Beyond Device Safety: Organisational Burden and Quality of Life in Oncology Outpatients with PICCs. A Descriptive Exploratory Study

Vollständiger Abstract

Worum geht es in dieser Arbeit?

Background and Objectives: Cancer care is increasingly delivered through outpatient pathways, thereby progressively transferring part of the organisational and practical workload of care to patients and informal caregivers. Although peripherally inserted central catheters (PICCs) are widely used in oncology for safe vascular access, comparatively less attention has been devoted to the organisational and logistical burden of PICC management and to the related involvement of informal caregivers in ambulatory settings. Materials and Methods: A single-centre descriptive study was conducted among adult oncology outpatients undergoing PICC placement within an ambulatory oncology service. Health-related quality of life was assessed at baseline (T0) and at two-month follow-up (T1) using the SF-36 questionnaire. A structured exploratory 20-item survey was additionally administered at follow-up to investigate physical, psychological, and organisational/social burden associated with PICC management. Descriptive statistics and Wilcoxon signed-rank tests were used for analysis. Results: Forty patients were enrolled, and 37 completed the follow-up assessment. In exploratory analyses, statistically significant reductions were observed in the SF-36 domains of general health (p = 0.034) and vitality (p = 0.016), whereas no statistically significant changes were observed in the remaining domains. PICC-related complications were recorded in five participants (12.5%). The exploratory survey identified the highest burden scores within the organisational/social domain, particularly for travel requirements for weekly dressing changes, caregiver assistance with transportation, and travel-related costs. Conclusions: The findings provide preliminary evidence of practical and organisational demands within outpatient PICC management pathways that are not fully reflected by conventional device-related outcomes or generic HRQoL measures. Given the descriptive, single-centre design and exploratory burden assessment, these findings should be considered hypothesis-generating. Larger multicentre and longitudinal studies using validated measures are needed to confirm these observations and evaluate alternative models of PICC follow-up.