【作者】 王丽娜；

【导师】 关红；

【作者基本信息】 大连医科大学 ， 护理学， 2015， 硕士

【摘要】 研究目的：探讨同伴教育在PICC带管患者健康教育中的应用效果。比较实验组和对照组两组患者在PICC自我管理能力、知识掌握程度和并发症发生率方面的差异,探讨同伴教育能否提高患者自我管理能力,提高患者知识掌握程度,降低患者PICC并发症。研究方法：本研究采用实验研究方法,于2014年5月至2014年12月在我院收治入院的并且符合研究纳入标准的60例患者随机分到实验组和对照组两组,对照组行常规健康教育,实验组在常规健康教育基础上加入同伴教育。具体措施：1.根据同伴教育者纳入标准选出4名同伴教育者进行培训,考核通过后进行同伴教育活动。2.患者置管后第一周和第三周安排同伴教育活动,包括培训式同伴教育活动和口口相传式同伴教育活动。3.患者置管后一个月采用PICC自我管理能力量表、PICC知识问卷对两组患者PICC自我管理能力和知识掌握水平进行测量；根据PICC并发症诊断标准统计两组患者并发症发生情况。4.应用SPSS 17.0统计软件进行数据录入与分析,计量资料以均数和标准差描述,计数资料率和构成比(百分比)比较用卡方(χ2)检验,两样本间均数比较用独立样本t检验,P<0.05为差异有统计学意义。研究结果：1.两组患者在年龄、性别、疾病构成、文化程度组成上进行统计学分析均无统计学意义(P>0.05),两组患者具有可比性。2.两组患者自我管理能力得分实验组(157.93±9.864)高于对照组(130.23±14.945),总体自我管理能力差异有统计学意义(P<0.05)。各维度得分统计分析,实验组在维度1“日常导管维护”、维度3“导管管理信心”、维度5“信息获取”、维度6“带管运动”和维度7“带管日常生活”这5个维度得分高于对照组,差异有统计学意义(P<0.05)。维度2“维护依从性”和维度4“异常情况处理”两个维度实验组和对照组得分差异无统计学意义(P>0.05)。3.两组患者知识掌握问卷调查结果经卡方检验得出有8项条目,分别是1、10、11、12、20、21、22、25差异有统计学意义(P<0.05),实验组知识掌握情况优于对照组。4.两组患者导管相关并发症发生例数实验组2例(6.67%)低于对照组8例(26.67%),两组差异有统计学意义(P<0.05)。研究结论：1.同伴教育有助于提高PICC带管患者自我管理能力。2.同伴教育有助于提高PICC带管患者知识掌握程度。3.同伴教育能降低患者PICC并发症。4.同伴教育模式值得于PICC带管患者健康教育中推广应用。更多还原

【Abstract】 Objective:The purpose of this study was to test the effectiveness of a peer education applied to patients with peripherally inserted central catheter. To compare the difference of two different groups(the control group and the experimental group) in p self-management ability of PICC patients,education and the incidence of complications.To study if Peer Education can improve PICC patients’self-management ability,assess more knowledge and reduce the incidence of complications.Methods:The patients(n=30) in the experimental group received peer education and regular health education, while the patients(n=30) in control group received routine nursing care.1. Four patients met inclusion criteria are accept training.When they pass the exam,they can carry out peer education activity.2. The activity carry out in the first and third week after the patient Inserting Central Catheter.patients who participate in peer education activity,clinical nurse specialist and researchers make sure two content of activity.And the 4 patients to teach the health education.3. To evaluate the self-management ability of PICC patients,education of two groups.According to the diagnostic criteria,the incidence of complications can analyze.4. questionnaire survey’s analysis by using SPSS17.0 statistical package. The rates of complications of the two groups were also recorded. Patients of the test group and the control group were given questionnaire inventories of knowledge questionnaire and PICC self-management ability questionnaire.Results:1. There are no significant differences in the demographic data characteristics about age, sex, education level and course of the disease between the the experimental group and control group (P>0.05)2. The patients in the experimental group are well-behaved than those in the control group in the aspect of the self-management ability. The total scores in experimental group(157.93±9.864)are higher than the control group(130.23±14.945), there are significant difference between the two groups(P<0.05).There are significant differences in the dimension of daily catheter maintenance, catheter management confidence, access to information, with catheter movement and with catheter in daily life between the two groups. There are no significant differences(P>0.05) in the dimension of maintainability compliance and exception handling.3. After peer education intervention for one month, patients of the experimental group and the control group were given questionnaire inventories of knowledge questionnaire are statistically significant of the items in 1,10,11,12,20,21,22,25.4. Patients of the test group and the control group on complication rates (6.67%, 26.67%) are statistically significantConclusions:1. Peer education can improve patients’ self-management ability.2. Peer education could improve patients’knowledge level.3. Peer education could reduce the complication rates of patients with peripherally inserted central catheter.4. Peer education is suitable to application of the patients with peripherally inserted central catheter.更多还原