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Cytotoxic chemotherapy for incurable colorectal cancer: living with a PICC-line

Authors

  • Doreen Molloy,

    1. Authors:Doreen Molloy, BA, MSc, PGCT LHE, RGN, Nursing, Edith Cowan University, Australia; Lorraine N Smith, BScN, MEd, PhD, Nursing & Health Care, Faculty of Medicine, University of Glasgow, Glasgow, UK; Tom Aitchison, BSc, Senior Lecturer, Department of Statistics, Faculty of information and Mathematical Sciences, University of Glasgow, Glasgow, UK
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  • Lorraine N Smith,

    1. Authors:Doreen Molloy, BA, MSc, PGCT LHE, RGN, Nursing, Edith Cowan University, Australia; Lorraine N Smith, BScN, MEd, PhD, Nursing & Health Care, Faculty of Medicine, University of Glasgow, Glasgow, UK; Tom Aitchison, BSc, Senior Lecturer, Department of Statistics, Faculty of information and Mathematical Sciences, University of Glasgow, Glasgow, UK
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  • Tom Aitchison

    1. Authors:Doreen Molloy, BA, MSc, PGCT LHE, RGN, Nursing, Edith Cowan University, Australia; Lorraine N Smith, BScN, MEd, PhD, Nursing & Health Care, Faculty of Medicine, University of Glasgow, Glasgow, UK; Tom Aitchison, BSc, Senior Lecturer, Department of Statistics, Faculty of information and Mathematical Sciences, University of Glasgow, Glasgow, UK
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Professor Lorraine N Smith, Nursing & Health Care, University of Glasgow, 59 Oakfield Avenue, Glasgow G12 8LW, UK. Telephone: +44 141 330 5498.
E-mail: l.n.smith@clinmed.gla.ac.uk

Abstract

Aims.  (i) To determine which aspects of living with a peripherally inserted central catheter (PICC) line cause Modified de Gramont (MdG) patients most difficulty. (ii) To explore MdG patients’ views of the PICC-line experience. (iii) To determine if patients view PICC-lines as a benefit or a burden when receiving ambulatory MdG chemotherapy.

Design.  A two-stage, descriptive study.

Methods.  Phase 1 comprised semi-structured interviews. Phase 2 surveyed the MdG population. Phase 1 interview data informed the Phase 2 questionnaire. The setting was a West of Scotland Cancer Care Centre and the sample was: Phase 1, a convenience sample of 10 MdG patients; Phase 2, 62 consecutive patients.

Results.  A response rate of 93·9% for Phase 2. The majority of PICC-line patients held favourable views towards having a PICC-line and adapted well with minimal disruption to daily life. Concerns were evident regarding coping at home with a PICC-line, chemotherapy spillage, dealing with complex information and the responsibility of patients/carers regarding PICC-line management. Patients preferred ambulatory chemotherapy to in-patient treatment.

Conclusions.  PICC-lines should be considered for more chemotherapy patients but service development is necessary to ensure individual needs are addressed.

Relevance to clinical practice. Contributes to the PICC-line literature by providing a national patient perspective on a range of daily living activities (DLAs). PICC-line patients prefer out-patient ambulatory chemotherapy rather than in-patient treatment. The longer a patient has a PICC-line, the more able they are to manage activities such as dressing. Concerns remain over chemotherapy spillage, partner/carer responsibility for PICC-line maintenance and the proper balance between required information and what the patient wants to know.

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