Study On The Current Status And Influencing Factors Of Self-management Of PICC Among Cancer Patients

Objective:1. To develop a instrument for PICC Self-management in cancer patients and to test its psychometrics properties.2. To investigate the current status of PICC self-management and identify its influencing factors in cancer patients.Method:This study was carried out in two phases. In the first phase, the cancer patients PICC self-management questionnaire (CPPSM) was preliminarily developed based on the self-management theoretical framework review and interviews with the cancer patient and PICC clinical nurse. The final version of the CPPSM was established through polit study, item analysis and exploratory factor analysis. Its reliability was proven by Cronbach's alpha and test-retest coefficient. The content validity index (CVI) and exploratory factor analysis (EFA) was conducted to test its validity. During the second phase, a cross-sectional design was adopted. A sample of114cancer patients was selected from3tertiary hospitals outpatients in Shanghai. Participants were asked to complete CPPSM, together with Hospital Anxiety and Depression scale, social support scale, and self-efficacy scale. Demographic and disease-related variables were also collected. Data analyses were performed with SPSS statistical software.Result:1. The results showed that the35-item CPPSM has satisfactory reliability and validity. Regarding the reliability, Cronbach's alpha coefficient was0.904for the overall questionnaire, and re-test was0.933. For the validity, CVI was0.922. Exploratory factor analysis identified seven-factor structure that explained62.26%of the variance.2. The overall CPPSM sore in our study was145.63±15.25. Among the total sample,61.4%of participants got scores>140points and38.6%of patients got>105-140points.3. Multiple stepwise regression analysis indecated that cancer patients PICC self-management was predicted by self-efficacy, social support, and family residence. These predictors can explain the cancer patients PICC self-management score39.8%(R2=0.398) of variation.Conclusion:1. Our results support the35-item CPPSM as a feasible and valid tool for assessing and representing PICC self-management experiences in cancer patients.2. This study showed a moderate overall level of PICC self-management skills in cancer patients, suggesting a further space to improve.3. Our study indicated that self-efficacy,social support and living in a rural area were important factors to predict cancer patients'PICC self-management. Clinical nurses should address interventions to enhance patients' self-efficacy and social support. Our study also suggests that more attention and guidance should be given for those patients from rural areas.