1
|
Dilbilir Y, Kavurmaci M. Determining the effect of arteriovenous fistula care training on the self-care behaviors of hemodialysis patients. Ther Apher Dial 2024. [PMID: 38872366 DOI: 10.1111/1744-9987.14174] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2023] [Revised: 04/05/2024] [Accepted: 05/27/2024] [Indexed: 06/15/2024]
Abstract
INTRODUCTION The aim was to determine the effect of arteriovenous fistula (AVF) care training given to hemodialysis (HD) patients on the self-care behaviors of patients. METHODS The randomized controlled experimental study was conducted in the HD unit. The study was carried out with a total of 66 patients. Patients in the intervention group were trained using the AVF Care Education Book for 4 weeks. The study data were collected using the scale for evaluating self-care behaviors related to AVF in HD patients (ASBHD-AVF). Shapiro-Wilk and Kolmogorov-Smirnov tests, independent t-tests, and ANOVA were used in the SPSS 25.0 package program. RESULTS As a result of the research, it was determined that the average ASBHD-AVF score of the patients in the trained intervention group increased from 54.52 ± 7.41 to 73.77 ± 3.05 (p <0.05). The mean ASBHD-AVF score of the patients in the control group increased from 56.14 ± 4.51 to 58.14 ± 5.93 (p >0.05). When the difference between the two groups was examined, it was determined that the average ASBHD-AVF score of the patients in the intervention group was statistically significantly higher than the control group (p <0.05). CONCLUSION AVF care education given to HD patients improves patients' self-care behaviors. Improved fistula self-care behaviors of patients will contribute to the healthy functioning of the AVF and the effective HD treatment of patients.
Collapse
Affiliation(s)
- Yakup Dilbilir
- Bitlis Eren University, Faculty of Health Sciences, Department of Nursing, Bitlis, Turkey
| | - Mehtap Kavurmaci
- Nursing Faculty, Department of Internal Medicine Nursing, Atatürk University, Erzurum, Turkey
| |
Collapse
|
2
|
Sousa CN, Teles P, Sousa R, Cabrita F, Ribeiro OMPL, Delgado E, Coutinho S, Moura SCM, Delgado MF, Costa JF, Sá TG, Teixeira SMP, Mendonça AEO, Ozen N. Hemodialysis vascular access coordinator: Three-level model for access management. Semin Dial 2024; 37:85-90. [PMID: 37026486 DOI: 10.1111/sdi.13153] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2023] [Revised: 03/22/2023] [Accepted: 03/26/2023] [Indexed: 04/08/2023]
Abstract
Management of vascular access is a challenge for the dialysis team, particularly to keep the arteriovenous access working. The vascular access coordinator can positively contribute to increase the number of arteriovenous fistulas and reduce central venous catheters. In this article, we introduce a new approach to vascular access management centered on (the results of setting up) the role of vascular access coordinator. We described the three-level model (3Level_M) for vascular access management organized in three levels: vascular access nurse manager, vascular access coordinator, and vascular access consultant. We defined the instrumental skills and training required to be developed by each element and clarify the articulation between the model and all members of the dialysis team related to vascular access.
Collapse
Affiliation(s)
- Clemente Neves Sousa
- S Francisco Dialysis Unit, Porto, Portugal
- CINTESIS@RISE, Porto University, Porto, Portugal
- Nursing School of Porto, Porto, Portugal
| | - Paulo Teles
- School of Economics and LIAAD-INESC Porto LA, Porto University, Porto, Portugal
| | - Rui Sousa
- CINTESIS@RISE, Porto University, Porto, Portugal
| | | | | | | | | | - Sandra Cristina Mendo Moura
- CINTESIS@RISE, Porto University, Porto, Portugal
- Mogadouro Dialysis Unit, TECSAM, Mogadouro, Bragança, Portugal
- Unidade Local Saúde Nordeste, EPE, Bragança, Portugal
| | | | | | | | | | | | - Nurten Ozen
- Florence Nightingale Hospital School of Nursing, Demiroglu Bilim University, Istanbul, Turkey
| |
Collapse
|
3
|
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.
