Effect of IMPACT management mode on self-care and management abilities of patients with breast cancer undergoing chemotherapy with implantable venous access port_West China Medical Journal

Authors：

ZENG Cuifang ^1,2 , WU Wenjuan ³ , ZHANG Xingxia ⁴ , JIA Ying ^2,5 , HOU Ping ³ ,  YANG Xiaoqin ^2,5

1. Department of General Surgery, West China Hospital, Sichuan University / West China School of Nursing, Sichuan University , Chengdu, Sichuan 610041, P. R. China;
2. Breast Center, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, P. R. China;
3. Department of General Surgery, Shangjin Hospital, West China Hospital, Sichuan University, Chengdu, Sichuan 611700, P. R. China;
4. West China School of Nursing, Sichuan University, Chengdu, Sichuan 610041, P. R. China;
5. Department of General Surgery, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, P. R. China;

Corresponding?author：

YANG Xiaoqin, Email: 1240118009@qq.com

Keywords：

Breast cancer; implantable venous access port; IMPACT management mode; self-care ability; self-management ability

DOI：

10.7507/1002-0179.202201114

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Objective To observe the effectiveness of IMPACT management mode on self-care and management abilities of breast cancer patients undergoing chemotherapy with implantable venous access port (VAP). Methods Breast cancer patients who underwent chemotherapy with VAP at Shangjin Hospital, West China Hospital, Sichuan University between March 2020 and June 2021 were prospectively included. IMPACT mode was used for self-management training guidance. The patient self-care abilities before training and at 1 month, 2 months, and 3 months of training were compared, and the patient self-management abilities at 1 month and 3 months of training were compared. Results A total of 74 patients with breast cancer undergoing chemotherapy with VAP were included. The total score of self-care ability of patients before training and at 1 month, 2 months, and 3 months of training was 112.11±14.63, 123.20±15.73, 127.95±13.89, and 131.92±13.60, respectively, and all the between-time-point differences were statistically significant (P<0.05). In terms of self-concept score, all the between-time-point differences were statistically significant (P<0.05) with increasing score over time, except the difference between the score at 3 months of training and that at 2 months of training (P>0.05). In terms of self-responsibility and self-care skill scores, all the between-time-point differences were statistically significant (P<0.05) with increasing scores over time, except the difference between the score at 2 months of training and that at 1 month of training (P>0.05). In terms of health knowledge level, the scores at 1 month, 2 months, and 3 months of training were higher than that before training (P<0.05), and the score at 3 months of training was higher than that at 1 month of training (P<0.05). The self-management ability scores in all dimensions at 3 months of training were higher than those at 1 month of training, and the differences were statistically significant (P<0.05). Conclusion The IMPACT management mode can effectively improve the self-care and management abilities of breast cancer patients undergoing chemotherapy with VAP, thereby ensuring the normal use of VAP, reducing the occurrence of complications, and reducing the burden on families and society.

Citation： ZENG Cuifang, WU Wenjuan, ZHANG Xingxia, JIA Ying, HOU Ping, YANG Xiaoqin. Effect of IMPACT management mode on self-care and management abilities of patients with breast cancer undergoing chemotherapy with implantable venous access port. West China Medical Journal, 2023, 38(6): 878-883. doi: 10.7507/1002-0179.202201114 Copy

1.	Chavez-MacGregor M, Clarke CA, Lichtensztajn DY, et al. Delayed initiation of adjuvant chemotherapy among patients with breast cancer. JAMA Oncol, 2016, 2(3): 322-329.
2.	Song MG, Seo TS, Kang EY, et al. Innominate vein stenosis in breast cancer patients after totally implantable venous access port placement. J Vasc Access, 2015, 16(4): 315-320.
3.	Shankar G, Jadhav V, Ravindra S, et al. Totally implantable venous access devices in children requiring long-term chemotherapy: analysis of outcome in 122 children from a single institution. Indian J Surg Oncol, 2016, 7(3): 326-331.
4.	Minichsdorfer C, Füreder T, M?hr B, et al. A cross-sectional study of patients’ satisfaction with totally implanted access ports. Clin J Oncol Nurs, 2016, 20(2): 175-180.
5.	方水芹, 侯進, 陸新建. 家庭醫生制度下 IMPACT 培訓模式對居家長期照護者照護知識和技能的影響. 護理研究, 2016, 30(10C): 3744-3748.
6.	方水芹, 侯進, 陸新建. 家庭醫生制度下居家護理員的 IMPACT 管理模式及其實踐效果評價. 中國全科醫學, 2017, 8(20): 2703-2709.
7.	中國抗癌協會乳腺癌專業委員會. 中國抗癌協會乳腺癌診治指南與規范(2017 年版). 中國癌癥雜志, 2017, 27(9): 695-759.
8.	Yamashita M. The exercise of self-care agency scale. West J Nurs Res, 1998, 20(3): 370-381.
9.	劉春麗, 顏美瓊, 陸箴琦. 腫瘤患者 PICC 自我管理能力量表的構建及測評. 護理學雜志 2012, 27(23): 1-4.
10.	劉飛, 趙璇, 劉瑤, 等. 應用植入式上臂輸液港病人自我管理行為量表的編制及信效度檢驗. 護理研究, 2020, 34(18): 3210-3213.
11.	陳紅梅, 曹淑芬. 植入式輸液港和 PICC 在乳腺癌患者中的臨床應用研究. 臨床護理雜志, 2015, 14(1): 72-74.
12.	嚴梅, 劉莉娟, 王雪芹. 三種中心靜脈導管應用于乳腺癌化療中的并發癥觀察分析. 護士進修雜志, 2016, 31(19): 1805-1807.
13.	王今, 梁琳, 熊壯, 等. 腫瘤患者應用植入式靜脈輸液港與中心靜脈置管效果的 Meta 分析. 中華疾病控制雜志, 2015, 19(11): 1158-1161, 1173.
14.	張偉蘭, 關次宜, 曾志強, 等. 乳腺癌化療病人應用植入式靜脈輸液港的觀察與護理. 全科護理, 2015, 13(3): 258-260.
15.	葉明, 高坤, 李靜. 植入式靜脈輸液港患者的護理管理. 廣州醫學院學報, 2013, 41(3): 135-136.
16.	蘇金娜, 焦俊琴, 王建新, 等. 規范化管理在靜脈輸液港植入病人護理中的應用. 護理研究, 2013, 27(19): 2008-2009.
17.	李帆, 朱瑞儀, 官莉, 等. 靜脈輸液港在我國乳腺癌化療患者中的應用及研究進展. 解放軍護理雜志, 2018, 35(2): 44-48.
18.	申瑞杰. 強化訓后管理是促進教育技術培訓成果轉化的有效策略. 教學與管理(理論版), 2013(6): 40-42.
19.	莊佳銘, 劉慧宇, 朱悅, 等. PICC 置管腫瘤患者導管自我管理能力的研究進展. 中華現代護理雜志, 2020, 26(22): 3109-3112.
20.	林玉珍, 黃靜, 梁素芳, 等. 惡性腫瘤患者 PICC 綜合維護模式與病區維護模式的反應性評價比較. 中華現代護理雜志, 2016, 22(14): 1997-2001.

