Abstract
Introduction: The chronic kidney disease and hemodialysis status for end stage kidney diseases is a major health problem worldwide. When the question of choice of vascular access in hemodialysis is raised, arteriovenous fistula is the choice point because of the longer duration of survival and reduction in complications associated with its use. But a lack of understanding and the lack of good self-care habits may result in infection, thrombosis, stenosis and failure of the fistula.
Objective: To determine the knowledge and self-care practice among hemodialysis patient regarding arteriovenous fistula in a public hospital of Lahore Pakistan.
Methodology: A quasi-experimental study was done in the dialysis unit of Sir Ganga Ram Hospital, Lahore. Convenient sampling was used and a total of 78 patients who were undergoing hemodialysis and had arteriovenous fistula were selected. Structured questionnaire that had been adapted was used in data collection. Patients were also pre-assessed and then given the educational guidance via the brochure and re-assessed after 3 weeks. SPSS version 25.0 was used to analyze the data and the Wilcoxon signed-rank test was used (p < 0.05 was taken as statistically significant).
Results: The average age of the subjects was 48.82 ± 12.40 years. Among 78 patients, 45 (57.7%) were male and 33 (42.3%) were female. Of the 73 respondents, most (93.6%) received hemodialysis three times a week. Knowledge increased following education (post education: awareness of AVF site 100%, sleeping on AVF site 94.9%, avoiding heavy weight lifting 98.7%, and avoiding sleeping on AVF site 78.2%). Self-care practices have also improved particularly in relation to AVF washing which has risen from 20.5% to 94.9% daily washing.
Conclusion: The study found that there was a statistically significant increase in patients' knowledge and their self-care practices in caring for their arteriovenous fistula after the education intervention. It is advisable to include health education using a nursing-led protocol to avoid complications, enhance outcomes in hemodialysis, and prevent complications arising from the use of AVFs.