| Objective:To clarify the real experiences and needs during the care of arteriovenous fistulas in hemodialysis patients.Using symptom management theory as a theoretical framework,we develop practical and feasible nursing intervention programs.To investigate the effects of nursing interventions based on symptom management theory on self-management ability,quality of life,and functions and related complications of arteriovenous fistulas during the care of hemodialysis patients Methods:In the first part,the objective sampling method was used to select 18 patients who underwent hemodialysis using arteriovenous fistula in a grade III class A hospital in Bengbu City,Anhui Province from November to December 2021.A semi-structured interview was conducted,and the data were summarized and analyzed using the Colaizzi 7-step analysis method to extract the topic.To clarify the real experience and needs of patients during the nursing process of arteriovenous fistula,and to use this as a symptom experience in symptom management theory to provide a basis for formulating nursing interventions.The second part is quasi experimental research.Using the convenient sampling method,84 patients who underwent hemodialysis using arteriovenous fistula in a grade III class A hospital in Bengbu City,Anhui Province from January to June 2022 were selected as the study subjects,41 patients admitted from January to March 2022 as the control group,and 43 patients admitted from April to June 2022 as the intervention group.The control group received routine nursing,while the intervention group received nursing intervention based on symptom management theory.The arteriovenous fistula self-management level scale for hemodialysis patients,Kidney Disease Questionnaire(KDQ),was used to assess patients in both groups before,1 month after,and 3 months after the intervention,and to compare the functional abnormalities and associated complications of arteriovenous fistulas during a 3-month intervention period.Results:1.Most hemodialysis patients have difficulties in symptom management and lack of knowledge of daily maintenance during the nursing process of arteriovenous fistula,requiring medical personnel to provide nursing service support for patients to meet their nursing needs.The main symptoms and experiences of this study include cognitive biases in diseases,difficulty in symptom management,lack of daily maintenance knowledge,insufficient support systems,sleep pattern disorders,and emotional control disorders.2.The total score of self management level and three dimensional scores in the intervention group were significantly higher than those in the control group after 1month and 3 months of intervention,with a statistically significant difference(P<0.05).Multiple comparisons were made between the total scores of self management and the three dimensional scores of patients in the intervention group before,1 month,and 3months of intervention,and the differences between the two groups were statistically significant(P<0.05).3.The total score of KDQ and five dimensions in the intervention group were significantly higher than those in the control group after 1 month and 3 months of intervention,with a statistically significant difference(P<0.05).The total quality of life scores and five dimensional scores of patients in the intervention group before,1 month,and 3 months of intervention were compared,and the difference between the two groups was statistically significant(P<0.05).4.The incidence of arteriovenous fistula dysfunction,bleeding,swelling,stenosis,and thrombosis in the intervention group was significantly lower than that in the control group,with a statistically significant difference(P<0.05).Conclusions:1.Using the framework of symptom management theory and qualitative research methods,it is possible to extract the real symptom experience during the nursing process of arteriovenous fistula in hemodialysis patients,identify nursing problems,and provide a basis for formulating nursing interventions.2.Nursing intervention based on symptom management theory can improve the self-management ability of arteriovenous fistula in hemodialysis patients.3.Nursing interventions based on symptom management theory can improve the quality of life of hemodialysis patients.4.Nursing interventions based on symptom management theory are able to maintain the function of arteriovenous fistulas and reduce the occurrence of arteriovenous fistula related complications. |
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