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Luo Y, Wang F, Duan D, Li R, Yang X, Ma D, Yuan L. Construction and validation of a scale to assess knowledge, attitude, and practice regarding vascular protection anticipatory to the creation of an arteriovenous fistula. J Vasc Access 2024:11297298241258793. [PMID: 39097788 DOI: 10.1177/11297298241258793] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/05/2024] Open
Abstract
BACKGROUND The possibility of creating an arteriovenous fistula (AVF) depends on the existence of an arterial-venous network that is in good condition, defined by the size and elasticity of the blood vessels. The knowledge, attitudes, and practices (KAP) toward vascular protection play a crucial role in preserving the vascular network for patients with end-stage renal disease (ESRD), it is observed that there is a significant lack of tools to measure these variables. Thus, the aim of this study is to develop and validate a scale to assess KAP regarding vascular protection anticipatory to the creation of an arteriovenous fistula (the KAP-VPAC-AVF Scale). METHODS Initial item development was guided by a literature review and clinical experience, after which the items were improved and perfected through the Delphi process. The content of the scale was judged by an expert panel for content validity. In a convenience sample of 551 patients with ESRD, exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) were conducted to examine the instrument's factor structure. RESULTS The KAP-VPAC-AVF Scale encompasses 11 items distributed over three factors: knowledge, attitude, and practice, demonstrated excellent internal consistency (Cronbach's alpha = 0.917) and construct validity, as confirmed by CFA with satisfactory fit indices (χ2/df = 2.394, RMSEA = 0.075, RMR = 0.049, CFI = 0.969, GFI = 0.936, AGFI = 0.892, TLI = 0.957, IFI = 0.970). CONCLUSION The KAP-VPAC-AVF Scale is a scientific and effective assessment tool that can evaluate the KAP of ESRD patients regarding measures to preserve the vascular network.
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Affiliation(s)
- Yan Luo
- Department of Nephrology, West China Hospital, Sichuan University/West China School of Nursing, Sichuan University, Chengdu, Sichuan Province, China
| | - Fang Wang
- Department of Nephrology, West China Hospital, Sichuan University/West China School of Nursing, Sichuan University, Chengdu, Sichuan Province, China
| | - Difei Duan
- Department of Nephrology, West China Hospital, Sichuan University/West China School of Nursing, Sichuan University, Chengdu, Sichuan Province, China
| | - Rao Li
- Department of Endocrinology and Metabolism, West China Hospital, Sichuan University/West China School of Nursing, Sichuan University, Chengdu, Sichuan Province, China
| | - Xiaoling Yang
- Department of Endocrinology and Metabolism, West China Hospital, Sichuan University/West China School of Nursing, Sichuan University, Chengdu, Sichuan Province, China
| | - Dengyan Ma
- Department of Nephrology, West China Hospital, Sichuan University/West China School of Nursing, Sichuan University, Chengdu, Sichuan Province, China
| | - Li Yuan
- Department of Endocrinology and Metabolism, West China Hospital, Sichuan University/West China School of Nursing, Sichuan University, Chengdu, Sichuan Province, China
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Şahan S, Yıldız A, Özdemir C, Günay İsmailoğlu E. The effect of video-based fistula care education on hemodialysis patients' self-care behaviors: A randomized controlled study. Ther Apher Dial 2023; 27:1095-1102. [PMID: 37635386 DOI: 10.1111/1744-9987.14058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2023] [Revised: 07/21/2023] [Accepted: 08/15/2023] [Indexed: 08/29/2023]
Abstract
OBJECTIVE This study aimed to determine the effect of face-to-face and video-based education for fistula care on hemodialysis patients' self-care behaviors. METHODS The study was conducted as a randomized controlled experimental study. Accordingly, 60 patients were included in the study for 95% strength. Fistula care training was given to the patients in the control group using face-to-face education technique. Fistula care training was given to the patients in the experimental group using a video-based technique. RESULTS The analysis showed that the post-test second week (p = 0.044) and fourth week (p = 0.00) mean scores of the experimental group were higher compared to those of the control group. CONCLUSION These results showed that the video-based education given to hemodialysis patients was more memorable and instructive than the verbal education, and it was observed that the video-based education showed a higher level of success in developing self-care skills.
