V. 4 N. 2 (2025): post-ICU pathways
Articles

Dealing with Central Vascular Access Devices: A Qualitative Study on Cancer Patients' Experiences

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  • Martina Torreggiani,
  • Deborah Maselli,
  • Stefano Botti,
  • Genny Mazza,
  • Monia Ferrarini,
  • Monica Guberti
Martina Torreggiani
Health Professions Department, Research & EBP Unit, Azienda USL-IRCCS di Reggio Emilia, Reggio Emilia, Italy
Deborah Maselli
Health Professions Department, Research & EBP Unit, Azienda USL-IRCCS di Reggio Emilia, Reggio Emilia, Italy; International Doctorate School in Clinical and Experimental Medicine, University of Modena and Reggio Emilia, Modena, Italy
Stefano Botti
Hematology Unit, Azienda USL-IRCCS di Reggio Emilia, Reggio Emilia, Italy
Genny Mazza
Oncology Day Care Unit, Azienda USL-IRCCS di Reggio Emilia, Reggio Emilia, Italy
Monia Ferrarini
General and Specialist Surgery Department, Azienda USL-IRCCS di Reggio Emilia, Reggio Emilia, Italy
Monica Guberti
Nursing and Health Professions Directorate, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy
DOI: https://doi.org/10.36253/if-3428

Pubblicato 2025-06-30

Parole chiave

  • Qualitative Research,
  • Oncology,
  • Vascular Access Devices,
  • PICC Line Catheterization,
  • Port-A-Cath

Copyright (c) 2025 Martina Torreggiani, Deborah Maselli, Stefano Botti, Genny Mazza, Monia Ferrarini, Monica Guberti

Creative Commons License

TQuesto lavoro è fornito con la licenza Creative Commons Attribuzione 4.0 Internazionale.

Abstract

Introduction. Central vascular access devices are widely used in oncology settings due to the significant side effects of chemotherapy on blood vessels. Despite the methodological robustness of the literature, the enhanced integration of patients’ perspectives would enrich the evidence on this topic. This study explores oncology patients' experiences with cVADs (PICC and TIVAD), from insertion to daily life management.  

Methods. We conducted a  generic qualitative interview study with thematic analysis. Adult patients with a Peripherally Inserted Central Catheter or a Totally Implantable Venous Access Device receiving oncological treatment at the Oncology Department of the Azienda USL – IRCCS of Reggio Emilia were included, as also those who completed the treatment plan. 

Results. The emerging themes were categorized into three main areas: (1) catheter implantation, (2) catheter maintenance, and (3) “daily life” with the catheter. Patients reported a high degree of satisfaction with the information and the education received by healthcare professionals: this appeared crucial in reducing anxiety and fear during the device placement and its daily management. However, patient engagement in the device selection appeared less consistent. The devices were well tolerated and had a low impact on their daily activities. All participants perceived the devices as helpful and safe during their care pathway.    

Discussion. The study confirmed the importance of central venous access devices to minimize patient discomfort during chemotherapy treatment. The competence and empathy of healthcare professionals, along with adequate information and education, contribute to reducing patient’s anxiety. Improving patients’ engagement in the device choice is necessary. Patients reported a positive experience, enabling them to cope with the device, even at home.

