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.

Qualidade de vida de pacientes renais crônicos submetidos à hemodiálise / Quality of life of chronic kidney patients submitted to hemodialysis / Calidad de vida de pacientes renales crónicos sometidos a hemodiálisis

Objetivo: avaliar a qualidade de vida dos pacientes renais crônicos submetidos à hemodiálise. Método: trata-se de um estudo quantitativo, descritivo, transversal, realizado com 137 pacientes renais crônicos em tratamento hemodialítico. Coletaram-se os dados por meio de um questionário semiestruturado e do instrumento de avaliação de qualidade de vida para pacientes renais crônicos Kidney Disease and Quality of Life Short Form (KDQOL SF-36). Analisaram-se os dados no software EpiInfo, versão 7.2, recorrendo-se à análise estatística descritiva para a caracterização dos sujeitos. Compararam-se o escore de qualidade de vida e a escolaridade dos pacientes por meio do teste Kruskall-Wallis. Resultados: mostrou-se a qualidade de vida comprometida nos domínios Situação Profissional, Função Física, Função Emocional, Sobrecarga da Doença Renal e Funcionamento Físico. Conclusão: observou-se que os pacientes renais crônicos em tratamento hemodialítico apresentaram a redução da qualidade de vida em alguns domínios. Torna-se relevante referenciar a necessidade de uma equipe multidisciplinar para se intervir nos fatores físicos e psicológicos desses pacientes para se melhorar a qualidade de vida deles.(AU)

Objective: to evaluate the quality of life of chronic kidney patients submitted to hemodialysis. Method: This is a quantitative, descriptive, cross-sectional study of 137 chronic kidney patients undergoing hemodialysis. The data were collected by means of a semi-structured questionnaire and the quality of life assessment tool for Kidney Disease and Quality of Life Short Form (KDQOL SF-36) chronic kidney patients. The data were analyzed in EpiInfo software, version 7.2, using descriptive statistical analysis to characterize the subjects. The Kruskall-Wallis test was used to compare the quality of life and education scores of patients. Results: the quality of life in the domains Professional Situation, Physical Function, Emotional Function, Kidney Disease Overload and Physical Function was shown. Conclusion: It was observed that chronic kidney patients in hemodialysis treatment presented a reduction in quality of life in some areas. It becomes relevant to refer to the need of a multidisciplinary team to intervene in the physical and psychological factors of these patients to improve their quality of life.(AU)

Objetivo: evaluar la calidad de vida de los pacientes renales crónicos en hemodiálisis. Método: se trata de un estudio cuantitativo, descriptivo, transversal, realizado con 137 pacientes renales crónicos en hemodiálisis. Los datos fueron recolectados a través de un cuestionario semiestructurado y el instrumento de evaluación de la calidad de vida para pacientes renales crónicos, Kidney Disease and Quality of Life Short Form (KDQOL SF-36). Los datos se analizaron mediante el software EpiInfo, versión 7.2, mediante análisis estadístico descriptivo para caracterizar a los sujetos. La puntuación de la calidad de vida y la educación de los pacientes se compararon mediante la prueba de Kruskall-Wallis. Resultados: la calidad de vida se vio comprometida en los dominios Situación profesional, Función física, Función emocional, Carga de enfermedad renal y Funcionamiento físico. Conclusión: se observó que los pacientes renales crónicos sometidos a hemodiálisis mostraron una reducción de la calidad de vida en algunos dominios. Es relevante referirse a la necesidad de un equipo multidisciplinario que intervenga en los factores físicos y psicológicos de estos pacientes para mejorar su calidad de vida.(AU)

Construcción y validación del contenido de un video acerca del autocuidado de la fístula arteriovenosa / Construction and validation of content of a video on self-care with arteriovenous fistula