Collapse
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
| |
Collapse
|
4
|
Sousa CN, Teles P, Paquete ARC, Dias VFF, Manzini CSS, Nicole AG, Sousa RASS, de Souza LH, Ribeiro OMPL, Lira MN, de Queiroz Frazão CMF, Ramos VP, Leal L, Ribeiro RCHM, Magalhães ALP, de Sá Basílio Lins SM, Mendonça AEO, Delgado MF, Pressi MMT, Pressi NT, Campos L, Ozen N. Effects of Demographic and Clinical Character on Differences in Self-care Behaviour Levels with Arteriovenous Fistula by Haemodialysis Patients: An Ordinal Logistic Regression Approach. Ther Apher Dial 2022; 26:992-998. [PMID: 34981641 DOI: 10.1111/1744-9987.13788] [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: 06/01/2021] [Revised: 12/07/2021] [Accepted: 12/29/2021] [Indexed: 11/30/2022]
Abstract
INTRODUCTION Haemodialysis (HD) patients should be trained to develop self-care behaviors in order to prevent and preserve their arteriovenous fistula (AVF). The aim of this study was identifying the factors that affect the levels of self-care behavior with AVF by HD patients. METHODS A cross-sectional study was conducted involving 89 patients. RESULTS Self-care levels were negatively affected by patients' location (Azores) and positively affected by marital status, education, employment, AVF duration and absence of complications with the AVF. Concerning the management of signs and symptoms, self-care levels were negatively affected by patients' location. Regarding prevention of complications, self-care levels were negatively affected by age and marital status and positively affected by marital status, employment, CKD etiology, AVF duration and previous AVF. CONCLUSION Further studies are required in order to confirm whether the considered factors affect levels of self-care behaviors with AVF, or whether other factors are needed as well.
Collapse
Affiliation(s)
- Clemente Neves Sousa
- CINTESIS - Center for Health Technology and Services Research Faculty of Medicine, Porto University.,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.,Nursing School of Porto, Porto, Portugal
| | | | | | | | - Luciana Leal
- Federal University of Pernambuco, Recife, Brazil
| | | | | | | | | | | | | | | | | | - Nurten Ozen
- Florence Nightingale Hospital School of Nursing, Demiroglu Bilim University, Istanbul, Turkey
| |
Collapse
|
5
|
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.
Collapse
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
| |
Collapse
|
6
|
Lira MN, Sousa CN, Wanderley MCM, Pessoa NRC, Lemos KCR, Manzini CSS, Nicole AG, Morais SCRV, Frazão CMFDQ, Ramos VP, Teles P, Ribeiro OMPL, Dias VFF, de Souza LH, Ribeiro RCHM, Magalhães ALP, de Sá Basílio Lins SM, Pressi MMT, Dourado PBM, Delgado MF, Mendonça AEO, Pinheiro JAA, Ozen N. Scale of Assessment of Self-Care Behaviors with Arteriovenous Fistula in Hemodialysis: A Psychometric Study in Brazil. Clin Nurs Res 2021; 30:875-882. [PMID: 33491487 DOI: 10.1177/1054773821989800] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
The purpose of this study was to evaluate the psychometric properties of the Brazilian Scale for the Assessment of Self-Care Behaviors with Arteriovenous Fistula in Hemodialysis. Cross-sectional validation study, followed the recommendation provided by Sousa and Rojjanasrirat. Content validity, explanatory and confirmatory factor analyses used to check validity and Cronbach's alpha was the reliability measure. Three hundred hemodialysis patients with arteriovenous fistula were included in the study. The expert committee assessed the content validity. Exploratory factor analysis confirmed the same two-factor structure found for the original scale, explaining 60.10% of the variance. Such solution was checked by confirmatory factor analysis with Cronbach's alpha equal to 0.920, 0.810, and 0.884 for the overall scale, the self-care in management of signs and symptoms and the self-care in prevention of complications subscales respectively. The scale has good psychometric properties to assess self-care behaviors and can be used with Brazilian patients on hemodialysis with arteriovenous fistula.
