The impact of a PICC line on the patient receiving modified de Gramont ambulatory chemotherapy

Molloy, Doreen (2007) The impact of a PICC line on the patient receiving modified de Gramont ambulatory chemotherapy. MSc(R) thesis, University of Glasgow.

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Abstract

Growing demand for cytotoxic chemotherapy has led to restructuring of cancer services in the UK. The majority of patients who receive chemotherapy now do so in the outpatient/ambulatory setting. Ambulatory care is now the fastest growing health-care service delivery model in industrialised nations. The expansion of ambulatory chemotherapy has led to an increase in the use of Peripherally Inserted Central Catheters (PICC lines) which are seen as a cost-effective way of safely administering chemotherapy in the ambulatory setting. The Modified de Gramont (MdG) regimen is one such commonly used ambulatory chemotherapy regimen which requires insertion of a PICC line or other Central Venous Access Device (CVAD) to undertake. Despite the additional care requirements of ambulatory chemotherapy patients, little is known about the ways in which PICC lines impact on the lives of patients and the challenges they face in coping at home with a PICC line in situ. It was the aim of this study to examine the views and experiences of patients receiving ambulatory MdG chemotherapy via a PICC line, to discover which aspects of living with a PICC line caused most difficulty and to determine if patients viewed PICC lines as a benefit or a burden when receiving ambulatory chemotherapy. The study was conducted in a large oncology unit in Scotland. A triangulated descriptive study was implemented in two phases over two years. Phase 1 used semi-structured interviews with a convenience sample of 10 MdG patients. The qualitative data were analysed using content analysis and emerging themes identified. The themes were used to construct the questionnaire used in Phase 2 with a convenience sample of 62 MdG patients (response rate 90%). The quantitative data were subject to analysis using Confidence Interval estimation to determine which views were most likely to be held by the population represented by the sample in this study. The key findings were that the majority of MdG PICC-line patients held favourable views towards having a PICC line and generally adapted well to the experience. The main reported benefits in having a PICC line were the reduced need for venepuncture and cannulation, the ease of chemotherapy administration and not requiring hospital admission to receive chemotherapy. Bathing, showering, hair washing and sleeping caused patients most difficulty when living with a PICC line. The most common fears when living with a PICC line were of the chemotherapy spilling, PICC-line malfunction and the PICC line falling out. Furthermore, a number of challenges in providing informational support to this group of patients were evident as patients reported high information needs yet found the information given overwhelming and at times unhelpful. Despite this, the biggest majority of patients viewed the PICC line as a benefit not a burden when receiving MdG ambulatory chemotherapy.

Item Type: Thesis (MSc(R))
Qualification Level: Masters
Additional Information: Adviser: Lorraine N Smith
Keywords: Oncology, Medicine, Pharmacology
Date of Award: 2007
Depositing User: Enlighten Team
Unique ID: glathesis:2007-71018
Copyright: Copyright of this thesis is held by the author.
Date Deposited: 09 May 2019 14:28
Last Modified: 09 May 2019 14:28
URI: http://theses.gla.ac.uk/id/eprint/71018

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