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Riferimenti bibliografici

  1. Ho C, Spry C. Central Venous Access Devices (CVADs) and Peripherally Inserted Central Catheters (PICCs) for Adult and Pediatric Patients: A Review of Clinical Effectiveness and Safety. Ottawa (ON): Canadian Agency for Drugs and Technologies in Health; 2017. Accessed via NCBI Bookshelf. PMID: NBK470810.
  2. Sansivero GE. Features and selection of vascular access devices. Semin Oncol Nurs. 2010;26(2):88–101. doi: https://doi.org/10.1016/j.soncn.2010.02.006
  3. Ivziku D, Gualandi R, Pesce F, De Benedictis A, Tartaglini D. Adult oncology patients’ experiences of living with a central venous catheter: a systematic review and metasynthesis. Support Care Cancer. 2022;30(7):3773–3791. doi: https://doi.org/10.1007/s00520-022-06819-8
  4. Ritchie M, Kelly LJ, Moss J, Paul J, Shaw R. Exploring attitudes towards a randomised controlled trial of venous access devices – a nested pre‑trial qualitative study. J Vasc Access. 2015;16(5):407–412. doi: https://doi.org/10.5301/jva.5000447
  5. Madabhavi I, Patel A, Sarkar M, Kataria P, Kadakol N, Anand A. A study of the use of peripherally inserted central catheters in cancer patients: A single‑center experience. J Vasc Nurs. 2018;36(3):149–156. doi: https://doi.org/10.1016/j.jvn.2018.05.00
  6. Linnemann B. Management of complications related to central venous catheters in cancer patients: an update. Semin Thromb Hemost. 2014;40(3):382–394. doi: https://doi.org/10.1055/s-0034-1371005
  7. Yacobovich J, Ben‑Ami T, Abdalla T, Tamary H, Goldstein G, Weintraub M, et al. Patient and central venous catheter related risk factors for blood stream infections in children receiving chemotherapy. Pediatr Blood Cancer. 2015;62(3):471–476. doi: https://doi.org/10.1002/pbc.25281
  8. Pu YL, Li ZS, Zhi XX, Shi YA, Meng AF, Cheng F, et al. Complications and costs of peripherally inserted central venous catheters compared with implantable port catheters for cancer patients: A meta‑analysis. Cancer Nurs. 2020;43(6):455–467. doi: https://doi.org/10.1097/ncc.0000000000000742
  9. Taxbro K, Hammarskjöld F, Thelin B, Lewin F, Hagman H, Hanberger H, et al. Clinical impact of peripherally inserted central catheters vs implanted port catheters in patients with cancer: an open‑label, randomised, two‑centre trial. Br J Anaesth. 2019;122(6):734–741. doi: https://doi.org/10.1016/j.bja.2019.01.038
  10. Wang Y, Wang X, Qiu X. Indwelling experience and coping strategies of upper arm infusion ports in patients with cancer: a qualitative study. BMJ Open. 2023;13(3):e069772. doi: https://doi.org/10.1136/bmjopen-2022-069772
  11. Patel GS, Jain K, Kumar R, Strickland AH, Pellegrini L, Slavotinek J, et al. Comparison of peripherally inserted central venous catheters (PICC) versus subcutaneously implanted port-chamber catheters by complication and cost for patients receiving chemotherapy for non‑haematological malignancies. Support Care Cancer. 2014;22(1):121–128. doi: https://doi.org/10.1007/s00520-013-1941-1
  12. Ryan C, Hesselgreaves H, Wu O, Moss J, Paul J, Dixon‑Hughes J, et al. Patient acceptability of three different central venous access devices for the delivery of systemic anticancer therapy: a qualitative study. BMJ Open. 2019;9(7):e026077. doi:10.1136/bmjopen-2018-026077
  13. Robinson‑Reilly M, Paliadelis P, Cruickshank M. Venous access: the patient experience. Support Care Cancer. 2016;24(3):1181–1187. doi: https://doi.org/10.1007/s00520-015-2900-9
  14. Parás-Bravo P, Paz-Zulueta M, Santibañez M, Fernández-de-las‑Peñas C, Herrero‑Montes M, Caso‑Álvarez V, et al. Living with a peripherally inserted central catheter: the perspective of cancer outpatients—a qualitative study. Support Care Cancer. 2018;26(2):441–449. doi: https://doi.org/10.1007/s00520-017-3815-4