Collapse
Affiliation(s)
- Marta Nunes Lira
- Getúlio Vargas Hospital, Recife, Brazil and UNISÃOMiguel Centro Universitário, Recife, Brazil
| | - Clemente Neves Sousa
- Nursing School of Porto, Porto, Portugal.,CINTESIS-Center for Health Technology and Services Research Faculty of Medicine, University of Porto, Porto, Portugal
| | | | | | | | | | - Andressa Garcia Nicole
- Espírito Santo Federal University, Espírito Santo, Brazil and School of Nursing University of São Paulo, Espírito, Brazil
| | | | | | | | - Paulo Teles
- School of Economics and LIAAD-INESC Porto LA, University of Porto, Porto, Portugal
| | - Olga Maria Pimenta Lopes Ribeiro
- Nursing School of Porto, Porto, Portugal.,CINTESIS-Center for Health Technology and Services Research Faculty of Medicine, University of Porto, Porto, Portugal
| | - Vanessa Filipa Ferreira Dias
- Institute of Health Sciences of Porto, University of Católica Porto, Porto, Portugal.,Unidade de Saúde Familiar Santo André de Canidelo, Vila Nova de Gaia, Portugal
| | - Lara Helk de Souza
- Faculty of Medicine of São José do Rio Preto (FAMERP), São Paulo, Brazil
| | | | | | | | | | | | | | | | | | - Nurten Ozen
- Florence Nightingale Hospital School of Nursing, Demiroglu Bilim University, Istanbul, Turkey
| |
Collapse
|
7
|
Sousa CN, Paquete ARC, Teles P, Pinto CMCB, Dias VFF, Ribeiro OMPL, Manzini CSS, Nicole AG, Souza LH, Ozen N. Investigating the Effect of a Structured Intervention on the Development of Self-Care Behaviors With Arteriovenous Fistula in Hemodialysis Patients. Clin Nurs Res 2020; 30:866-874. [PMID: 33269608 DOI: 10.1177/1054773820974834] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
This study aimed to assess the effectiveness of a structured intervention on the frequency of self-care behaviors with arteriovenous fistula (AVF) by patients on hemodialysis. This is a quasi-experimental study with pre- and post-measurements. Participants were assigned to an intervention group (IG) (n = 48) or to a control group (CG) (n = 41). IG patients were subject to a structured intervention on self-care with AVF (SISC-AVF) consisting of both a theoretical and a practical part. After SISC-AVF application, patients in the IG showed better overall self-care behaviors with AVF than patients in the CG (79.2% and 91.4%, respectively, p < .001) as well as better self-care concerning both the management of signs and symptoms (90.1% and 94.4% respectively, p = .004) and the prevention of complications (72.7% and 89.5%, respectively, p < .001). The study results suggest that the SISC-AVF had positive effects on patients in the IG.
Collapse
Affiliation(s)
- Clemente Neves Sousa
- 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, University of Porto and LIAAD-INESC Porto LA, Porto, Portugal
| | - Cristina Maria Correia Barroso Pinto
- CINTESIS-Center for Health Technology and Services Research Faculty of Medicine, Porto University, Porto, Portugal.,Nursing School of Porto, Porto, Portugal
| | - Vanessa Filipa Ferreira Dias
- Institute of Health Sciences, Católica University, Lisbon, Portugal.,Unidade de Saúde Familiar St. André de Canidelo, Vila Nova de Gaia, 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
| | | | | | - Lara Helk Souza
- Faculdade Medicina São José Rio Preto (FAMERP), São josé do Rio Preto, Brazil
| | - Nurten Ozen
- Florence Nightingale Hospital School of Nursing, Demiroglu Bilim University, Istanbul, Turkey
| |
Collapse
|
8
|
İkiz SN, Usta YY, Sousa CN, Teles P, Dias VFF, Magalhães ALP, de Sá Basílio Lins SM, Ribeiro OMPL. Validation of the scale of assessment of self-care behaviours for arteriovenous fistula in patients ongoing haemodialysis in Turkey. J Ren Care 2020; 47:279-284. [PMID: 33140539 DOI: 10.1111/jorc.12354] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2020] [Revised: 09/19/2020] [Accepted: 09/29/2020] [Indexed: 11/27/2022]
Abstract
BACKGROUND Several guidelines recommend that patients with chronic kidney disease treated by haemodialysis (HD) take care of their own arteriovenous fistula (AVF). The dialysis nurse plays an important role in the development of such self-care behaviours. A very small number of instruments are available to assess self-care behaviours with AVF in Turkey. OBJECTIVE Cultural adaptation and psychometric testing of the Turkish version of the scale of assessment of self-care behaviours with arteriovenous fistula in haemodialysis (ASBHD-AVF) patients. DESIGN Cross-sectional validation study. PARTICIPANTS AND MEASUREMENTS This study was conducted involving 160 patients in the Bolu region in Turkey. The guidelines provided by Sousa and Rojjanasrirat were taken into account in the scale translation, adaptation and validation process. Validity was analysed through content validity and construct validity. The latter was measured through principal component analysis with varimax rotation, considering only factor loadings of 0.30 or larger. Reliability analysis was based on internal consistency measured by Cronbach's α. RESULTS A two-factor structure was extracted explaining 59.01% of the total variance. Cronbach's α was 0.91, 0.85 and 0.84 for the overall scale, the self-care in prevention of complications subscale and the self-care in management of signs and symptoms subscale, respectively. CONCLUSIONS The Turkish version of the scale of ASBHD-AVF patients is a reliable and valid instrument and can therefore be used.
