RESUMO
Abstract: The purpose of this quasi-experimental research was to determine the effect of a supportive-educative nursing system on dependent care behaviors and the occurrence of complications among children with long-term tunneled catheter after 2 weeks post discharge. The conceptual framework was based on Orem’s Self-care Deficit Nursing Theory. Between May 2003 and May 2004, caregivers of children with first time inserted catheter who were admitted to pediatric wards at Ramathibodi Hospital were recruited by using purposive sampling. The subjects were primary caregivers, responsible for changing the catheter exit site dressing when the children were at home, and had no prior experience in catheter care. The sample consisted of 30 caregivers equally divided into control and experimental group, 15 in each group. Both groups received conventional nursing care. The experimental group received an extra supportive-educative nursing system. The caregivers completed two questionnaires, which measured caregiving behaviors and complication occurrence at two weeks post discharge. All data were analyzed by SPSS/FW program. The results revealed that the score of caregiving behaviors at two weeks post discharge in the experimental group was significantly higher than in the control group (p \< .001). The occurrence of complications in children whose caregivers were in the control group was significantly higher than in the experimental group (p \< .007). No partial occlusion and catheter dislodgement occurred in both groups. The supportive-educative nursing system for encouraging catheter caregiving behaviors is effective and tends to reduce catheter related complications. Therefore, its use is recommended.
RESUMO
Medications and nutritions are generally given to patients via the intestinal tract. When oral administration is not possible, the venous system is an alternative route which comprises peripheral and central veins. The selection of either peripheral or central venous route depends on the purpose of usage. With advances in medical technology, many kinds of long-term venous access devices have been developed for central venous use in children such as Hickman catheter, Broviac catheter, and Subcutaneous port for long-term uses, depending on the patient’s necessity and suitability. Catheter related complications are particularly related to age, development, and type of catheter in pediatric patients. Nurses have important roles in catheter care. They must have knowledge of the type, size, indication, advantage, and disadvantage of each catheter type. To fulfill these important roles, they must have adequate experiences and proficiency in catheter care in basis to maintain these devices as long as they are needed.