Interventions to promote self‐care of people with arteriovenous fistula

Abstract

Based on these results, it is necessary to delineate clear intervention programmes and objectives, in order to assess self-care with the AVF by people with ESRD, as well as to develop guidelines that provide guidance for self-care for the person with an AVF.

Construction and validation of a scale of assessment of self‐care behaviors with arteriovenous fistula in hemodialysis

“…In the process of metric analysis (ASBHD‐AVF‐31 version), 11 items were eliminated and three items (“I remove crusts from puncture sites of the fistula at home,” “I sleep over the fistula arm,” and “I use tight clothes in the fistula arm”) were eliminated because they had a negative correlation with the factor, which means they have an opposite behavior to that of other items. These self‐care behaviors should not be done because the withdrawal of crusts from the puncture sites will enhance the infection, as well as enhance the risk of AVF thrombosis because they can cause distal hypoperfusion . Patients do not do these behaviors, but they do the other self‐care behaviors.…”

“…We considered each behavior of self‐care as an item. The construction of the instrument began with the compilation of a set of self‐care behaviors to include in the scale, based on clinical experience and literature review conducted by the researcher in the area of vascular access for HD . We had a guideline to build a simple scale without redundancy, allowing good acceptance/understanding by patients.…”

“…The Vascular Access Guidelines and the Europerian Guidelines recommend the importance of educating patients about the care of vascular access. Nurses have a key role in promoting the development of self‐care behavior by providing the necessary knowledge to patients so that they develop the necessary skills to take care of the arteriovenous fistula (AVF) . The teachings should be directed to the specific care in the maintenance and functioning of the AVF, namely those associated with the prevention of infection and thrombosis, the aseptic precautions prior to puncture, and the care to treat hematomas …”

“…Sousa et al . conducted a review study verifying the lack of tools to assess the self‐care behaviors with the AVF performed by patients.…”

“…Nurses have a key role in promoting the development of self-care behavior by providing the necessary knowledge to patients so that they develop the necessary skills to take care of the arteriovenous fistula (AVF). [6][7][8][9][10] The teachings should be directed to the specific care in the maintenance and functioning of the AVF, namely those associated with the prevention of infection and thrombosis, the aseptic precautions prior to puncture, and the care to treat hematomas. 8,9 Pagels et al 11 have shown that information conveyed by the nurse related to vascular access improve self-care of the patient with the access.…”