Collapse
Affiliation(s)
| | | | - Clemente Neves Sousa
- 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, University of Porto, Porto, Portugal
| | - Vanessa Filipa Ferreira Dias
- Institute of Health Sciences, University Católica Porto, Porto, Portugal.,Unidade de Saúde Familiar Santo André de Canidelo, Vila Nova de Gaia, 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
| |
Collapse
|
9
|
Fadlalmola HA, Elkareem EMA. Impact of an educational program on knowledge and quality of life among hemodialysis patients in Khartoum state. INTERNATIONAL JOURNAL OF AFRICA NURSING SCIENCES 2020. [DOI: 10.1016/j.ijans.2020.100205] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
|
10
|
Construction and validation of content of a video on self-care with arteriovenous fistula. ENFERMERIA CLINICA 2019; 30:317-325. [PMID: 30954393 DOI: 10.1016/j.enfcli.2018.12.012] [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: 04/07/2018] [Accepted: 12/05/2018] [Indexed: 11/22/2022]
Abstract
OBJECTIVE To validate the content of the script of an educational video to promote self-care with arteriovenous fistula in chronic renal patients with nurses and social communicators. METHOD Methodological study that constructed and validated an educational video. Firstly, the demands of self-care were identified through a literature review on self-care with arteriovenous fistula. Then the construction of the video followed the steps of pre-production, production and post-production. The script's content validation occurred in the pre-production phase and counted on 22 nursing judges and media professionals. The study was approved by the Ethics Committee in Research, under opinion 61705516.0.0000.5208. RESULTS The following items received a negative evaluation from the judges: "The scenes described reflect stereotypes or discrimination" (p = 0.008) and "The pace of the scenes is tiring" (p = 0.001/p = 0.034), "The characters/images are appealing to the audience (p = 0.006), "The illustrations reflect important aspects of subject under study" (p = 0.006), "The illustrations promote the understanding of the video message" (p = 0.001) and "The general structure is creative" (p = 0.001). CONCLUSION The educational video was considered valid by the nursing judges and media professionals to promote self-care with arteriovenous fistula among renal patients.
Collapse
|
11
|
Sousa CN, Marujo P, Teles P, Lira MN, Dias VFF, Novais MELM. Self-Care Behavior Profiles With Arteriovenous Fistula in Hemodialysis Patients. Clin Nurs Res 2018; 29:363-367. [DOI: 10.1177/1054773818787110] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Patients with end-stage renal disease should be educated and trained to take care of their own arteriovenous fistula (AVF) with the purpose of developing self-care behaviors concerning vascular access. This was a prospective and observational study. We designed this research to identify clinically meaningful self-care behavior profiles in hemodialysis (HD) patients, and it was carried out in a private dialysis unit in the Lisbon region, Portugal, involving 101 patients. The proportion of male patients was 66.3%, the mean age was 60.9 years, and the frequency of self-care behaviors was 71%. Cluster analysis based on the subscale scores grouped patients in two clusters named “moderate self-care” and “high self-care.” Those profiles exhibit significant differences concerning gender, education, employment, dialysis vintage, AVF duration, and information on care with the AVF. Identification of self-care-behavior profiles in HD patients with AVF enables one to adjust education programs to the patients’ characteristics.