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Affiliation(s)
- Seda Şahan
- Health Sciences Faculty, Nursing Department, Izmir Bakircay University, İzmir, Turkey
| | - Ayşegül Yıldız
- Nursing Department, Health Science High School, Cappadocia University, Nevşehir, Turkey
| | - Cevriye Özdemir
- İncesu Vocational School, Department of Medical Services and Techniques, Dialysis Program, Kayseri University, Kayseri, Turkey
| | - Elif Günay İsmailoğlu
- Health Sciences Faculty, Nursing Department, Izmir Bakircay University, İzmir, Turkey
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Sousa CN, Teles P, Ribeiro OMPL, Sousa R, Lira MN, Delgado E, Oliveira D, Campos L, Fernandes F, Moura SCM, Delgado MF, Sá TG, Teixeira SMP, Souza LH, Ribeiro RCHM, Oliveira GFN, Mendonça AEO, Ozen N. How to choose the appropriate cannulation technique for vascular access in hemodialysis patients. Ther Apher Dial 2023; 27:394-401. [PMID: 36717974 DOI: 10.1111/1744-9987.13973] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2022] [Revised: 01/20/2023] [Accepted: 01/23/2023] [Indexed: 02/01/2023]
Abstract
The cannulation technique is important for the survival of the arteriovenous access. Choosing the appropriate technique is a complex decision. Such choice must be customized to patients, considering their characteristics, the type of arteriovenous access and the experience of the hemodialysis team. We describe seven items that can help nurses to identify the appropriate cannulation technique: type of arteriovenous access; drainage vein; hygienic self-care profile; experience of the nursing staff in the cannulation technique and nurse-to-patient ratio; hemodialysis treatment method; patient's condition; and patient's decision. Such items can help nurses in decision-making on the "ideal" cannulation technique for each patient.
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Affiliation(s)
- Clemente Neves Sousa
- S Francisco Dialysis Unit, Porto, Portugal.,CINTESIS-Center for Health Technology and Services Research Faculty of Medicine, Porto University, Porto, Portugal.,Nursing School of Porto, Porto, Portugal
| | - Paulo Teles
- School of Economics and LIAAD-INESC Porto LA, Porto University, Porto, Portugal
| | - Olga Maria Pimenta Lopes Ribeiro
- CINTESIS-Center for Health Technology and Services Research Faculty of Medicine, Porto University, Porto, Portugal.,Nursing School of Porto, Porto, Portugal
| | - Rui Sousa
- CINTESIS-Center for Health Technology and Services Research Faculty of Medicine, Porto University, Porto, Portugal
| | | | | | | | | | | | - Sandra Cristina Mendo Moura
- CINTESIS-Center for Health Technology and Services Research Faculty of Medicine, Porto University, Porto, Portugal.,Mogadouro Dialysis Unit-TECSAM; Unidade de Local Saúde Nordeste, Bragança, Portugal
| | - Millena Freire Delgado
- CINTESIS-Center for Health Technology and Services Research Faculty of Medicine, Porto University, Porto, Portugal
| | | | | | - Lara Helk Souza
- Medical School of São José do Rio Preto (FAMERP), São Paulo, Brazil
| | | | | | | | - Nurten Ozen
- Florence Nightingale Hospital School of Nursing, Demiroglu Bilim University, Istanbul, Turkey
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Wang B, Hu Y. Treatment of arteriovenous fistula with aneurysm using the forearm branch of the cephalic vein as a candidate vessel: A case report. Medicine (Baltimore) 2023; 102:e32715. [PMID: 36701717 PMCID: PMC9857457 DOI: 10.1097/md.0000000000032715] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/27/2023] Open
Abstract
BACKGROUND Arteriovenous fistula (AVF) is the preferred vascular access for hemodialysis patients due to its better patency rates and fewer complications than other access types. However, some complications related to AVF could not be ignored, including swollen hands and an aneurysm. Although a patient could not continue hemodialysis, it might threaten the patient's life if the rupture of the aneurysm is not immediately treated by the surgeon. A report of using the cephalic vein branch to treat this complication is uncommon. CASE PRESENTATION Herein, we present a case of a 42-year-old man in whom an AVF with an aneurysm was successfully treated using the excess cephalic vein branch. This method is a simple and effective intervention for managing aneurysm-associated complications. Additionally, this approach helps maintain the benefits of autogenous access while conserving future dialysis sites. CONCLUSION The surgery was effective and safe for this kind of complication with swollen hands and aneurysm. Using the excess cephalic vein branch could reconstruct the AVF.
