| ObjectiveBased on a comprehensive search of domestic and foreign literature on health education for patients with PICC catheterization,the limitations of health education after PICC implantation in clinical nursing work were systematically summarized and analyzed,and a precise health education program with the improvement of patients’daily life behavior habits as the core was constructed.Clinical empirical study was conducted to explore the effect of this program on the incidence of PICC-related complications,the knowledge and practice level of daily catheter management during catheterization,self-efficacy level and nursing satisfaction,in order to further enrich the connotation and methods of health education for patients with PICC catheterization,and improve the precision and effectiveness of health education.To provide reference for effective implementation of health education for patients with PICC catheterization and improvement of patients’quality of life and medical experience during catheterization.Methods1.Delphi method(Expert letter consultation method):According to the expert selection criteria and the purpose of this study,18 experts were included to conduct two rounds of expert letter consultation on the initially constructed Precision Health Education Program on patients with PICC,so as to ensure the reliability and scientificity of the research results.Excel 2019 and SPSS25.0 were used for data entry and analysis.2.Clinical empirical research:The convenience sampling method was used to strictly implement the inclusion,exclusion and exclusion criteria.140 tumor chemotherapy patients who received PICC implantation for the first time in the PICC outpatient department of a Class A hospital in Jinan,Shandong Province from July 2022 to January 2023 were selected as the study subjects.The subjects were randomly divided into control group and experimental group according to the random number table method.There were 70 patients in each group.The control group received conventional health education program after PICC implantation,and the experimental group received precision health education program based on the control group.Baseline data of the two groups were collected before intervention,and the incidence of catheter-related complications,knowledge and practice level of PICC daily management,self-efficacy level and nursing satisfaction of the two groups were analyzed and compared after 6 cycles of chemotherapy.SPSS25.0 was used for data analysis and processing.Results1.Delphi method Results:After two rounds of expert letter consultation,the"Precision Health Education Program on Patients with PICC"was finally formed,which included 7 first-level indicators,14 second-level indicators,and 33 third-level indicators,including large movement of the catheterized arm,excessive force of the catheterized arm,slowed blood circulation of the catheterized arm,contact between the catheter and water,clothing,sedentary behavior,and diet.The two rounds of correspondence consultation experts were the same,the authority coefficient of the letter consultation experts ranged from 0.8 to 1.0,the authority coefficient of the expert group was 0.97,the recovery rate of the two rounds of correspondence consultation questionnaires were 100%,the rate of experts who put forward opinions or suggestions were 55.6%and 16.7%,respectively,and the average importance score was between 4.33 and 5.00,both>4.0.The full score rate ranged from 40%to 100%,all>20%,coefficient of variation ranged from 0.16 to 0.00,all<0.25,Kendall harmony coefficient of the second round of correspondence was 0.12 to0.26(X~2=28.46 to 112.8,P<0.05),the results of the second round of correspondence were higher than those of the first round.2.Empirical research results:(1)Baseline data comparison results:Before intervention,there was no statistical significance in general demographic data,PICC daily management knowledge,practice level and self-efficacy level between the two groups(P>0.05),and baseline data were comparable.(2)Incidence of PICC-related complications:A total of 21 patients in the two groups developed catheter-related complications after the intervention,including 16 patients in the control group,accounting for 22.9%,and 5 patients in the experimental group,accounting for 7.1%.The results of intergroup comparison of the total incidence of complications between the two groups showed statistical significance(P<0.05),but there was no statistical significance in the individual incidence of various complications(P>0.05).(3)Results of PICC daily management knowledge and practice:After intervention,the scores and total scores of PICC daily management knowledge and practice in control group and experimental group were improved compared with before intervention,and the difference was statistically significant(P<0.05).Further comparison between groups showed that the scores and total scores of PICC daily management knowledge and practice in experimental group were significantly higher than those in control group,with statistical significance(P<0.05).(4)Results of self-efficacy level:After the intervention,the scores of all dimensions and total scores of the self-efficacy level of the experimental group were increased compared with that before the intervention,and the difference was statistically significant(P<0.05).In control group,the score of positive attitude dimension and total score of self-efficacy level were increased compared with before intervention,the difference was statistically significant(P<0.05),while the score of self-decompression and self-decision dimension was not improved compared with before intervention,the difference was not statistically significant(P>0.05).Further comparison between groups showed that the scores and total scores of all dimensions of self-efficacy in experimental group were significantly higher than those in control group,with statistical significance(P<0.05).(5)Results of satisfaction with health education:After the intervention,the total score of satisfaction of patients in the control group and the experimental group was 54.63±1.44 and 71.41±3.14,respectively,with statistical significance(P<0.05),and the scores of satisfaction of patients in the experimental group were significantly better than those in the control group in the dimensions of professional knowledge,professional skills and professional attitude,with statistical significance(P<0.05).Conclusions1.Guided by the concept of"precise nursing",based on literature research and expert consensus,and through the research method of expert correspondence,this study constructed the"Precise Health Education Program on patients with PICC"covering 7 first-level indicators,14 second-level indicators and 33 third-level indicators,so as to improve the effectiveness of health education knowledge transmission and make the content of health education precise and concrete.It is helpful for patients/family members to understand,master and implement the content of health education.2.In this study,the Precise Health Education Program on patients with PICC was applied to clinical practice,which effectively reduced the incidence of catheter-related complications during catheterization,improved the knowledge,practice and self-efficacy level of patients’daily catheter management during catheterization,further improved patient nursing satisfaction and clinical nursing service quality,and was conducive to the professional development of nursing discipline.It is worthy of further clinical application. |