Collapse
Affiliation(s)
- Clemente Neves Sousa
- Center for Health Technology and Services Research Faculty of Medicine (CINTESIS), Porto University, Portugal
- Nursing School of Porto, Portugal
| | | | - Paulo Teles
- School of Economics and LIAAD-INESC Porto, Porto University, Portugal
| | | | - Vanessa Filipa Ferreira Dias
- Institute of Health Sciences, University Católica Porto, Portugal
- Unidade de Saúde Familiar Santo André de Canidelo, Vila Nova de Gaia, Portugal
| | | |
Collapse
|
12
|
Sousa CN, Ligeiro I, Teles P, Paixão L, Dias VF, Cristovão AF. Self-care in Preserving the Vascular Network: Old Problem, New Challenge for the Medical Staff. Ther Apher Dial 2018; 22:332-336. [PMID: 29573146 DOI: 10.1111/1744-9987.12664] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2017] [Revised: 11/26/2017] [Accepted: 12/01/2017] [Indexed: 12/01/2022]
Abstract
Teaching/educating patients with end stage renal disease (ESRD) and identifying their self-care behaviors for vascular network preservation are very important. However, the self-care behaviors regularly performed by patients are still unknown. We compared self-care behaviors for vascular network preservation performed by patients who are/are not followed-up by the nephrologist. The study design was a prospective, observational and comparative study. Inclusion criteria were as follows: ESRD patients (at stages 4 or 5); at least 18 years old; in pre-dialysis with at least a 6-month follow-up period by the nephrologist or who started dialysis in emergency and were not followed-up by the nephrologist; with no memory problems; and medically stable. Primary outcome was the frequency of self-care behaviors for vascular network preservation. Secondary outcome was the comparison between self-care behaviors by ESRD patients who were/were not followed-up by the nephrologist. The study involved 145 patients, 64.1% were female, the mean age was 69.5 years and the self-care behaviors mean score was 36.8% (with a SD of 39.8%). The number of patients followed-up and not followed-up by the nephrologist was 109 (group 1) and 36 (group 2), respectively. Social characteristics were similar in the two groups (P > 0.05). The mean self-care behaviors were 29.4% and 59.2% in groups 1 and 2, respectively (P = 0.000). Patients performed self-care behaviors for vascular network preservation with a relatively low frequency (the mean score was 36.8% only). Patients not followed by the nephrologist performed self-care behaviors more often than those who were followed (59.2% vs. 29.4% respectively, P = 0.000).
Collapse
Affiliation(s)
- Clemente N Sousa
- 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, University of Porto, Porto, Portugal
| | - Lúcia Paixão
- Centro Hospitalar Lisboa Central, Lisbon, Portugal
| | - Vanessa Ff Dias
- Institute of Health Sciences, Católica University, Porto, Portugal.,Unidade de Saúde Familiar St. André de Canidelo, Vila Nova de Gaia, Porto, Portugal
| | | |
Collapse
|
13
|
Sousa CN, Marujo P, Teles P, Lira MN, Novais MELM. Self-Care on Hemodialysis: Behaviors With the Arteriovenous Fistula. Ther Apher Dial 2017; 21:195-199. [DOI: 10.1111/1744-9987.12522] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2016] [Revised: 11/22/2016] [Accepted: 11/29/2016] [Indexed: 11/30/2022]
Affiliation(s)
- Clemente Neves Sousa
- Nursing School of Porto; Porto Portugal
- CINTESIS - Center for Health Technology and Services Research Faculty of Medicine; Porto University; Porto Portugal
| | | | - Paulo Teles
- School of Economics and LIAAD-INESC Porto LA; Porto University; Porto Portugal
| | - Marta Nunes Lira
- SOS Renal Service, Olinda Pernambuco, Brasil and Nursing Master student; Federal University of Pernambuco; Recife Brazil
| | | |
Collapse
|
14
|
