乳腺癌术后化疗患者选择输液港和经外周静脉中心静脉置管的质性研究
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摘要
目的深入了解乳腺癌改良根治术后需要化疗的患者选择输液港和经外周静脉中心静脉置管(PICC)为静脉通路的真实感受。方法对13例乳腺癌改良根治术后需要化疗的患者进行深入访谈,按自愿的原则对输液港和PICC做出选择,资料分析采用Colaizzi的分析法,对获得的资料进行分析、整理,提出主题。结果归纳患者在选择两种输液工具时经历的2个阶段6个主题,第1阶段:选择输液工具前3个主题为内心的矛盾、顾虑、无奈;第2阶段:输液工具置入后3个主题为身体不适感、疑惑感、获益感。结论通过访谈使医护人员更深入地了解不同患者对选择置管的需求不同,总体上选择输液港优于PICC,护士要做好置管前后的宣教和维护管理,提高患者生活质量。
Objective To make a further understanding about the true feelings of patients, who are in need of chemotherapy after modified radical mastectomy, when they make the selection of infusion port or peripherally inserted central catheter(PICC) as the pathway of intravenous infusion. Methods In-depth interview was conducted with 13 patients with breast cancer who were in need of chemotherapy after modified radical mastectomy. On a voluntary basis, the selection of using infusion port or using PICC as the pathway of intravenous infusion was made by own will of each patient. Colaizzi analysis method was used to analyze and arrange the obtained data, and topic matter was proposed. Results The patients went through two stages,covering six topics, when they made selection of two infusion methods. In the first stage, before choosing the infusion method the patient had three psychological worries: inner contradiction, worry and helplessness. In the second stage, after the infusion device was implanted the patient considered other three problems :physical discomfort, feeling of doubt and sense of benefit. Conclusion In-depth interview can help the health care personnel to more deeply understand the need of patients in selecting the infusion method.Generally speaking, the infusion port is superior to PICC. Nurses should complete a good job in education,maintenance and management before and after implantation of infusion device for chemotherapy so as to improve the quality of life of patients.
Objective To make a further understanding about the true feelings of patients, who are in need of chemotherapy after modified radical mastectomy, when they make the selection of infusion port or peripherally inserted central catheter(PICC) as the pathway of intravenous infusion. Methods In-depth interview was conducted with 13 patients with breast cancer who were in need of chemotherapy after modified radical mastectomy. On a voluntary basis, the selection of using infusion port or using PICC as the pathway of intravenous infusion was made by own will of each patient. Colaizzi analysis method was used to analyze and arrange the obtained data, and topic matter was proposed. Results The patients went through two stages,covering six topics, when they made selection of two infusion methods. In the first stage, before choosing the infusion method the patient had three psychological worries: inner contradiction, worry and helplessness. In the second stage, after the infusion device was implanted the patient considered other three problems :physical discomfort, feeling of doubt and sense of benefit. Conclusion In-depth interview can help the health care personnel to more deeply understand the need of patients in selecting the infusion method.Generally speaking, the infusion port is superior to PICC. Nurses should complete a good job in education,maintenance and management before and after implantation of infusion device for chemotherapy so as to improve the quality of life of patients.
引文
[1]徐晓,况文霞.植入式静脉输液港在乳腺癌化疗患者中的应用效果与护理干预分析[J].系统医学,2018,3:190-192.
[2]张红霞,陈利芬,何雄霞,等.应用循证护理规范植入式输液港维护操作的实践[J].中国医学创新,2015,12:72-75.
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[10]莫伟,徐源,阳秀春,等.PTBD患者院外带管生活体验的质性研究[J].介入放射学杂志,2018,27:178-180.
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[12]Johansson E,Hammarkjold F,Lundberg D,et al.Advantages and disadvantages of peripherally inserted central venous catheters(PICC)compared to other central venous lines:a systematic review of the literature[J].Acta Oncol,2013,52:886-892.
[13]李曼,盛一平,谢伟群,等.静脉输液港在我国的应用现状研究[J].浙江医学,2016,38:896-897.