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Affiliation(s)
- Bo Wang
- Division of Nephrology, West China Hospital of Sichuan University, Chengdu, China
| | - Ying Hu
- Division of Nephrology, West China Hospital of Sichuan University, Chengdu, China
- Department of Nephrology, People’s Hospital of Guizhou Province, Guiyang, China
- * Correspondence: Ying Hu, Nephrology Department, Division of Nephrology, People’s Hospital of Guizhou Province, Guiyang 550002, China (e-mail:)
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Sousa H, Bártolo A, Ribeiro O, Figueiredo D. A family-centred perspective on the arteriovenous fistula in end-stage renal disease: Findings from dyadic interviews. Scand J Caring Sci 2021; 36:426-438. [PMID: 34921431 DOI: 10.1111/scs.13055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2021] [Accepted: 12/05/2021] [Indexed: 11/29/2022]
Abstract
INTRODUCTION The preservation of a well-functioning arteriovenous fistula (AVF) is crucial for successful dialysis in patients with end-stage renal disease (ESRD); nonetheless, complications are frequent which leads to lower quality of life, hospitalisations and death. Self-care behaviours help to reduce the risk of complications and family caregivers can play an important role as partners for behaviour change. However, the patient and family caregiver's experiences with such an invasive intervention are largely unknown. AIMS This study aimed to explore the experiences of patients with ESRD and their family caregivers with the AVF through joint interviews. METHODS A qualitative exploratory study was conducted with a purposive sample. Semi-structured joint interviews were conducted with 14 dyads (28 participants) composed of patients on haemodialysis with AVF and their respective family caregivers. Interviews were audiotaped, transcribed verbatim and submitted to thematic analysis. FINDINGS Four major themes were identified: (i) AVF negative impacts; (ii) (un)presence of self-care behaviours; (iii) AVF self-management facilitators and (iv) AVF self-management barriers. DISCUSSION The findings suggested that more attention needs to be paid to patients' and their family caregivers' support needs (e.g. fears, concerns, knowledge, adherence barriers and facilitators) regarding AVF self-management. The dyads seem to be aware of how to take care of the AVF; however, self-care behaviours still need to be improved. CONCLUSION Innovative interventions need to follow an interdisciplinary approach with an educational and support component. The integration of family caregivers should also be considered, since this study evidenced their lack of knowledge and skills, and willingness to participate in these initiatives.
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Affiliation(s)
- Helena Sousa
- Center for Health Technology and Services Research (CINTESIS.UA), Department of Education and Psychology, University of Aveiro (Campus Universitário de Santiago), Aveiro, Portugal
| | - Ana Bártolo
- Center for Health Technology and Services Research (CINTESIS.UA), Piaget Institute - ISEIT/Viseu, (Estrada do Alto do Gaio), Aveiro, Portugal
| | - Oscar Ribeiro
- Center for Health Technology and Services Research (CINTESIS.UA), Department of Education and Psychology, University of Aveiro (Campus Universitário de Santiago), Aveiro, Portugal
| | - Daniela Figueiredo
- Center for Health Technology and Services Research (CINTESIS.UA), School of Health Sciences, University of Aveiro (Campus Universitário de Santiago), Aveiro, Portugal
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Grubbs V, Jaar BG, Cavanaugh KL, Ephraim PL, Ameling JM, Cook C, Greer RC, Boulware LE. Impact of pre-dialysis nephrology care engagement and decision-making on provider and patient action toward permanent vascular access. BMC Nephrol 2021; 22:60. [PMID: 33593328 PMCID: PMC7885501 DOI: 10.1186/s12882-021-02264-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2020] [Accepted: 01/13/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND While catheters are often thought the result of emergency hemodialysis (HD) initiation among patients with little or no pre-dialysis nephrology care, the role of patient level of engagement in care and modality decision-making have not been fully explored. METHODS This is a retrospective medical record review of adults (age 18-89 years) who received care in academically affiliated private practice, public hospital, or Veterans Administration settings prior to initiating HD with a catheter between 10/1/2011 and 9/30/2012. Primary predictors were level of patient engagement in nephrology care within 6 months of HD initiation and timing of modality decision-making. Primary outcomes were provider action (referral) and any patient action (evaluation by a vascular surgeon, vein mapping or vascular surgery) toward [arteriovenous fistula or graft, (AVF/AVG)] creation. RESULTS Among 92 incident HD patients, 66% (n = 61) initiated HD via catheter, of whom 34% (n = 21) had ideal engagement in care but 42% (n = 25) had no documented decision. Providers referred 48% (n = 29) of patients for AVF/AVG, of whom 72% (n = 21) took any action. Ideal engagement in care predicted provider action (adjusted OR 13.7 [95% CI 1.08, 175.1], p = 0.04), but no level of engagement in care predicted patient action (p > 0.3). Compared to patients with no documented decision, those with documented decisions within 3, 3-12, or more than 12 months before initiating dialysis were more likely to have provider action toward AVF/AVG (adjusted OR [95% CI]: 9.0 [1.4,55.6], p = 0.2, 37.6 [3.3423.4] p = 0.003, and 4.8 [0.8, 30.6], p = 0.1, respectively); and patient action (adjusted OR [95% CI]: 18.7 [2.3, 149.0], p = 0.006, 20.4 [2.6, 160.0], p = 0.004, and 6.2 [0.9, 44.0], p = 0.07, respectively). CONCLUSIONS Timing of patient modality decision-making, but not level of engagement in pre-dialysis nephrology care, was predictive of patient and provider action toward AVF/AVG Interventions addressing patients' psychological preparation for dialysis are needed.