OBJETIVO: Validar el contenido del guion de un video educativo para promover el autocuidado de la fístula arteriovenosa en los pacientes renales crónicos, con enfermeras y comunicadores sociales. MÉTODO: Estudio metodológico que construyó y validó un video educativo. En primer lugar, las demandas de autocuidado se identificaron por medio de una revisión de la literatura sobre autocuidado con fístula arteriovenosa. A continuación, la construcción del video siguió los pasos de preproducción, producción y posproducción. La validación del contenido del video ocurrió en la fase de preproducción y contó con 22 jueces de enfermería y profesionales de los medios. El estudio fue aprobado por el Comité de Ética en Investigación, bajo el Certificado de ética: 61705516.0.0000.5208. RESULTADOS: Los siguientes ítems presentaron una evaluación negativa de los jueces: las escenas descritas reflejan estereotipos o discriminación (p = 0,008), el ritmo de las escenas es agotador (p = 0,001/p = 0,034), los personajes/imágenes son atractivos para el público (p = 0,006), las ilustraciones reflejan aspectos importantes del tema en el estudio (p = 0,006), las ilustraciones motivan la comprensión del mensaje de video (p = 0,001) y la estructura general es creativa (p = 0,001). CONCLUSIÓN: El video educativo fue considerado válido por jueces de enfermería y profesionales de los medios de comunicación, para promover el autocuidado de la fístula arteriovenosa en pacientes renales

OBJECTIVE: To validate the content of the script of an educational video to promote self-care with arteriovenous fistula in chronic renal patients with nurses and social communicators. METHOD: Methodological study that constructed and validated an educational video. Firstly, the demands of self-care were identified through a literature review on self-care with arteriovenous fistula. Then the construction of the video followed the steps of pre-production, production and post-production. The script's content validation occurred in the pre-production phase and counted on 22 nursing judges and media professionals. The study was approved by the Ethics Committee in Research, under opinion 61705516.0.0000.5208. RESULTS: The following items received a negative evaluation from the judges: "The scenes described reflect stereotypes or discrimination" (p = 0.008) and "The pace of the scenes is tiring" (p = 0.001/p = 0.034), "The characters/images are appealing to the audience (p = 0.006), "The illustrations reflect important aspects of subject under study" (p = 0.006), "The illustrations promote the understanding of the video message" (p = 0.001) and "The general structure is creative" (p = 0.001). CONCLUSION: The educational video was considered valid by the nursing judges and media professionals to promote self-care with arteriovenous fistula among renal patients

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.

Práticas científicas dos enfermeiros das clínicas de hemodiálise / Scientific practices of clinic nurses hemodialysis

Objetivo: identificar como a produção científica está inserida enquanto prática nas atividades dos enfermeiros que trabalham em clínicas de hemodiálise da cidade do Recife e Região Metropolitana. Metodologia: Estudo transversal, exploratório de abordagem quantitativa, desenvolvido em 14 clínicas de hemodiálise. A amostra foi composta por 84 enfermeiros. A análise dos dados foi feita no software Produtos e serviços soluções estatísticos versão 13. Pesquisa aprovada sob protocolo 2151-11 e Certificado de Apresentação para Apreciação Ética 0280.0.099.000-10. Resultados: Verificou-se que as atividades científicas estão sendo iniciadas, 39,3% da amostra já participaram de alguma pesquisa junto a outros profissionais e 22,6% já realizaram alguma pesquisa na clínica que trabalha. Sendo os especialistas em Nefrologia os mais dedicados à pesquisa. Contudo apenas 11,9% informaram ter publicado seus trabalhos em revista científica.Conclusão: Os resultados deste estudo evidenciaram que ainda há necessidade de avançar as práticas científicas, mas já se percebe o início de um despertar pelo conhecimento.

Objective: To identify how scientific production is inserted as a practice in the activities of nurses working in hemodialysis clinics in the city of Recife and the metropolitan area. Methodology: Cross-sectional, exploratory study with a quantitative approach, developed in 14 dialysis clinics. The sample consisted of 84nurses. Data analysis was done in software products and services statistical solutions version 13. Research approved under protocol 2151-11 and Certificate Presentation to Ethics Assessment 0280.0.099.000-10. Results: It was found that scientific activities are being initiated, 39.3% of the sample have taken part insome research with other professionals and 22.6% have already done some research on the clinical working.Being experts in nephrology the most dedicated to research. However, only 11.9% reported having their work published in a scientific journal. Conclusion: Results of this study showed that there is a need to advances cientific practices, but already see the beginning of an awakening for knowledge.

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.