Central venous catheters (CVCs) are often inserted to provide chemotherapy and marrow suppression therapy. However, CVCs are regularly associated with infections, particularly after hospital discharge. A 2005 study in the Journal of Hospital Infection of an educational program at a Danish hospital showed that the 42 patients who were instructed in catheter care experienced a 50% reduction in the rate of CVC-related infection, compared with a control group of 40 patients who received standard catheter care from nurses. In a follow-up study, the researchers interviewed nine participants from each group to determine how their experiences of leukemia treatment, catheter care, and social interactions differed.
Patients in both groups were afraid of CVC complications such as infection, but they understood that the catheter was necessary and were motivated to protect against these complications. Participants in both groups also expressed a desire to hide the catheter, leading to social and physical isolation, although patients (primarily in the intervention group) who were open with family and friends about their catheter experienced less emotional discomfort.
Patients in the intervention group felt a greater sense of control over their health and care. In addition, feelings of insecurity and a loss of control during direct conflict with health care providers were less prevalent in this group. Similarly, the intervention group felt that the CVC care they performed was as good as or better than that provided by health care professionals. Patients who received the training felt a sense of security and felt less dependent on providers. They also experienced greater actual independence because they could perform catheter care according to their own schedule. The authors surmised that the intervention group's greater sense of control and "mastery over catheter techniques" was part of the reason for the decreased risk of infection and concluded that individualized patient education should be provided to patients needing a CVC.-SDSJ
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