ผลของโปรแกรมส่งเสริมการรับรู้สมรรถนะแห่งตนต่อพฤติกรรมการป้องกันและภาวะแทรกซ้อน ในผู้ป่วยมะเร็งท่อทางเดินน้ำดีที่ได้รับการใส่ท่อระบายทางเดินน้ำดีผ่านทางผิวหนัง

Amornrat Papakang; Apinya  Wongpiriyayothar

Authors

Amornrat Papakang Faculty of Nursing, Mahasarakham University
Apinya Wongpiriyayothar Faculty of Nursing, Mahasarakham University

Keywords:

PTBD, self-efficacy theory, complication prevention behavior, complications cholangiocarcinoma

Abstract

This quasi-experimental study aimed to examine the effects of a self-efficacy promotion program on prevention behaviors and clinical complications in patients with cholangiocarcinoma undergoing percutaneous transhepatic biliary drainage (PTBD). The sample consisted of 46 patients with newly diagnosed cholangiocarcinoma who underwent PTBD and were admitted to the surgical department of Roi Et Hospital. Simple random sampling was used to recruit sample. They were divided into an experimental group and a control group, with 23 patients in each group. The program was developed based on Bandura’s Self-Efficacy Theory, comprising emotional arousal reduction, modeling, mastery experiences, and verbal persuasion. The activities were conducted over a five-week period. Data were collected using a complication prevention behavior questionnaire and a complication record form. Data were analyzed using descriptive statistics, independent t-test, Chi-square test, and Fisher’s exact test.

The results revealed that the experimental group had significantly higher complication prevention behavior scores (p<0.001); and significantly lower incidence of complications including dislodgement, obstruction, and infection (p<0.05) compared to the control group. Therefore, the program can be applied in pre-discharge care and home-based care.

References

World Health Organization. Liver cancer fact sheet: GLOBOCAN 2022 [Internet]. [cited 2024 Nov 10]. Available from: https://gco.iarc.fr/today/data/factsheets/cancers/11-Liver-fact-sheet.pdf

Cholangiocarcinoma Research Institute. Cholangiocarcinoma in Thailand [Internet]. 2024 [cited 2024 Dec 10]. Available from: https://cascap.kku.ac.th/ (in Thai)

Khan S, Rushbrook S, Kendall T, Zen Y, Albazaz R, Manoharan P, et al. Cholangiocarcinoma [Internet]. 2024 [cited 2025 Jan 10]. Available from: https://ammf.org.uk/ cholangiocarcinoma/

Yu H, Park J, Jung G, Seo K, Park H, Yun J. Predictive factors for symptomatic dislodgement of percutaneous transhepatic biliary drainage catheter in patients with malignant biliary obstruction. J Korean Soc Radiol 2023;84:1350-1360. doi:10.3348/jksr.2023.0063.

Chen X, Wei X, Yue L, Xiao Y. Efficacy and safety of preoperative biliary drainage in patients with hilar cholangiocarcinoma: a systematic review and meta-analysis. Int J Surg 2025;111(5):3543-3560. doi:10.1097/JS9.0000000000002324.

Wang D, Chang P, Tintara S, Chang F, Phan J. Comparative analysis of ERCP and PTBD for biliary interventions for readmission rates and patient outcomes. J Clin Gastroenterol 2024. doi:10.1097/MCG.0000000000002074.

Roi Et Hospital Information Center. Statistics of patients with biliary tract cancer. Roi Et Hospital; 2023. (in Thai)

Rattanakanlaya K, Vuttanon N, Noppakun L, Sangwattanarat W, Boonyu N. Transition experience of liver cancer and cholangiocarcinoma patients after receiving first invasive percutaneous transhepatic biliary drainage. Nurs J 2022;49(1):290-301. (in Thai)

Rattanakanlaya K, Vuttanon N, Noppakun L, Sangwattanarat W, Boonyu N. Hospital discharge needs: perspectives of patients with liver and bile duct cancer undergoing invasive percutaneous transhepatic biliary drainage and family caregivers. Nurs J 2021;48(3):260-273. (in Thai)

Bandura A. Self-efficacy: the exercise of control. New York: W.H. Freeman and Company; 1997.

Puspitasari AW, Kristina SA, Farrukh MJ. The association among adherence, self-efficacy and health-related quality of life in cancer patients with oral chemotherapy in Indonesia. Pharm Pract (Granada) [Internet]. 2025 [cited 2025 Jun 8];23(1):3107. Available from: https://www.pharmacypractice.org/index.php/pp/article/view/3107

Tu H, Zhang L, Xu M, Zhao Z, Han J, Yan L. The mediating effect of self-efficacy on social support and cancer screening behavior among Chinese women: a cross-sectional study. BMC Women's Health 2024; 24(1):454. doi:10.1186/s12905-024-03296-5.

Sripukdee S, Somjaivong B, Tipunya A. Effects of postoperative recovery program on self-efficacy, quality of postoperative recovery, and postoperative complications among patients with cholangiocarcinoma. J Nurs Sci Health 2022;45(2):78-92. (in Thai)

Panyakom S, Chensirimongkol J. The effects of a digital media-based self-efficacy promotion program post-discharge on the self-care behaviors of colorectal cancer patients with ostomies. Thai Red Cross Nurs J 2024;17(3):105-20. (in Thai)

Huang YL, Lin MC, Wang BY. Efficacy and safety analysis of continued nursing of complications in discharged patients after percutaneous transhepatic biliary drainage. World J Clin Cases 2024;12(19):3898-907. doi:10.12998/wjcc.v12.i19.3898.

Prasopdee S, Rojthongpond T, Chitkoolsamphan Y, Pholhelm M, Yusuk S, Pattaraarchachai J, et al. Update on the risk factors for opisthorchiasis and cholangiocarcinoma in Thailand. Parasites Hosts Dis 2023;61(4):463-70. doi:10.3347/PHD.23032. (in Thai)

Prakobwong S, Suwannatrai K. Reduction of reinfection rates with Opisthorchis viverrini through a three-year management program in endemic areas of northeastern Thailand. Parasites Hosts Dis 2020;58(5):527-35. Available from: https://www.parahostdis.org/journal/view.php?doi=10.3347/kjp.2020.58.5.527

Taniai M. Alcohol and hepatocarcinogenesis. Clin Mol Hepatol 2020;26:736-46. doi:10.3350/cmh.2020.0203.

Ji Jiang H, Jiang G. Effect of a preventive nursing model on postoperative nursing and complications after PTBD in hepatobiliary surgery. Int J Clin Exp Med 2020;13(2):644-53.