Application Of Health Education Based On HAPA Model In Patients With Hematologic Malignancies PICC Tube

Objective:To construct a health education program for catheter management based on the HAPA model;and to explore the application effect of this health education program on the stage change of catheter management behavior,catheter self-management ability,self-efficacy,catheterization satisfaction and related complications in patients with malignant blood disease PICC catheterization,to provide some theoretical guidance and reference for improving the health education effect of patients with clinical malignant blood diseases PICC tube.Method:Through the literature review method and semi-structured interview method,the health education program of catheter management based on HAPA model was initially formulated,and the feasibility of the health education program was demonstrated by the expert group meeting method and pre-experiment,and the health education program of catheter management based on the HAPA model was determined.Convenience sampling method was used to select patients with malignant hematological diseases who were admitted to the department of hematology from March to October 2021 in a tertiary first-class hospital in Gansu Province and who met the admission and discharge criteria for primary intubation of PICC.According to the order of admission,the patients were divided into an intervention group and a control group,with 51 cases in each group,for a total of 102 cases.The control group was given routine health education;the intervention group was given health education based on the HAPA model on the basis of routine health education.Before the intervention,at the time of discharge,4 weeks,8 weeks and 12 weeks after the inter-vention,the changes of catheter management behavior,the scores of the PICC Self-Management Ability Scale(CPPSM)and the General Self-Efficacy Scale(GSES)were compared between the two groups.At 12 weeks of intervention,the PICC catheter satisfaction score and the incidence of catheter-related complications were compared between the two groups,and the data were analyzed using SPSS 25.0.Result:1.The health education program of catheter management based on HAPA model was demonstrated by the expert group meeting method and pre-experiment,and the final health education program was determined after modification according to expert opinion and pre-experiment.According to the characteristics of patients in different behavioral stages,the program uses strategies such as collective education,individualized guidance,and motivational interviews,and provides corresponding menu-based interventions to promote individual behavioral changes.2.A total of 102 patients with malignant hematological diseases with PICC tubes were included in this study,with 51 cases in the intervention group and 51 in the control group.After 12 weeks of intervention,6 cases in the intervention group dropped out,45 cases remained,3 cases in the control group were lost to follow-up,and the remaining 45 cases were lost.Of the 48 patients,93 patients with HM tubes were eventually included and completed the intervention.3.Baseline data comparison: Before intervention,there were no statistical differences in general sociodemographic data,catheter placement information,changes in catheter management behavior stages,CPPSM scores,and GSES scores between the two groups(P>0.05),which were comparable.4.Comparison of the changes in the behavioral stages of catheters between the two groups: the changes in the behavioral stages of the intervention group were better than those of the control group at the 4th,8th,and 12 th weeks of intervention(P<0.05),and the degree of the forward span of the behavioral stage was greater than that of the control group(P<0.05).5.Comparison of CPPSM scores between the two groups: at the time of discharge,4 weeks,8 weeks,and 12 weeks of intervention,the CPPSM scores of the intervention group and the control group and their dimensions(catheter daily observation,catheter maintenance compliance,catheter management confidence),catheter abnormality,catheter information acquisition,exercise with catheter,daily activities with catheter)scores all improved,but the change trend of CPPSM score in the intervention group was better than that in the control group,with a statistically significant difference(P<0.05).6.Comparison of GSES scores between the two groups: when the patients were discharged from the hospital,at 4 weeks,8 weeks,and 12 weeks of intervention,the self-efficacy levels of the two groups were improved,but the change trend of the GSES scores in the intervention group was better than that in the control group.Statistical difference(P<0.05).7.Comparison of the incidence of PICC complications between the two groups:the incidence of catheter-related complications in the intervention group was lower than that in the control group,and there was a statistical difference(P<0.05).8.Comparison of the satisfaction scores of the two groups of patients with the tube: the satisfaction score of the patients in the intervention group was higher than that of the control group,and there was a statistical difference(P<0.05).Conclusion:1.The catheter management health education program based on the HAPA model constructed in this study is scientific and feasible.2.Health education based on HAPA model can promote the development of catheter management behavior in patients with malignant hematological diseases with PICC catheter.3.Health education based on HAPA model can improve the catheter self-management ability of patients with malignant hematological diseases with PICC catheter.4.Health education based on HAPA model can improve the self-efficacy level of patients with malignant hematological diseases with PICC tube.5.Health education based on the HAPA model can reduce the incidence of catheter complications in patients with malignant hematological diseases with PICC catheters.6.Health education based on HAPA model can improve the satisfaction of patients with malignant hematological diseases with PICC tubes.