How to choose the appropriate cannulation technique for vascular access in hemodialysis patients.

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.

Effects of demographic and clinical character on differences in self-care behavior levels with arteriovenous fistula by hemodialysis patients: An ordinal logistic regression approach.

INTRODUCTION: Hemodialysis (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, chronic kidney disease 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.

Scale of Assessment of Self-Care Behaviors with Arteriovenous Fistula in Hemodialysis: A Psychometric Study in Brazil.

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.

Self-Care Behavior Profiles With Arteriovenous Fistula in Hemodialysis Patients.

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.

Tecnologias educacionais direcionadas para pacientes renais crônicos na promoção do autocuidado / Educational technologies focused on the chronic renal patients aiming to the self-care promotion / La tecnología educativa dirigida a los pacientes renales crónicos en promocion del autocuidado

Objective: The study's purpose has been to identify the technologies focused on the health education of chronic renal patients aiming to promote the self-care. Methods: It is an integrative review that was performed in the databases LILACS, MEDLINE, SCOPUS, CINAHL and in the COCHRANE Library, where the final sample consisted of 16 articles. Results: The publications occurred between 2008 and 2016, prevailing studies with level III of evidence. The findings showed that the technologies used in health education for the promotion of chronic renal patient self-care used written materials (brochures, booklets and handouts), audiovisuals (videos, website, PowerPoint presentation, soap opera and interactive CD) and educational games as a communication vehicle. Conclusion: Among the articles that brought out these technologies, it was not verified their occurrence in the Brazilian scientific literature, then configuring a knowledge gap in that country

Objetivo: C: 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

Objetivo: Identificar las tecnologías dirigidas a la educación de la salud en pacientes renales crónicos para promover el autocuidado. Método: Se trata de una revisión integradora llevado a cabo en las bases de datos LILACS, MEDLINE, Scopus, CINAHL y Cochrane Library, y la muestra final de 16 artículos. Resultados: Publicaciones ocurrieron entre 2008 y 2016, los estudios ya existe con las pruebas de nivel III. Los resultados mostraron que las tecnologías utilizadas en la educación sanitaria para la promoción de los materiales renal crónica paciente autocuidado utilizados por escrito (folletos, prospectos y folletos), audiovisuales (videos, sitios web, presentaciones de Power Point, series de televisión y CD interactivo) y juegos educativos como vehículo de comunicación. Conclusión: Entre los artículos que trajeron estas tecnologías no eran representantes en la literatura científica brasileña, la creación de un vacío de conocimiento en este país

Self-Care on Hemodialysis: Behaviors With the Arteriovenous Fistula.

End stage renal disease (ESRD) patients should be educated to maintain and preserve the arteriovenous fistula (AVF) in the best condition. The purpose of this work was to evaluate self-care frequency and factors that influenced such frequency. A prospective study was performed in 101 hemodialysis patients. Self-care behaviors were measured with the Scale of Assessment of Self-Care Behaviours with Arteriovenous Fistula in Hemodialysis. A regression model was used to determine the relevant predictors of self-care frequency and their influence. The incidence of self-care behaviors was 71.0%. The regression model showed that self-care behaviors were positively influenced by gender (female), ESRD etiology (hypertension, polycystic kidneys and other kidney diseases), duration of AVF and negatively by the existence of previous AVF and health professional (doctor). The frequency of self-care behaviors was lower than expected and below an appropriate standard. Education programs designed to improve self-care behaviors with AVF should be further explored in a prospective randomized trial.

Cenário atual da enfermagem em nefrologia do Recife e região metropolitana / Escenario actual de nefrología enfermería y región metropolitana de Recife / Current scenario of nephrology nursing and Recife metropolitan region

Objective: To identify how nephrology has been developing within the nursing, and the profile of nurses working in hemodialysis clinics in Recife and the metropolitan region. Method: cross-sectional study, exploratory quantitative approach, developed in 14 hemodialysis clinics. The sample consisted of 84 nurses. The data were collected through a questionnaire was completed. Data analysis was performed with SPSS version 13. Approved research protocol number 2151-11 and CAAE No. 0280.0.099.000-10. Results: nurses have specialist title in nephrology (66.7%), and acquired on average 62.8 months after the start of the activity in the area. Achievements were reached by category, such as professional autonomy, recognition and respect for patients and society. Conclusion: non-specialized nurses are being admitted to hemodialysis services due to the lack of these professionals in the job market.

Objetivo: identificar como a nefrologia vem se desenvolvendo dentro da Enfermagem, e o perfil dos enfermeiros que trabalham em clínicas de hemodiálise da cidade do Recife e Região Metropolitana. Método: estudo transversal, exploratório de abordagem quantitativa, desenvolvido em 14 clínicas de hemodiálise. A amostra foi composta por 84 enfermeiros. A coleta de dados ocorreu mediante preenchimento de questionário. A análise dos dados foi feita no software SPSS versão 13. Pesquisa aprovada sob protocolo nº2151-11 e CAAE nº 0280.0.099.000-10. Resultados: os enfermeiros possuem título de especialização em nefrologia (66,7%), e o adquiriu em média, 62,8 meses depois de iniciada a atividade na área. Conquistas foram alcançadas pela categoria, como a autonomia profissional, o reconhecimento e respeito pelos pacientes e pela sociedade. Conclusão: enfermeiros não especializados estão sendo admitidos nos serviços de hemodiálise, devido à carência destes profissionais no mercado de trabalho.

Objetivo: Determinar la forma en nefrología se ha desarrollado dentro de la enfermería, y el perfil de las enfermeras que trabajan en las clínicas de hemodiálisis en Recife y en la Región Metropolitana. Método: Estudio transversal, exploratorio enfoque cuantitativo, desarrollado en 14 centros de hemodiálisis. La muestra estuvo conformada por 84 enfermeras. Los datos fueron recolectados a través de un cuestionario se completó. El análisis de datos se realizó con elprograma SPSS versión 13. Número de protocolo de investigación aprobado 2151-11 y CAAE No. 0280.0.099.000-10. Resultados: las enfermeras tienen título de especialista en Nefrología (66,7%), y adquirieron un promedio de 62,8 meses después del inicio de la actividad en el área. Los logros fueron alcanzados por categoría, tales como la autonomía profesional, el reconocimiento y el respeto de los pacientes y la sociedad. Conclusión: las enfermeras no especializados están siendo admitidos en los servicios de hemodiálisis, debido a la falta de estos profesionales en el mercado laboral.