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Affiliation(s)
- Vanessa Grubbs
- Division of Nephrology, San Francisco/ San Francisco General Hospital Renal Center, University of California, Box 1341, 1001 Potrero Avenue, Bldg 100, Room 342, San Francisco, CA, 94110, USA.
| | - Bernard G Jaar
- Department of Medicine, Johns Hopkins School of Medicine, Baltimore, MD, USA.,Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.,Welch Center for Prevention, Epidemiology and Clinical Research, Johns Hopkins University, Baltimore, MD, USA.,Nephrology Center of Maryland, Baltimore, MD, USA
| | - Kerri L Cavanaugh
- Division of Nephrology & Hypertension, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Patti L Ephraim
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.,Welch Center for Prevention, Epidemiology and Clinical Research, Johns Hopkins University, Baltimore, MD, USA
| | - Jessica M Ameling
- Department of Internal Medicine, University of Michigan Medical School, Ann Arbor, MI, USA.,Patient Safety Enhancement Program, University of Michigan and VA Ann Arbor Healthcare System, Ann Arbor, MI, USA
| | - Courtney Cook
- Department of Medicine, Johns Hopkins School of Medicine, Baltimore, MD, USA.,Welch Center for Prevention, Epidemiology and Clinical Research, Johns Hopkins University, Baltimore, MD, USA
| | - Raquel C Greer
- Department of Medicine, Johns Hopkins School of Medicine, Baltimore, MD, USA.,Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.,Welch Center for Prevention, Epidemiology and Clinical Research, Johns Hopkins University, Baltimore, MD, USA
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Costa Pessoa NR, de Souza Soares Lima LH, Dos Santos GA, de Queiroz Frazão CMF, Sousa CN, Ramos VP. Self-care actions for the maintenance of the arteriovenous fistula: An integrative review. Int J Nurs Sci 2020; 7:369-377. [PMID: 32817861 PMCID: PMC7424158 DOI: 10.1016/j.ijnss.2020.06.007] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2019] [Revised: 06/02/2020] [Accepted: 06/11/2020] [Indexed: 11/28/2022] Open
Abstract
Objective To identify self-care actions for the maintenance of arteriovenous fistula of renal patients. Method An integrative review study was conducted and literature were searched in Medline/PubMed, Scopus, CINAHL, LILACS, BDENF and SciELO Library databases using the descriptors chronic renal insufficiency, arteriovenous fistula, self-care, and knowledge. The inclusion criteria were that the documents be written in Portuguese, English, and Spanish, full text available, published in the last five years, and that they address the research question. Reflection articles, theses, dissertations, editorials of non-scientific journals, and research studies that did not follow the necessary methodological rigor were excluded. Data were analyzed with the IRAMUTEQ software. Results Fifteen articles were selected and comprised the final sample. Seven classes of self-care actions emerged from the text segments analysis and grouped into three categories: 1) Self-care actions that maintain the arteriovenous fistula; 2) Self-care actions for the prevention and the monitoring of complications with arteriovenous fistula; 3) Self-care actions directed at the perioperative period of arteriovenous fistula preparation. Conclusion The results allowed us to identify important care for the maintenance of arteriovenous fistula functionality. The self-care actions identified in this study can guide a nursing care policy for implementation with protocols that help identify problems related to self-care actions and, thus, subsidize the development of actions aimed at the renal patient. However, more studies with high levels of evidence that identify self-care actions with arteriovenous fistula and the factors involved in its implementation are needed.
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Affiliation(s)
| | | | | | | | - Clemente Neves Sousa
- Center for Health Technology and Services Research, Faculty of Medicine (CINTESIS), Porto University, Nursing School of Porto, Portugal
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