Risk factors for peripherally inserted central catheter (PICC)-associated infections in patients receiving chemotherapy and the preventive effect of a self-efficacy intervention program: a randomized controlled trial.

BACKGROUND: A peripherally inserted central catheter (PICC) effectively reduces frequent vein punctures in cancer patients. With increasing clinical applications, PICC-associated infections are attracting increasing attention. In this study, we retrospectively analyzed PICC-associated infections in chemotherapy patients treated at our hospital in recent years to identify risk factors for PICC-associated infections and the preventive effect of a self-efficacy intervention program. METHODS: Using a convenience sampling method, we selected 159 cancer patients who received chemotherapy through a PICC at our hospital between July 2017 and December 2018, and the patients were randomly divided to an observation group (n=79) and a control group (n=80) using a random number table. The control group received conventional intervention, and the observation group received a self-efficacy intervention. We analyzed self-efficacy scores before and after the intervention, the complication rate, the infection rate, pathogens identified, and risk factors for PICC-associated infections. RESULTS: Among the 159 chemotherapy patients, 26 (16.35%) experienced PICC-associated infections in this finished trial. Univariate analysis showed that sex, puncture site, and steroid use were unrelated to PICC-associated infections (P>0.05), whereas PICC indwelling time, white blood cell (WBC) count, a history of diabetes, and immunity were significantly related to PICC-associated infections (P<0.05). The self-efficacy score improved after the intervention in both groups, especially in the observation group (P<0.05). The incidence of complications such as catheter infection, catheter blockage, and catheter displacement was significantly lower in the observation group than in the control group (16. 67% vs. 88.10%; P<0.05). CONCLUSIONS: The self-efficacy intervention improves self-management and reduces complications in cancer patients receiving chemotherapy through a PICC. PICC indwelling time, WBC count, a history of diabetes, and immunity are independent risk factors for PICC-associated infections; thus, measures should be implemented to prevent infections. TRIAL REGISTRATION: Chinese Clinical Trial Registry ChiCTR2100050651.