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.
There was no relationship between some indicators of the outcome Knowledge: disease process with the sociodemographic variables in patients undergoing hemodialysis, a fact that underscores the importance of implementing nursing interventions that take into account the particularities of the individuals.
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.
Objetivo: Avaliar atividades de autocuidado com a fístula arteriovenosa em renais crônicos. Metodologia: Estudo descritivo, transversal, com abordagem quantitativa, realizado com 60 pacientes em unidade de diálise no Nordeste Brasileiro, de setembro a outubro de 2018. Os dados foram coletados por meio de entrevistas e analisados através de estatística descritiva. O estudo foi aprovado pelo Comitê de Ética e Pesquisa (Parecer nº 233.953/13). Resultados: Os cuidados realizados frequentemente foram: não permitir a verificação da pressão arterial (71,7%), administração de medicamentos e a coleta de sangue no membro da fístula (71,6%), realizar higiene do membro da fistula (68,4%) e evitar carregar peso (68,3%). Os cuidados menos referidos foram: colocar compressa morna no dia anterior à hemodiálise (30,0%) e fazer exercícios de preensão com bola de borracha (15%). Conclusão: O conhecimento dos pacientes quanto às atividades de autocuidado com a fístula arteriovenosa foi considerado insuficiente, ao evidenciar maior preocupação ante a possibilidade de procedimentos clínicos realizados no braço da fístula, seguidos da higiene e sobrecarga no membro. Estes dados reforçam a importância do planejamento das atividades educativas de forma criativa e permanente pelos profissionais de saúde direcionadas para este público e que poderão auxiliar o enfermeiro na priorização das ações.Descritores: Autocuidado; Diálise Renal; Educação em Saúde; Cuidados de Enfermagem.AUTOCUIDADO DEL PACIENTE RENAL CON LA FÍSTULA DE ARTERIOVENOSAObjetivo: Evaluar actividades de autocuidado con fístula arteriovenosa en renales crónicos. Metodología: Un estudio descriptivo, transversal con un enfoque cuantitativo, realizado con 60 pacientes en una unidad de diálisis en el noreste de Brasil, de septiembre a octubre de 2018. Los datos fueron recolectados por médio de entrevistas y analizados mediante estadística descriptiva. El estudio fue aprobado por el Comité de Ética e Investigación (Opinión nº 233.953/13). Resultados: Los cuidados más frecuentes fueron: no permitir la verificación de la presión arterial (71,7%), la administración de medicamentos y la recolección de sangre en la extremidad de la fístula (71,6%), realizar la higiene de la extremidad de la fístula (68.4%) y evitar cargar peso (68.3%). Los cuidados menos informadas fueron: poner una compresa tibia el día anterior a la hemodiálisis (30.0%) y hacer ejercicios de agarre con pelota de goma (15%). Conclusión: El conocimiento de los pacientes renales crónicos con respecto a las actividades de auto cuidado con fístula arteriovenosa fue insuficiente, y se identificó la actividades más y menos conocida entre los pacientes. Estos datos refuerzan la importancia de las actividades educativas planificadas por profesionales de la salud dirigidas a este público y pueden ayudar a las enfermeras a planificar estas acciones.Descriptores: Autocuidado; Diálisis Renal; Educación en Salud; Atención de Enfermería.SELF CARE OF THE RENAL PATIENT WITH THE ARTERIOVENOSA FISTULAObjective: To evaluate self care activities with arteriovenous fistula in chronic renal patients. Methodology: A descriptive, cross-sectional study with a quantitative approach, conducted with 60 patients in a dialysis unit in Northeast Brazil, from September to October 2018. Data were collected through interviews and analyzed using descriptive statistics. The study was approved by the Ethics and Research Committee (Opinion nº 233.953/13). Results: The most frequent cares were: not allowing blood pressure verification (71.7%) and medication administration and blood collection in the fistula limb (71.6%), perform fistula limb hygiene with water and antiseptic soap (68.4%) and avoid carrying weight (68.3%). The least reported cares were: putting warm compress on the day before hemodialysis (30.0%) and do pressure exercise with rubber ball (15%). Conclusion: The knowledge of chronic renal patients regarding self care activities with arteriovenous fistula was insufficient, and the most and least known care among patients was identified. These data reinforce the importance of educational activities planned by health professionals aimed at this audience and can assist nurses in planning these actions.Descriptors: Self Care; Renal Dialysis; Health Education; Nursing Care.
OBJETIVO: Identificar as tecnologias direcionadas para a educação em saúde de pacientes renais crônicos para a promoção do autocuidado. MÉTODOS: Trata-se de uma revisão integrativa realizada nas bases de dados LILACS, MEDLINE, SCOPUS, CINAHL e na Biblioteca COCHRANE, sendo a amostra final composta por 16 artigos. RESULTADOS: As publicações ocorreram entre 2008 e 2016, prevalecendo estudos com nível III de evidência. Os achados mostraram que as tecnologias utilizadas na educação em saúde para a promoção do autocuidado do paciente renal crônico utilizaram materiais escritos (folhetos, livretos e apostilas), audiovisuais (vídeos, website, apresentação de Power point, telenovela e CD interativo) e jogos educacionais como veículo de comunicação. CONCLUSÃO: Dentre os artigos que trouxeram essas tecnologias, não foram representantes na literatura cientifica brasileira, configurando-se uma lacuna de conhecimento nesse país.
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