Investigation of the knowledge and attitudes of patients who are undergoing hemodialysis treatment regarding their arteriovenous fistula. J Vasc Access 2016; 18:64-68. [DOI: 10.5301/jva.5000618] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/18/2016] [Indexed: 01/01/2023] Open
Abstract
Purpose The major cause of morbidity in hemodialysis patients is arteriovenous fistula deficiency. The patient should have adequate knowledge to ensure arteriovenous fistula patency. Our aim is to investigate the knowledge and attitude of the patients undergoing hemodialysis treatment regarding arteriovenous fistula. Methods This study was conducted on 335 patients who met the study criteria. Data collection forms evaluating the “Socio-Demographic and Medical Characteristics” and “Knowledge and Attitudes about arteriovenous fistula” of the patients were developed following a literature review by the investigators. Results The rules most known and implemented were “to not measure blood pressure” and “to not draw blood from arms with fistula”, while the least known and implemented were “to use blood vessels on the hands in arms without fistula for intravenous intervention” and “to know which situations cause hypotension”. Conclusions Hemodialysis patients with arteriovenous fistulas need to know that developing self-care behavior is a means to reconcile lifestyles with current health status. Accordingly, planned training in self-care should be provided to hemodialysis patients and their families, and nurses should repeat information to patients who demonstrate a lack of knowledge.
Collapse
|
15
|
Sousa CN, Figueiredo MH, Dias VF, Teles P, Apóstolo JL. Construction and validation of a scale of assessment of self-care behaviours anticipatory to creation of arteriovenous fistula. J Clin Nurs 2015; 24:3674-80. [PMID: 26420742 DOI: 10.1111/jocn.12970] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/04/2015] [Indexed: 11/27/2022]
Abstract
AIMS AND OBJECTIVES We developed a scale to assess the self-care behaviours developed by patients with end-stage renal disease to preserve the vascular network prior to construction of arteriovenous fistula. BACKGROUND The possibility of creation of an arteriovenous fistula depends on the existence of an arterial and venous network in good condition, namely the size and elasticity of the vessels. It is essential to teach the person to develop self-care behaviours for the preservation of the vascular network, regardless of the modality of dialysis selected. DESIGN Methodological study. METHODS The scale was developed based on clinical experience and research conducted by the researcher in the area of the vascular access for haemodialysis. The content of the scale was judged by two panels of experts for content validity. The revised version of the scale was administered to a convenience sample of 90 patients with end-stage renal disease. In the statistical analysis, we used the Cronbach's alpha, the Kaiser-Meyer-Olkin and scree plot and the principal component analysis with varimax rotation. RESULTS A principal component analysis confirmed the univariate structure of the scale (KMO = 0·759, Bartlett's sphericity test-approximate χ(2) 142·201, p < 0·000). Cronbach's α is 0·831, varying between 0·711-0·879. CONCLUSION This scale revealed properties that allow its use to assess the patients self-care behaviours regarding the preservation of the vascular network. RELEVANCE TO CLINICAL PRACTICE This scale can be used to evaluate educational programmes for the development of self-care behaviours in the preservation of vascular network. This scale can identify not only the patients that are able to take care of their vascular network but also the proportion of patients who are not able to do it, that need to be educated.
