首页|医护一体化风险管理模式预防乳腺癌化疗患者PICC导管相关性感染的效果

医护一体化风险管理模式预防乳腺癌化疗患者PICC导管相关性感染的效果

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目的 探讨医护一体化风险管理模式对乳腺癌患者化疗期间导管相关性感染的预防效果及自我管理、心理应激的影响。方法 选取2021年1月一 2022年12月东南大学医学院附属南京同仁医院收治的乳腺癌患者88例为研究对象，以随机数字表法分为对照组44例和试验组44例，分别给予经外周静脉置入中心静脉导管(PICC)常规管理和医护一体化风险管理模式，比较两组患者出院时导管维护依从性、满意度，自我管理能力、心理应激、应对方式及导管相关性感染发生情况。结果 出院时，试验组导管维护总依从率及总满意率分别为95。45％、93。18％，高于对照组的77。27％、77。27％(P＜0。05);试验组信息获取、维护依从性管理、运动管理、日常生活管理、日常导管观察、导管管理信心、异常情况处理及面对评分均高于对照组(P＜0。05);试验组心理应激及应对方式均优于对照组(P＜0。05);管理期间，试验组导管相关性感染总发生率为9。09％，低于对照组的27。27％(P＜0。05)。结论 医护一体化风险管理模式可提高乳腺癌经PICC化疗患者导管维护依从性，改善患者自我管理能力、心理应激及应对方式，进而可提高患者满意度，并可预防导管相关性感染的发生，提高安全性。
Effect of integrated medical and nursing risk management model on prevention of PICC-related infection in breast cancer patients during chemotherapy
OBJECTIVE To observe the effect of integrated medical and nursing risk management model on preven-tion of peripherally inserted central venous catheter(PICC)-related infection in the breast cancer patients during chemotherapy and analyze the impact on self-management and psychological stress.METHODS Totally 88 patients with breast cancer who were treated in Nanjing Tongren Hospital Affiliated to Southeast University School of Medicine from Jan 2021 to Dec 2022 were recruited as the research subjects and were randomly divided into the control group with 44 cases and the experimental group with 44 cases.The control group was treated with conven-tional management of PICC,and the experimental group was treated with the integrated medical and nursing risk management model.The catheter maintenance compliance,satisfaction,self-management capacity,psychological stress,coping style and incidence of PICC-related infection were observed and compared between the two groups of patients at the discharge from hospitals.RESULTS The catheter maintenance compliance rate of the experimen-tal group was 77.27％at the discharge from the hospital,higher than 77.27％of the control group;the total sat-isfaction rate of the experimental group was 93.18％,higher than 77.27％of the control group 77.27％(P＜0.05).The scores of information acquisition,maintenance compliance management,sporting management,daily life management,daily observation of catheter,confidence for catheter management,dealing with and facing to abnormal cases were higher in the experimental group than in the control group(P＜0.05).The psychological stress and coping style of the experimental group were superior to those of the control group(P＜0.05).The to-tal incidence of PICC-related infection of the experimental group was 9.09％during the management,lower than 27.27％of the control group(P＜0.05).CONCLUSION The integrated medical and nursing risk management model may raise the catheter maintenance compliance of the breast cancer patients,improve the self-management capacity,psychological stress and coping style,raise the patients'satisfaction,prevent the PICC-related infection and boost the safety.

Breast cancerPeripherally inserted central venous catheterChemotherapyCatheter-related infec-tionIntegrated medical and nursingRisk managementSelf-managementPsychological stress

王媛媛、李丽、解修园、陈雁群、周亚琴

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东南大学医学院附属南京同仁医院肿瘤内科,江苏南京 211100

南京医科大学附属无锡人民医院静脉输液门诊,江苏无锡 214000

江苏省人民医院(南京医科大学第一附属医院)甲乳外科,江苏南京 210029

东南大学医学院附属南京同仁医院老年科,江苏南京 211100

东南大学医学院附属南京同仁医院护理部,江苏南京 211100

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乳腺癌 经外周静脉置入中心静脉导管 化疗 导管相关性感染 医护一体化 风险管理 自我管理 心理应激

无锡市卫生健康委科研项目

Q202056

2024

10.11816/cn.ni.2024-230776

中华医院感染学杂志
中华预防医学会 中国人民解放军总医院

中华医院感染学杂志

CSTPCD北大核心
影响因子：1.885
ISSN：1005-4529
年,卷(期)：2024.34(2)
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