The risk factors of autogenous arteriovenous fistula dysfunction in maintenance hemodialysis patients and the curative effect of personalized nursing

摘要

Objective: To explore the effect of individualized nursing intervention on autologous arteriovenous fistula (AVF) dysfunction and the risk factors leading to failures in maintenance hemodialysis (MHD) patients. Methods: A total of 196 patients undergoing MHD in our hospital from March 2017 to May 2019 were recruited as the study cohort and divided into two groups according to the nursing method each patient underwent. The patients who underwent individualized nursing intervention were placed in the research group (RG, n = 107), and the patients who underwent routine nursing intervention were placed in the control group (CG, n = 89). The proportion of patients with primary dysfunction in the use of AVF was recorded, and the patients’ psychological states, treatment compliance, and self-nursing abilities in the two groups before and after the nursing intervention were observed. The complications, the life treatment scores, and the patients’ nursing satisfaction were recorded after the nursing intervention. A logistic regression analysis was performed for the patients with initial AVF dysfunction. Results: Compared with the CG, the patients in the RG after the nursing intervention had statistically lower AVF dysfunction rates, notably lower SAS and SDS scores, remarkably higher total compliance rates and ESCA scores, and a dramatically lower total incidence of complications. AVF dysfunction occurred in 26 of 196 patients (13.4%) during the follow-up, with an increased risk of AVF loss in patients over 60 years old, lower blood pressure, higher hemoglobin concentrations, lower treatment compliance, self-care inability, and routine nursing interventions. After the nursing, the WHOQOL-BREF and nursing satisfaction scores in the RG were noticeably higher than they were in the CG. Conclusion: Autologous AVF dysfunction is the result of multiple risk factors, and personalized nursing can reduce the incidence of complications, improve patients’ treatment compliance and self-care abilities, and ameliorate their quality of life.