  15. Alpenberg S, Joelsson G, Rosengren K. Feeling Confident in Using PICC Lines: Patients’ Experiences of Living With a PICC Line During Chemotherapy Treatment. Home Health Care Manag Pract. 2015;27(3):119–125. doi: https://doi.org/10.1177/1084822314566300
  16. Sharp R, Grech C, Fielder A, Mikocka‑Walus A, Cummings M, Esterman A. The patient experience of a peripherally inserted central catheter (PICC): A qualitative descriptive study. Contemp Nurse. 2014;48(1):26–35. doi: https://doi.org/10.5172/conu.2014.48.1.26
  17. Wu O, Boyd K, Paul J, McCartney E, Ritchie M, Mellon D, et al. Hickman catheter and implantable port devices for the delivery of chemotherapy: a phase II randomised controlled trial and economic evaluation. Br J Cancer. 2016;114(9):979–985. doi: https://doi.org/10.1038/bjc.2016.76
  18. Caelli K, Ray L, Mill J. ‘Clear as mud’: toward greater clarity in generic qualitative research. Int J Qual Methods. 2003;2:1–13. doi: https://doi.org/10.1177/160940690300200201
  19. Kahlke RM. Generic qualitative approaches: pitfalls and benefits of methodological mixology. Int J Qual Methods. 2014;13:37–52. doi:10.1177/160940691401300119
  20. Tong A, Sainsbury P, Craig J. Consolidated criteria for reporting qualitative research (COREQ): a 32‑item checklist for interviews and focus groups. Int J Qual Health Care. 2007;19(6):349–357. doi: https://doi.org/10.1093/intqhc/mzm042
  21. Nagel T. Satisfaction and quality of life: a survey-based assessment in patients with a totally implantable venous port systemic. Eur J Cancer Care (Engl). 2012;21(2):197–204. doi: https://doi.org/10.1111/j.1365-2354.2011.01275.x
  22. Braun V, Clarke V. Using thematic analysis in psychology. Qual Res Psychol. 2006;3:77–101. doi: https://doi.org/10.1191/1478088706qp063oa
  23. Braun V, Clarke V. Reflecting on reflexive thematic analysis. Qual Res Sport Exerc Health. 2019;11(4):589–597. doi: https://doi.org/10.1080/2159676X.2019.1628806
  24. Sasso L, Bagnasco A, Ghirotto L. La ricerca qualitativa. Una risorsa per i professionisti della salute. Milano: EDRA; 2015.
  25. Guion LA, Diehl DC, McDonald D. Triangulation: Establishing the Validity of Qualitative Studies. EDIS. 2011. doi: https://doi.org/10.32473/edis-fy394-2011
  26. Chan ZC, Fung Y, Chien W. Bracketing in phenomenology: only undertaken in the data collection and analysis process. Qualitative Report. 2013;18(30):1–9. doi: https://doi.org/10.46743/2160-3715/2013.1486
  27. Reid AM, Brown JM, Smith JM, et al. Ethical dilemmas and reflexivity in qualitative research. Perspect Med Educ. 2018;7:69–75. doi: https://doi.org/10.1007/s40037-018-0412-2
  28. Park EJ, Park K, Kim JJ, Oh SB, Jung KS, Oh SY, et al. Safety, efficacy, and patient satisfaction with initial peripherally inserted central catheters compared with usual intravenous access in terminally ill cancer patients: a randomized phase II study. Cancer Res Treat. 2021;53(3):881–888. doi: https://doi.org/10.4143/crt.2020.1008
  29. Arora NK, McHorney CA. Patient preferences for medical decision making. Who really wants to participate? Med Care. 2000;38(3):335–341. doi: https://doi.org/10.1097/00005650-200003000-00010
  30. Jasvinder A, Singh JA, Sloan PJ. Preferred roles in treatment decision making among patients with cancer: a pooled analysis of studies using the Control Preferences Scale. Am J Manag Care. 2010;16(9):688–696.
  31. Krist AH, Tong ST, Aycock RA, Longo DR. Engaging patients in decision‑making and behavior change to promote prevention. Stud Health Technol Inform. 2017;240:284–302. doi: https://doi.org/10.3233/ISU-170826