Improving the level of arteriovenous fistula (AVF) self‐care behavior by people receiving hemodialysis is an effective way to reduce the occurrence of complications and mortality. The aim of this study was to assess the self‐care behavior of Chinese patients undergoing hemodialysis with arteriovenous fistula. The assessment of self‐care behaviors with arteriovenous fistula in hemodialysis (ASBHD‐AVF, Portuguese version) was translated into Chinese using Brislin's translation model. The content validity was evaluated by six experts. Then we involved 301 hemodialysis patients with AVF to explore the construct validity of the Chinese version of ASBHD‐AVF. Ultimately 216 patients from eight dialysis centers of general hospitals in China were recruited to evaluate the patients’ self‐care behavior about AVF. Measures included demographic questionnaire, and the Chinese ASBHD‐AVF. The Chinese ASBHD‐AVF that included 12 items has a good internal consistency (α = 0.865) and content validity (CVI = 0.979). Principal component analysis generated two factors which explained 53.525% of the total variance. About 69.9% of hemodialysis patients’ AVF self‐care behavior were at a low or moderate level. The level of self‐care behavior and knowledge need to be improved. Nurses should give specific guidance according to the patients’ own characteristics and different influence factors, in order to improve the recipients’ self‐care behavior.
Background: Currently, the prediction values of models for the prognosis of acute kidney injury (AKI) receiving continuous renal replacement therapy (CRRT) were ordinary and establishing a better prediction model is necessary. Nursing notes are an important predictor of in-hospital mortality in intensive care unit (ICU) patients. This study established prognostic prediction models for AKI patients receiving CRRT especially using nursing notes.Methods: Totally, 682 AKI patients undergoing CRRT were included. AKI was diagnosed based on Kidney Disease: Improving Global Outcomes (KDIGO) criteria. Four hundred and twelve patients lacking nursing notes data were excluded. Finally, 270 patients were included and randomly divided into a training set (n=189) and a testing set (n=81) at a ratio of 7:3. Univariate analysis explored the possible predictors of mortality in AKI patients receiving CRRT. Random forest models and broad learning system (BLS) models (with or without sentiment scores) were respectively constructed in the training set and verified in the testing set. The performances of the models were assessed by the sensitivity, specificity, and area under the curve (AUC).Results: For the random forest model including the sentiment scores, the AUC was 0.86 (95% CI: 0.81-0.91), the sensitivity was 0.72 (95% CI: 0.63-0.80), and the specificity was 0.87 (95% CI: 0.80-0.94) in the training set and the AUC was 0.78 (95% CI: 0.68-0.88), the sensitivity was 0.65 (95% CI: 0.49-0.80), and the specificity was 0.75 (95% CI: 0.62-0.88) in the testing set. For the BLS model including the sentiment scores, the AUC was 0.87 (95% CI: 0.82-0.92), the sensitivity was 0.95 (95% CI: 0.91-0.99) and the specificity was 0.48 (95% CI: 0.38-0.59) in the training set and the AUC was 0.82 (95% CI: 0.73-0.91), the sensitivity was 0.41 (95% CI: 0.25-0.56) and the specificity was 0.98 (95% CI: 0.93-1.00) in the testing set. Conclusions:The BLS models including the sentiment scores might offer a tool for quickly identifying patients AKI patients receiving CRRT with high risk of mortality and providing timely interventions to them for improving their prognosis.
This study was conducted to evaluate the effect of multidisciplinary collaborative nursing intervention on AVF in patients with chronic kidney disease (CKD) undergoing hemodialysis. Patients ( n = 84) with CKD who underwent the first autologous AVF were randomly divided into control group and multidisciplinary collaborative nursing intervention (MCNI) group and they received routine nursing procedure and multidisciplinary collaborative nursing intervention procedure, respectively. The natural blood flow and vessel diameter in MCNI group were higher than that in control group at the fourth week after surgery ( p < .05). The vessel diameter in MCNI group at 2 and 4 weeks after operation was significantly larger than that in control group ( p < .05).In conclusions, the implementation of multidisciplinary collaborative nursing intervention procedure can significantly promote the maturation of AVF, effectively increase the blood flow of AVF and promote the growth of vessel diameter.
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