Search

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)., (© 2018 International Society for Apheresis, Japanese Society for Apheresis, and Japanese Society for Dialysis Therapy.)

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., (© 2015 John Wiley & Sons Ltd.)

Several guidelines recommend the importance of educating the patient about the care of vascular access. Nurses have a key role in promoting the development of self-care behaviors by providing the necessary knowledge to patients, so that they develop the necessary skills to take care of the arteriovenous fistula (AVF). This article describes the process of building a scale of assessment of self-care behaviors with arteriovenous fistula in hemodialysis (ASBHD-AVF). This is a cross-sectional study in which the development, construction, and validation process followed the directions of the authors Streiner and Norman. This is a convenience sample, sequential, and nonprobabilistic constituted by 218 patients. The study was conducted in two stages during 2012-2014. The first phase corresponds to the scale construction process, 64 patients participated, while the second corresponds to the evaluation of metric properties and 154 patients participated. The principal component analysis revealed a two-factor structure, with factorial weights between 0.805 and 0.511 and between 0.700 and 0.369, respectively, explaining 39.12% of the total variance of the responses. The Cronbach's alpha of the subscale management of signs and symptoms is 0.797 and from the subscale prevention of complications is 0.722. The ASBHD-AVF revealed properties that allow its use to assess the self-care behaviors in the maintenance and conservation of the AVF., (© 2014 International Society for Hemodialysis.)

Aims and Objectives: The literature shows many self-care behaviours related to people with end-stage renal disease (ESRD). Our aim is to identify interventions within the 'teaching' that promote self-care (behaviour) with arteriovenous fistula (AVF)., Background: The development of self-care behaviours with the AVF allows the access to maintain the best possible conditions, because its state influences the efficacy of the dialysis treatment. However, few studies assess self-care behaviours that people with ESRD have with the AVF, as well as interventions that promote this self-care., Design: Discursive paper., Methods: Our research was conducted in MEDLINE, Health Nursing and Allied Literature (CINAHL), Web of Science and SCOPUS using three search expressions, between the period of 2000-2010. We selected studies that identified interventions that promote self-care with AVF., Results: No study has shown in detail the interventions that aimed at promoting self-care behaviours with the AVF for patients with ESRD. We verify that the interventions that promote self-care are directed mostly to the moments after AVF construction., Conclusions: This paper reinforces the need to develop guidelines that provide guidance for self-care with the AVF to be developed by people with ESRD. We also found that self-care behaviours directed to the AVF are mostly associated with postconstruction of the access., Relevance to Clinical Practice: 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., (© 2013 John Wiley & Sons Ltd.)

Vascular access is one of the leading causes of mobilization of financial resources in health systems for people with chronic kidney disease on hemodialysis. Physical examination of the arteriovenous fistula (AVF) has demonstrated its effectiveness in identifying complications. We decided to evaluate the influence of nurses' professional experience in the detection of complications of the AVF (venous stenosis and steal syndrome). The study took place in eight hemodialysis centers between May and September of 2011 in the north of Portugal. Sample was constituted by registered nurses. The nurses involved in the experiment were divided in two groups: those who had more than 5 years of experience and those who had less than 5 years of experience. Ninety-two nurses participated in the study: 34 nurses had less than 5 years of professional experience and 58 had more than 5 years of professional experience. In the practices considered by nurses in the detection of venous stenosis, there were no differences observed between the groups (P > 0.05). In steal syndrome, there were no differences observed between the groups in the practices of the nurses in the detection of this complication of the AVF (P > 0.05). We concluded that professional experience does not influence the detection of venous stenosis and steal syndrome., (© 2014 International Society for Hemodialysis.)

Physical examination has demonstrated its effectiveness in identifying complications of arteriovenous fistula (AVF). It should be initiated at the stage prior to the construction of the AVF and continue in its accomplishment, maturation, and subsequent use in the treatment of hemodialysis. Nurses should incorporate the physical examination in their practices, in order to preserve the vascular net of patients and assist in the recognition of complications of AVF. It is intended to describe aspects of the physical examination that enable the identification of the AVF complications including: infection, accessory veins, venous stenosis, steal syndrome, high-output cardiac failure, and venous hypertension., (© 2012 The Authors. Hemodialysis International © 2012 International Society for Hemodialysis.)

The CIPESC® is a tool that informs the work of nurses in Public Health and assists in prioritizing their care in practice, management and research. It is also a powerful pedagogical instrument for the qualification of nurses within the Brazilian healthcare system. In the teaching of infectious diseases, using the CIPESC® assists in analyzing the interventions by encouraging clinical and epidemiological thinking regarding the health-illness process. With the purpose in mind of developing resources for teaching undergraduate nursing students and encouraging reflection regarding the process of nursing work, this article presents an experimental application of CIPESC®, using meningococcal meningitis as an example.