系统化护理干预对留置PICC导管的肺癌化疗患者疾病不确定感的影响

系统化护理干预对留置PICC导管的肺癌化疗患者疾病不确定感的影响

陈瑞1, 王晶2, 吴兰华3

(新疆医科大学第一附属医院1肿瘤中心，2小儿外二科，3护理部， 乌鲁木齐830054)

摘要：目的探讨系统化护理干预对经外周静脉植入中心静脉导管(PICC)肺癌化疗患者疾病不确定感及生活质量的的影响。方法将静脉留置PICC导管的肺癌化疗患者80例随机分为对照组(40例)和观察组(40例)。对照组患者接受PICC常规护理和健康教育，观察组在常规护理和健康教育的基础上实施系统化的护理干预。采用疾病不确定感量表(MUIS)和肿瘤患者生活质量量表(QOL)对两组患者进行问卷调查。结果观察组患者疾病不确定感下降幅度高于对照组，患者的生活质量高于对照组，差异均有统计学意义(P<0.05)。结论系统化的护理干预能明显降低静脉留置PICC导管肺癌化疗患者的不确定感，提高生活质量。

关键词：PICC； 护理干预； 疾病不确定感； 生活质量

中图分类号：R473.73文献标识码：A

doi:10.3969/j.issn.1009-5551.2015.04.001

[收稿日期：2014-08-29]

Influence of systemic nursing intervention on disease uncertainty among

lung cancer patients undergoing chemotherapy with indwelling PICC catheter

CHEN Rui1, WANG Jing2, WU Lanhua3

(1TumorCenter，2DepartmentofPadiatricSurgery,3DepartmentofNursing,

TheFirstAffiliatedHospital,XinjiangMedicalUniversity,Umuqi830054,China)

Abstract：ObjectiveTo probe into the effect of systematic nursing intervention on disease uncertainty and quality of life of lung cancer patients undergoing chemotherapy with PICC. Methods80 lung cancer patients undergoing chemotherapy with venous indwelling PICC catheter were randomly divided into the control group and the observation group with 40 patients in each group. The control group received PICC routine care and health education, and the observation group were given additional systematic nursing interventions. The uncertainty in illness scale (MUIS) and cancer patients′ quality of life scale (QOL) questionnaire adapted by professor Sun Yan were used to investigate the 80 lung cancer patients. ResultsAfter the systematic nursing intervention, the disease uncertainty drop of the patients in observation group was higher than in control group, and patient′s quality of life was higher than in control group (P<0.05, all had statistical significance). ConclusionThe systematic nursing intervention can obviously decrease disease uncertainty and improve quality of life of lung cancer patients undergoing chemotherapy with venous indwelling PICC catheter.

Key words: PICC nursing intervention； disease uncertainty； quality of life

疾病不确定感是指缺乏确定与疾病有关事物的能力，影响患者的生理状态、适应能力、康复进程和远期生存率[1]。肿瘤患者的治疗周期长，需要长期输入化疗药物及高浓度的营养物质，经外周静脉植入中心静脉导管(PICC)具有操作简单、留置时间长、可有效减轻反复穿刺给患者带来的痛苦等优点，在肿瘤患者治疗中的应用较为广泛。但由于PICC导管属于一种异物，长期留置于体内，给患者带来诸多的不适应及各种的思想顾虑，易使患者产生焦虑、抑郁等负面情绪，疾病不确定感明显。通过置管前、置管中、置管后及出院时有针对性系统化的护理干预方法，可对患者形成有效的刺激框架[2]，帮助患者了解导管的特性，知道能做什么不能做什么，从而减轻患者的思想顾虑，降低疾病不确定感。……