Study On Efficiency Of Health Education Clinical Path In Increasing Self-care Ability And Preventing Early Complications Related To Peripherally Inserted Central Catheter Among Cancer Patients

Objectives: To determine health behaviors (HP), the self-care agency (ECA) and factors regarding this agency among cancer patients with peripherally inserted central catheter in tertiary hospital in Hefei. To develop and use health education clinical path (HECP) scale in cancer patients with PICC; to explore effectiveness on patients'ECA and HP. To prevent early complications related to PICC among cancer patients.Methods: The intervention and control groups consisted of 51 patients who were given HECP in addition routines and 51 patients who were given routines only, respectively. All patients were followed up in a month. The effects were measured through face to face in the 1st day, 10th day and 1st month after PICC inserted.The instrument used was the exercise of self-care agency scale, the health promotion lifestyle profile and cather related complications'questionnaire.Date were evaluated by SPSS 13.0.Results: (1) The mean scores of ECA and HP among cancer patients with PICC were (89.16±19.75) and (98.21±18.90) respectively, which showed a moderate level. The results of stepwise regression analysis showed some factors affected patients'ECA, such as age, education, anxiety and health behaviors. (2) The results of repeated measures ANOVA showed that each dimension score and total scores of ECA and HP in the intervention group were obviously higher compared to the control group(p<0.05). The results of multivariate ANOVA showed that each dimension score and total scores of ECA and HP in the intervention group differed from those in the control group 10 days and 1 month after the intervention respectively(p<0.05), yet no statistic difference was found before the intervention(p>0.05), which indicating an improving ECA and HP in intervention group. Each dimension score and total scores of ECA and HP varied as time goes by, the intervention method and time interacted. (3) There were 27(26.47%) complications among 102 patients during 30 days, 7 (13.73%) complications in intervention group and 20(39.22%) in control group. The overall complications were 12(11.76%) during 10 days. Complications occurred in 5(9.8%) in intervention group(n=51) compared with 7(13.73%) in control group(n=51) (p>0.05). There were 15(14.71%) complications among 102 patients from 11 to 30 days, 2(3.92%) complications in intervention group and 13(25.49%) in control group. The incidence of catheter related infection(CRI) and overall complications in intervention group were significant lower than those in control group(p<0.01).Conclusions: (1) The mean ECA and HP rate of cancer patients with PICC in general were moderate, it was determined that patients'age, education, anxiety and HP affected ECA. (2) HECP is proved to raise the standand of ECA and HP of cancer patients with PICC, each dimension score and total scores of ECA and HP will increase as time goes by. (3) HECP is proved to prevent early complications related to PICC among cancer patients.