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Abstract

Introduzione: Il Peripherally Inserted Central Catheter (PICC) è un catetere venoso centrale adatto per pazienti in regime di Day Hospital. Il suo utilizzo è considerato vantaggioso ma comporta degli oneri di gestione a carico della persona. E' bene formare il paziente ad una corretta gestione domiciliare del presidio attraverso un'educazione strutturata.

Obiettivo: In un gruppo di pazienti portatori di PICC, valutare l'efficacia di un intervento educativo mirato attraverso la comparazione di: colloquio informativo, opuscolo cartaceo, video informativo. Metodo: Studio clinico randomizzato e controllato monocentrico, schema comparativo semplice a tre bracci. Popolazione: tutti i pazienti sottoposti all'impianto di PICC nel periodo di osservazione tra Ottobre 2013 e Febbraio 2014 presso l'Unití  Operativa Day Hospital Oncologico e Breast Unit, presidio Molinette di Torino. L'intervento educativo standard è erogato attraverso un colloquio con l'infermiere che esegue l'impianto. Il team di impiantatori è costituito da due infermieri con comprovata esperienza in ambito oncologico ed in possesso di Master di I Livello "Gestione degli accessi venosi".

I pazienti eleggibili, dopo randomizzazione, sono stati divisi in tre gruppi: gruppo A colloquio informativo; gruppo B opuscolo; gruppo C video. I pazienti dei gruppi B e C hanno ricevuto informazioni standard inte- grate con informazioni audiovisive oppure cartacee, in base al braccio al quale erano stati destinati; il grado di conoscenza raggiunto è stato indagato attraverso la somministrazione di questionari costruiti ad hoc, non vali- dati in quanto non presenti in letteratura.

Risultati: Adesione allo studio di 40 pazienti, campione di convenienza costituito da persone di etí  compresa tra 18 e 75 anni, consenzienti e risiedenti al proprio domicilio. L'analisi delle conoscenze apprese in seguito all'intervento educativo mostra una differenza statisticamente significativa in diversi ambiti necessari per la corretta gestione del PICC: quando eseguire la medicazione (p=0.001), quando indicato il lavaggio (p=0), segni/sintomi di infezione (p =0,001), comportamenti a rischio (p=0.005), controllo sito inserzione (p=0). Intervallo di confidenza (IC): 95%; significativití  fissata allo 0.05%. Conclusioni: L'utilizzo di uno strumento educativo multimediale risulta essere più efficace rispetto al solo colloquio nell'ampliare le competenze personali. Il video risulta avere un efficacia maggiore rispetto all'opu- scolo. I risultati ottenuti tengono conto dei limiti imposti dalla ridotta numerosití  del campione e del breve periodo di follow up, con una bassa generalizzabilití  delle conclusioni.

Parole Chiave: Catetere periferico, formazione infermieristica, infermieristica oncologica, self management


Efficacy of educational intervention for patients wearing peripherall inserted central catheter. A pilot study

Background: Peripherally Inserted Central Catheter (PICC) is a central venous catheter suitable for patients who receive chemotherapy in Day Hospital regimen. The patient must be educated to a proper home management of the PICC through targeted education. Aim: To evaluate the effectiveness of a targeted educational intervention through the comparison of: indi- vidual interview, brochure paper, informative video.

Method: Single-centre randomized controlled clinical trial with a simple three-arm comparative scheme. The study population is represented by all patients undergoing the insertion of PICC at the Oncological Day Hospital and Breast Unit in the observation period between October 2013 and February 2014. The Standard educational session is performed by the nurse positioning the PICC. PICC team consists of two nurses in possession of the first level master in venous access management.

Following randomization eligible patients were divided in three groups: group A received Standard educa- tional session; group B received the standard information and the brochure; group C received the stan- dard information and the informative video. The level of the achieved knowledge was investigated by administering targeted questionnaires

Results: A total of 40 patients joined the study: a convenience sample represented by people between the ages of 18 and 75 years, in outpatient care. Statistically significant difference in key areas necessary for the proper management of PICC: when to change the dressing (p=0.001), when to wash the catheter (p=0), how to recognize signs and symptoms of infection (p=0.001), identify at-risk behaviors (p=0.005), when carrying out the inspection of the cathe- ter's insertion site (p=0).Confidence interval (CI): 95%; statistical significance: 0.05%.

Conclusions: The administration of a multimedial educational tool was found to be superior in efficacy compared to the only Standard educational session to increase patient's knowledges. The video appears to be more effective than the brochure. The obtained results are influenced by the small sample size and by the shortness of the follow up timing; this leads to a low generalizability of the conclusions.

Keywords: Peripheral Catheterization, Educational Nursing, Oncological Nursing, Self Management.


Dettagli dell'articolo

Come citare
Fusco, F., Armando, T., Storto, S., & Mussa, M. V. (2016). Efficacia di un intervento educativo rivolto ai pazienti portatori di un catetere venoso centrale ad inserzione periferica: studio pilota. PROFESSIONI INFERMIERISTICHE, 69(1). Recuperato da https://www.profinf.net/pro3/index.php/IN/article/view/208
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