based education for cancer patients with peripherally inserted central catheters: a systematic review and meta-analysis.

作者信息

Huang Xiaotian, Shi Kefu, Zain Norhasmah Mohd, Yusuf Azlina

机构信息

Nursing Programme, School of Health Sciences, Health Campus, Universiti Sains Malaysia, Kota Bharu, Kelantan, Malaysia.

Nursing Department, Shenzhen Qianhai Taikang Hospital, No. 3099 Menghai Avenue, Nanshan District, Shenzhen, Guangdong Province, People's Republic of China, 518000.

出版信息

Support Care Cancer. 2025 Jun 30;33(7):639. doi: 10.1007/s00520-025-09667-4.

DOI:10.1007/s00520-025-09667-4
PMID:40586980
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12209036/
Abstract

PURPOSE

This study aimed to systematically review and meta-analyze the literature to identify the components of home care-based education for cancer patients with peripherally inserted central catheters (PICCs) and evaluate its effects compared to traditional health education.

METHODS

A comprehensive search was conducted in Chinese and English databases until November 2024. The searching strategy, screening, quality assessment data extraction, and meta-analysis were performed scientifically.

RESULTS

A total of 19 studies were included. Three core components of home care-based education were identified: catheter care, self-care, and resource support. Meta-analysis revealed significant improvements in eight outcomes for intervention groups: improved self-management abilities (MD = 17.77, 95% CI, Z = 9.2, P < 0.00001); reduced anxiety (MD = -8.53, 95% CI, Z = 4.56, P < 0.00001) and depression (MD = -11, 95% CI, Z = 3.97, P < 0.0001); lower complication incidence (OR = 0.17, 95% CI, Z = 11.79, P < 0.00001); higher compliance rate (OR = 0.16, 95% CI, Z = 4.98, P < 0.00001); improved self-efficacy (MD = 9.45, 95% CI, Z = 2.41, P = 0.02); increased satisfaction with nursing care (OR = 6.01, 95% CI, Z = 6.19, P < 0.00001); better quality of life (MD = 9.38, 95% CI, Z = 4.39, P < 0.0001).

CONCLUSIONS

Home care-based education improves self-management, psychological well-being, treatment outcomes, and satisfaction in cancer patients with PICCs. The identified components provide a practical framework for clinical implementation, though cultural adaptability and protocol standardization require further study. Trial registration CRD42024606607.

摘要

目的

本研究旨在系统回顾和荟萃分析文献，以确定外周静脉穿刺中心静脉置管（PICC）癌症患者居家护理教育的组成部分，并评估其与传统健康教育相比的效果。

方法

截至2024年11月，在中国和英文数据库中进行了全面检索。科学地进行检索策略制定、筛选、质量评估、数据提取和荟萃分析。

结果

共纳入19项研究。确定了居家护理教育的三个核心组成部分：导管护理、自我护理和资源支持。荟萃分析显示干预组在八个结局方面有显著改善：自我管理能力提高（MD = 17.77，95%CI，Z = 9.2，P < 0.00001）；焦虑（MD = -8.53，95%CI，Z = 4.56，P < 0.00001）和抑郁（MD = -11，95%CI，Z = 3.97，P < 0.0001）减轻；并发症发生率降低（OR = 0.17，95%CI，Z = 11.79，P < 0.00001）；依从率提高（OR = 0.16，95%CI，Z = 4.98，P < 0.00001）；自我效能提高（MD = 9.45，95%CI，Z = 2.41，P = 0.02）；对护理的满意度增加（OR = 6.01，95%CI，Z = 6.19，P < 0.00001）；生活质量改善（MD = 9.38，95%CI，Z = 4.39，P < 0.0001）。

结论

居家护理教育可改善PICC癌症患者的自我管理、心理健康、治疗结局和满意度。所确定的组成部分为临床实施提供了实用框架，不过文化适应性和方案标准化仍需进一步研究。试验注册号CRD42024606607。

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本文引用的文献

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Effects of self-management education integrated nursing on cancer patients with PICC placement: a systematic review and meta-analysis.自我管理教育综合护理对PICC置管癌症患者的影响：一项系统评价与Meta分析
J Res Nurs. 2024 Oct 11:17449871241268513. doi: 10.1177/17449871241268513.
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Commentary: Effects of self-management education integrated nursing on cancer patients with PICC placement: a systematic review and meta-analysis.述评：自我管理教育综合护理对行PICC置管的癌症患者的影响：一项系统评价与Meta分析
J Res Nurs. 2024 Oct 11:17449871241273898. doi: 10.1177/17449871241273898.
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The impact of internet multidisciplinary continuity care on the living quality of home-based patients with malignant tumors undergoing PICC catheterization.
互联网多学科延续性护理对居家PICC置管恶性肿瘤患者生活质量的影响
Am J Transl Res. 2024 Aug 15;16(8):4001-4010. doi: 10.62347/GPVQ2402. eCollection 2024.
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Supportive care needs of adults living with a peripherally inserted central catheter (PICC) at home: a qualitative content analysis.居家携带外周静脉穿刺中心静脉导管（PICC）的成年人的支持性护理需求：一项质性内容分析
BMC Nurs. 2024 Jan 2;23(1):4. doi: 10.1186/s12912-023-01614-0.
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Mental health needs in cancer - a call for change.癌症患者的心理健康需求——呼吁变革。
Future Healthc J. 2023 Jul;10(2):112-116. doi: 10.7861/fhj.2023-0059.
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Effectiveness of the Hospital-Community-Family Nursing Model in Breast Cancer Patients Discharged with PICC Lines.医院-社区-家庭护理模式对带管出院乳腺癌患者的效果。
J Community Health Nurs. 2023 Oct 2;40(4):255-265. doi: 10.1080/07370016.2023.2205405. Epub 2023 May 1.
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Digital health and telehealth in cancer care: a scoping review of reviews.数字健康和远程医疗在癌症护理中的应用：系统评价综述。
Lancet Digit Health. 2023 May;5(5):e316-e327. doi: 10.1016/S2589-7500(23)00049-3.
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[Design, implementation and evaluation of an educational approach for patients with PICC line and midline].[经外周静脉穿刺中心静脉置管（PICC）和中线导管患者教育方法的设计、实施与评估]
Ann Pharm Fr. 2023 Sep;81(5):882-892. doi: 10.1016/j.pharma.2023.02.001. Epub 2023 Feb 14.
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Lower risk of bloodstream infections for peripherally inserted central catheters compared to central venous catheters in critically ill patients.与中心静脉导管相比，外周静脉置入中心静脉导管在危重症患者中降低血流感染风险。
Antimicrob Resist Infect Control. 2022 Nov 9;11(1):137. doi: 10.1186/s13756-022-01180-1.
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Cancer-related psychosocial challenges.与癌症相关的社会心理挑战。
Gen Psychiatr. 2022 Oct 6;35(5):e100871. doi: 10.1136/gpsych-2022-100871. eCollection 2022.