标题：双链互动管理对宫颈癌PICC置管化疗患者自我效能、自我管理行为及并发症的影响

      作者：刘珊珊 1，吕爱莉 2，任文青 2    1.西北大学附属医院(西安市第三医院)妇产科，陕西 西安 710018；2.西安市人民医院(西安市第四医院)心脏泛血管病院，陕西 西安 710011

      卷次： 2022年33卷14期

      【摘要】 目的 探讨双链互动管理对宫颈癌经外周静脉穿刺中心静脉置管术(PICC)置管化疗患者自我效能、自我管理行为及并发症的影响。方法 选取2019年1月至2021年1月西北大学附属医院收治的66例宫颈癌患者为研究对象，采用1:1简单随机数表法将入组患者分为观察组和对照组，每组33例。对照组患者予以肿瘤科宫颈癌常规护理，观察组患者在对照组基础上联合应用双链互动管理，均进行持续3个月的护理干预，均于第3个月门诊复诊时以问卷调查的形式进行相关指标的监测和评估。分别于护理前、护理3个月后采用焦虑自评量表(SAS)和抑郁自评量表(SDS)评价患者的心理状态，自我效能量表(GSES)评价患者的自我效能水平，肿瘤科自制量表评价患者的自我管理行为水平，自我护理能力测定量表(ESCA)评价患者的自护能力；出院后6个月比较两组患者的并发症发生情况。结果 护理3个月后，观察组患者的SAS评分和SDS评分分别为(24.66±6.21)分、(25.91±6.25)分，明显低于对照组的(34.23±6.42)分、(35.24±5.14)分，差异均有统计学意义(P<0.05)；观察组患者GSES量表中的疾病与症状、饮食与运动、认知与行为评分分别为(34.23±3.12)分、(40.37±4.23)分、(41.33±4.28)分，明显高于对照组的(29.24±3.09)分、(37.48±3.98)分、(37.64±3.94)分，差异均有统计学意义(P<0.05)；观察组患者的病情观察、情绪控制、生活方式管理自我管理行为评分分别为(4.32±0.38)分、(4.08±0.44)分、(4.52±0.25)分，明显高于对照组的(4.09±0.37)分、(3.72±0.39)分、(4.08±0.37)分，差异均有统计学意义(P<0.05)；观察组患者的自我概念与能力、健康知识掌握水平、自护责任感评分分别为(41.25±6.35)分、(38.47±5.28)分、(32.16±5.12)分，明显高于对照组的(37.59±6.28)分、(34.39±5.14)分、(26.49±5.32)分，差异均有统计学意义(P<0.05)；出院6个月后，观察组患者发生静脉炎、堵管、感染、血栓、导管移位的总并发症发病率为6.06%，明显低于对照组的 24.24%，差异有统计学意义(P<0.05)。结论 宫颈癌PICC置管化疗患者采用双链互动护理管理可提高自我效能水平，增强自我管理行为，降低导管相关并发症发病率。
      【关键词】 双链互动管理；宫颈癌；外周静脉穿刺中心静脉置管术；自我效能；自我管理行为；并发症
      【中图分类号】 R473.73 【文献标识码】 A 【文章编号】 1003—6350（2022）14—1894—05

Effects of double-chain interactive management on self-efficacy, self-management behaviors, and complicationsin patients with cervical cancer undergoing peripherally inserted central catheter for chemotherapy.
LIUShan-shan 1, LV Ai-li 2, REN Wen-qing 2. 1. Department of Obstetrics and Gynecology, the Affiliated Hospital of NorthwestUniversity, the Third Hospital of Xi'an City, Xi'an 710018, Shaanxi, CHINA; 2. Cardiac Panvascular Hospital, Xi'anPeople's Hospital (Xi'an Fourth Hospital), Xi'an 710011, Shaanxi, CHINA
【Abstract】 Objective To explore the effects of double-chain interactive management on self-efficacy,self-management behaviors, and complications in patients with cervical cancer undergoing peripherally inserted centralcatheter (PICC) for chemotherapy.Methods A total of 66 patients with cervical cancer admitted to the Affiliated Hospi-tal of Northwest University were enrolled as the research objects between January 2019 and January 2021. According tosimple random number table method, they were divided into an observation group and a control group, with 33 patientsin each group. The control group was given routine nursing of Department of Oncology, while observation group wasgiven double-chain interactive management on the basis of the control group, both continuously for 3 months. The rele-vant indexes were monitored and evaluated by questionnaire at 3 months after nursing. Before and after 3 months of nurs-ing, psychological status of patients was evaluated by Self-rating Anxiety Scale (SAS) and Self-rating Depression Scale(SDS). The self-efficacy level was evaluated by General Self-efficacy Scale (GSES). The levels of self-management be-haviors were assessed by self-made scale in Department of Oncology. The self-care ability was evaluated by Exercise ofSelf-care Agency Scale (ESCA). The occurrence of complications between the two groups was compared at 6 months af-ter discharge. Results After 3 months of nursing, SAS and SDS scores in the observation group were (24.66±6.21) pointsand (25.91±6.25) points, significantly lower than (34.23±6.42) points and (35.24±5.14) points in the control group (P<0.05). GSES scores (diseases and symptoms, diet and exercise, cognition and behaviors) in the observation group were(34.23±3.12) points, (40.37±4.23) points, and (41.33±4.28) points, significantly higher than (29.24±3.09) points, (37.48±3.98) points, (37.64±3.94) points in the control group (P<0.05). The scores of self-management behaviors (condition ob-　　　·护理·doi:10.3969/j.issn.1003-6350.2022.14.034基金项目：陕西省自然科学基础研究计划(编号：S2018-JC-QN-1783)