PICC置管肿瘤患者对导管维护分级诊疗意愿调查

目的:了解置管患者对社区开展PICC维护的需求意愿及顾虑原因，探讨如何依托分级诊疗模式来满足PICC置管患者的维护服务需求提供参考依据。方法:采用自制问卷对2017年10月—12月在上海市第一人民医院进行导管维护的肿瘤置管467例患者进行问卷调查。结果:调查患者中愿意至社区进行PICC维护的愿意率为31.9%。不同年龄、学历、收入、花费交通时间、置管时间、有无置管延迟情况的患者对社区开展PICC维护需求意愿有差异，差异有统计学意义(P < 0. 05)。结论:老年、低收入、低学历、花费交通时间长的患者至社区进行PICC维护的意愿较高。但总体患者对社区开展维护护理的需求意愿不高，对社区护士的技术生疏、社区综合实力不够、社区设备落后和并发症处理能力不足的顾虑较大，并希望社区能够加强护士技术能力培训及提供上级护理专家坐诊。

Investigation of the willingness of grade diagnosis and treatment about catheter maintenance in tumor patients with PICC

Objective To understand the needs and concerns about PICC maintenance for tumor patients in the community, and to explore how to provide reference for meeting the needs of the maintenance service in PICC patients relying on the hierarchical diagnosis and treatment mode. Method 467 patients carrying out catheter maintenance in Shanghai General Hospital from October to December, 2017 were investigated by a self-designed questionnaire. Result The rate of willingness of PICC maintenance in the community was 31.9%. There was a statistically significant difference in demand for PICC maintenance in the community among age, education, income, transportation time, catheterization time and delay in maintenance (P < 0. 05). Conclusion elderly, low - income, low - education, long - transportation time patients have a stronger willingness to maintain PICC in the community. But overall demand for maintenance in the community is not high, because they concern about backwardness in comprehensive strength and equipment in the community and the capacity of nurse in new technology and treating complications. They hope that the community can strengthen the technical training for community nurse, and provide service from the superior nursing experts.