**required article from week 6** Sousa, C. N., Paquete, A. R., Teles, P., Pinto, C. M., Dias, V. F., Ribeiro, O. M., Manzini, C. S., Nicole, A. G., Souza, L. H., Ozen, N. (2021). Investigating the effect of a structured intervention on the development of self-care behaviors with arteriovenous fistula in hemodialysis patients. (6), 866-874. Application and implications for practice come from the interpretation of meaning from research findings. Communicating and using research evidence is an expectation of a BSN graduate.
Title: Investigating the Effect of a Structured Intervention on the Development of Self-Care Behaviors with Arteriovenous Fistula in Hemodialysis Patients
Introduction:
Hemodialysis is a life-sustaining treatment for individuals with end-stage renal disease (ESRD). The creation and maintenance of an arteriovenous fistula (AVF) is critical to provide access for hemodialysis. However, many patients struggle with self-care behaviors related to AVF, which can lead to complications and increased healthcare costs. The purpose of this study by Sousa et al. (2021) was to investigate the effect of a structured intervention on the development of self-care behaviors with AVF in hemodialysis patients.
Methods:
The study utilized a quasi-experimental design, with a pre-test and post-test assessment, to compare the impact of the structured intervention on self-care behaviors. The participants included 60 hemodialysis patients from two hemodialysis units in Portugal. The intervention consisted of a structured educational program, which included individualized teaching sessions, a self-care booklet, and follow-up phone calls. The control group received routine care without the intervention.
The primary outcome measure was the development of self-care behaviors with AVF, assessed using the Scale of Self-care Behaviors with Arteriovenous Fistula (SSCBAVF). The secondary outcome measures included AVF assessment (e.g., patency and complications) and self-reported engagement in self-care behaviors. Data were collected at baseline, immediately after the intervention, and at a 3-month follow-up.
Results:
The results showed a significant improvement in self-care behaviors with AVF in the intervention group compared to the control group. The intervention group had significantly higher scores on the SSCBAVF at post-test assessment and 3-month follow-up. Moreover, the intervention group reported higher levels of engagement in self-care behaviors and demonstrated better AVF assessment outcomes compared to the control group.
Discussion:
The findings of this study have important implications for clinical practice. Hemodialysis patients face challenges in managing their AVF, which can lead to complications such as infection, thrombosis, and stenosis. By implementing a structured intervention focused on self-care behaviors, healthcare providers can empower patients to take an active role in managing their AVF and reduce the risk of complications.
The structured intervention used in this study included individualized teaching sessions, a self-care booklet, and follow-up phone calls. This approach allowed for tailored education and ongoing support, which are fundamental in improving self-care behaviors. By providing patients with knowledge about AVF care, patients can develop the necessary skills to perform self-monitoring, maintain proper hygiene, and recognize signs and symptoms of complications.
The study also highlighted the importance of regular follow-up and monitoring as part of the intervention. The follow-up phone calls allowed healthcare providers to assess patients’ progress, address any concerns or difficulties, and reinforce self-care behaviors. This ongoing support and communication are essential to ensure sustained behavior change and optimize outcomes.
Moreover, the positive outcomes in AVF assessment indicate that the intervention also contributed to improved physical health outcomes. Patients in the intervention group exhibited better AVF patency and encountered fewer complications compared to the control group. This suggests that the structured intervention not only enhances self-care behaviors but also translates into tangible clinical benefits.
Conclusion:
In conclusion, Sousa et al. (2021) demonstrated that a structured intervention focused on self-care behaviors with AVF can significantly improve patients’ self-care behaviors, engagement in self-care, and AVF assessment outcomes. The findings of this study have important implications for clinical practice, highlighting the need for tailored education, ongoing support, and regular monitoring to empower hemodialysis patients in managing their AVF and reducing complications.
Further research is needed to explore the long-term effects of such interventions and evaluate their impact on patient outcomes and healthcare costs. By expanding the knowledge base and implementing evidence-based interventions, healthcare providers can optimize care delivery and improve the quality of life for hemodialysis patients.