1. Chavez-MacGregor M, Clarke CA, Lichtensztajn DY, et al. Delayed initiation of adjuvant chemotherapy among patients with breast cancer. JAMA Oncol, 2016, 2(3): 322-329.
2. Song MG, Seo TS, Kang EY, et al. Innominate vein stenosis in breast cancer patients after totally implantable venous access port placement. J Vasc Access, 2015, 16(4): 315-320.
3. Shankar G, Jadhav V, Ravindra S, et al. Totally implantable venous access devices in children requiring long-term chemotherapy: analysis of outcome in 122 children from a single institution. Indian J Surg Oncol, 2016, 7(3): 326-331.
4. Minichsdorfer C, Füreder T, M?hr B, et al. A cross-sectional study of patients’ satisfaction with totally implanted access ports. Clin J Oncol Nurs, 2016, 20(2): 175-180.
5. 方水芹, 侯進, 陸新建. 家庭醫生制度下 IMPACT 培訓模式對居家長期照護者照護知識和技能的影響. 護理研究, 2016, 30(10C): 3744-3748.
6. 方水芹, 侯進, 陸新建. 家庭醫生制度下居家護理員的 IMPACT 管理模式及其實踐效果評價. 中國全科醫學, 2017, 8(20): 2703-2709.
7. 中國抗癌協會乳腺癌專業委員會. 中國抗癌協會乳腺癌診治指南與規范(2017 年版). 中國癌癥雜志, 2017, 27(9): 695-759.
8. Yamashita M. The exercise of self-care agency scale. West J Nurs Res, 1998, 20(3): 370-381.
9. 劉春麗, 顏美瓊, 陸箴琦. 腫瘤患者 PICC 自我管理能力量表的構建及測評. 護理學雜志 2012, 27(23): 1-4.
10. 劉飛, 趙璇, 劉瑤, 等. 應用植入式上臂輸液港病人自我管理行為量表的編制及信效度檢驗. 護理研究, 2020, 34(18): 3210-3213.
11. 陳紅梅, 曹淑芬. 植入式輸液港和 PICC 在乳腺癌患者中的臨床應用研究. 臨床護理雜志, 2015, 14(1): 72-74.
12. 嚴梅, 劉莉娟, 王雪芹. 三種中心靜脈導管應用于乳腺癌化療中的并發癥觀察分析. 護士進修雜志, 2016, 31(19): 1805-1807.
13. 王今, 梁琳, 熊壯, 等. 腫瘤患者應用植入式靜脈輸液港與中心靜脈置管效果的 Meta 分析. 中華疾病控制雜志, 2015, 19(11): 1158-1161, 1173.
14. 張偉蘭, 關次宜, 曾志強, 等. 乳腺癌化療病人應用植入式靜脈輸液港的觀察與護理. 全科護理, 2015, 13(3): 258-260.
15. 葉明, 高坤, 李靜. 植入式靜脈輸液港患者的護理管理. 廣州醫學院學報, 2013, 41(3): 135-136.
16. 蘇金娜, 焦俊琴, 王建新, 等. 規范化管理在靜脈輸液港植入病人護理中的應用. 護理研究, 2013, 27(19): 2008-2009.
17. 李帆, 朱瑞儀, 官莉, 等. 靜脈輸液港在我國乳腺癌化療患者中的應用及研究進展. 解放軍護理雜志, 2018, 35(2): 44-48.
18. 申瑞杰. 強化訓后管理是促進教育技術培訓成果轉化的有效策略. 教學與管理(理論版), 2013(6): 40-42.
19. 莊佳銘, 劉慧宇, 朱悅, 等. PICC 置管腫瘤患者導管自我管理能力的研究進展. 中華現代護理雜志, 2020, 26(22): 3109-3112.
20. 林玉珍, 黃靜, 梁素芳, 等. 惡性腫瘤患者 PICC 綜合維護模式與病區維護模式的反應性評價比較. 中華現代護理雜志, 2016, 22(14): 1997-2001.

West China Medical Journal

Effect of IMPACT management mode on self-care and management abilities of patients with breast cancer undergoing chemotherapy with implantable venous access port

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