Collapse
Affiliation(s)
- Clemente Neves Sousa
- Escola Superior Enfermagem Porto (Nursing Scholl of Porto), Porto, Portugal.,Diaverum Portugal, Coimbra, Portugal
| | | | - Vanessa Filipa Dias
- Institute of Health Sciences, Católica University, Porto, Portugal.,Unidade de Saúde Familiar St. André de Canidelo, Vila Nova de Gaia, Portugal
| | - Paulo Teles
- School of Economics and LIAAD-INESC Porto LA, Porto University, Porto, Portugal
| | | |
Collapse
|
16
|
van der Veer SN, Haller MC, Pittens CACM, Broerse J, Castledine C, Gallieni M, Inston N, Marti Monros A, Peek N, van Biesen W. Setting Priorities for Optimizing Vascular Access Decision Making--An International Survey of Patients and Clinicians. PLoS One 2015; 10:e0128228. [PMID: 26151822 PMCID: PMC4494812 DOI: 10.1371/journal.pone.0128228] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2015] [Accepted: 04/07/2015] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Many decisions around vascular access for haemodialysis warrant a collaborative treatment decision-making process, involving both clinician and patient. Yet, patients' experiences in this regard have been suboptimal. Although clinical practice guidelines could facilitate collaborative decision making, they often focus on the clinicians' side of the process, while failing to address the patients' perspective. The objective of this study was to explore and compare kidney patients' and clinicians' views on what vascular access-related decisions deserved priority for developing guidelines that will contribute to optimizing collaborative decision making. METHODS In the context of updating their vascular access guideline, European Renal Best Practice surveyed an international panel of 85 kidney patients, 687 nephrologists, 194 nurses, and 140 surgeons/radiologists. In an electronic questionnaire, respondents rated 42 vascular access-related topics on a 5-point Likert scale. Based on mean standardized ratings, we compared priority ratings between patients and each clinician group. RESULTS Selection of access type and site, as well as prevention of access infections received top priority across all respondent groups. Patients generally assigned higher priority to decisions regarding managing adverse effects of arteriovenous access and patient involvement in care, while clinicians more often prioritized decisions around sustaining patients' access options, technical aspects of access creation, and optimizing fistula maturation and patency. CONCLUSION Apart from identifying the most pressing knowledge gaps, our study provides pointers for developing guidelines that may improve healthcare professionals' understanding of when to involve patients along the vascular access pathway.
Collapse
Affiliation(s)
- Sabine N. van der Veer
- European Renal Best Practice (ERBP) Methods Support Team, University hospital Ghent, Ghent, Belgium
- Health e-Research Centre, Institute of Population Health, University of Manchester, Manchester, United Kingdom
| | - Maria C. Haller
- European Renal Best Practice (ERBP) Methods Support Team, University hospital Ghent, Ghent, Belgium
- Center for Medical Statistics, Informatics and Intelligent Systems (CeMSIIS), Section for Clinical Biometrics, Medical University Vienna, Vienna, Austria
- Department for Internal Medicine III, Nephrology and Hypertension Diseases, Transplantation Medicine and Rheumatology, Krankenhaus Elisabethinen, Linz, Austria
| | - Carina A. C. M. Pittens
- Athena Institute for Research on Innovation and Communication in Health and Life Sciences, VU university, Amsterdam, the Netherlands
| | - Jacqueline Broerse
- Athena Institute for Research on Innovation and Communication in Health and Life Sciences, VU university, Amsterdam, the Netherlands
| | - Clare Castledine
- Sussex Kidney Unit, Brighton & Sussex University Hospital, Brighton, United Kingdom
| | - Maurizio Gallieni
- Vascular Access Society (VAS), Maastricht, the Netherlands
- Nephrology and Dialysis Unit, Ospedale San Carlo Borromeo, Milano, Italy
| | - Nicholas Inston
- Vascular Access Society of Britain and Ireland (VASBI), Glasgow, United Kingdom
- Department of Renal Transplantation and Renal Surgery, Queen Elizabeth Hospital Birmingham, Birmingham, United Kingdom
| | | | - Niels Peek
- Health e-Research Centre, Institute of Population Health, University of Manchester, Manchester, United Kingdom
| | - Wim van Biesen
- European Renal Best Practice (ERBP) Methods Support Team, University hospital Ghent, Ghent, Belgium
- Renal division, University Hospital Ghent, Ghent, Belgium
| |
Collapse
|
17
|
Sousa CN, Apóstolo JLA, Figueiredo MHJS, Dias VFF, Teles P, Martins MM. Construction and validation of a scale of assessment of self-care behaviors with arteriovenous fistula in hemodialysis. Hemodial Int 2014; 19:306-13. [DOI: 10.1111/hdi.12249] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- Clemente Neves Sousa
- Escola Superior Enfermagem do Porto (Nursing College of Porto); Portugal
- ICBAS-Oporto University; Porto Portugal
- Diaverum Portugal; Coimbra Portugal
| | | | | | | | - Paulo Teles
- School of Economics and LIAAD-INESC Porto LA; Porto University; Porto Portugal
| | | |
Collapse
|