[14]Gurkan S,Seber S,Gur O,et al.Retrospective evaluation of totally implantable venous access port devices:early and late complications[J].J BUON,2015,20:338-345.
[15]侯宁蕊,马元春,姚晚侠.PICC与IVPA在肿瘤化疗患者中的临床应用比较[J].现代肿瘤医学,2017,25:3160-3164.
[16]郭敏,康丽君,陈雪梅,等.上臂植入式输液港与上臂PICC应用效果比较[J].护理实践与研究,2016,13:125-126.
[17]张晓玲,许英娜,汪丹,等.植入式静脉输液港与外周静脉穿刺中心静脉置管在肿瘤化疗中的临床应用[J].中国医学导报,2015,6:136-139.
[18]王佳,郝飞,付诗.微信平台在乳腺癌术后输液港化疗患者延伸护理中的应用[J].护理学杂志,2016,31:91-93.
[19]李海洋,黄金,高竹林.完全植入式静脉输液港应用及护理进展[J].中华护理杂志,2012,47:953-956.
[2]张红霞,陈利芬,何雄霞,等.应用循证护理规范植入式输液港维护操作的实践[J].中国医学创新,2015,12:72-75.
[3]王伟娜,王建新,张彦茹.植入式静脉输液港在乳腺癌化疗患者中的应用与护理对策分析[J].实用临床医药杂志,2017,21:142-144.
[4]许立超,李文涛,陆箴琦.全程管理是中心静脉通路安全保障[J].介入放射学杂志,2017,26:673-675.
[5]王黎明,张帅,李兴,等.植入式静脉输液港相关感染并发症风险因素分析[J].介入放射学杂志,2016,25:949-953.
[6]张惠婷,张晶晶,张丽娟.乳腺癌保乳术中植入输液港的化疗防外渗护理[J].中国实用护理杂志,2017,33:1711-1714.
[7]裘佳佳,管佳琴.年轻乳腺癌患者的性生活与情感体验的质性研究[J].上海护理,2016,16:26-30.
[8]胡琳琳,钟云萍,黄琦,等.两种置管方式在乳腺癌治疗中的效果观察[J].护士进修杂志,2016,31:935-937.
[9]仇晓霞,钟卫菲,邵洁,等.肿瘤患者植入输液港信息认知与体验的质性研究[J].上海护理,2016,16:5-9.
[10]莫伟,徐源,阳秀春,等.PTBD患者院外带管生活体验的质性研究[J].介入放射学杂志,2018,27:178-180.
[11]洪金花.输液港在肿瘤病人中的应用研究[J].护理研究,2013,27:124-125.
[12]Johansson E,Hammarkjold F,Lundberg D,et al.Advantages and disadvantages of peripherally inserted central venous catheters(PICC)compared to other central venous lines:a systematic review of the literature[J].Acta Oncol,2013,52:886-892.
[13]李曼,盛一平,谢伟群,等.静脉输液港在我国的应用现状研究[J].浙江医学,2016,38:896-897.
[14]Gurkan S,Seber S,Gur O,et al.Retrospective evaluation of totally implantable venous access port devices:early and late complications[J].J BUON,2015,20:338-345.
[15]侯宁蕊,马元春,姚晚侠.PICC与IVPA在肿瘤化疗患者中的临床应用比较[J].现代肿瘤医学,2017,25:3160-3164.
[16]郭敏,康丽君,陈雪梅,等.上臂植入式输液港与上臂PICC应用效果比较[J].护理实践与研究,2016,13:125-126.
[17]张晓玲,许英娜,汪丹,等.植入式静脉输液港与外周静脉穿刺中心静脉置管在肿瘤化疗中的临床应用[J].中国医学导报,2015,6:136-139.
[18]王佳,郝飞,付诗.微信平台在乳腺癌术后输液港化疗患者延伸护理中的应用[J].护理学杂志,2016,31:91-93.
[19]李海洋,黄金,高竹林.完全植入式静脉输液港应用及护理进展[J].中华护理杂志,2012,47:953-956.