Status
Conditions
Treatments
About
This study will be conducted to evaluate the effect of Arterio-Venous Fistula (AVF) care training given to hamodialysis patients on quality of life, comfort and self-care behaviours. Patient education is one of the practices that help patients to gain self-care behaviours as well as reducing the cost of health expenditures. Nurses are health professionals who play an important role in patient education. Nurses provide patient education by using different materials. These materials can sometimes be mobile phones, videos, web-based applications, sometimes face-to-face interviews with patients, brochures or written materials. In this study, a training programme for AVF care will be developed. In addition, it is expected that the AVF care training to be given to HD patients will increase the quality of life and comfort areas, and increase the awareness and well-being levels of patients in self-care behaviours. The effectiveness of the study will be expanded by presenting the results of the research as a paper in an international comprehensive congress. An article of the study will be published in a journal scanned in international indexes and will be included in the literature.
Full description
Chronic Kidney Disease (CKD) is an important health problem whose prevalence continues to increase in Turkey and all over the world, has a high mortality rate and seriously reduces the quality of life. In the 2020 report of the World Health Organization (WHO), it was stated that CKD, which ranked 13th among the causes of death, rose to 10th place and 2.62 million people received dialysis treatment. According to the 2020 report of the World Health Organization (WHO), CKD has risen to 10th place among the causes of death and 2.62 million people have started dialysis treatment. The most preferred renal replacement therapy (RRT) in the world and in Turkey is hemodialysis (HD). HD is the process of correcting the fluid solutes of the blood taken from the patient through a membrane called dialyser and dialysis machine and returning it to circulation. Hemodialysis treatment is performed three or four days a week for an average of four hours depending on residual renal function, creatine clearance, clinical and chronic disease status of the patient. HD treatment is administered in acute renal failure until renal function is normalised, and in CKD and end-stage renal disease (ESRD) patients until kidney transplantation is performed. HD therapy requires a vascular access route that can provide the desired amount of blood flow. The increase in the duration and quality of life of patients is directly dependent on actively functioning vascular access. The most commonly used vascular access methods are indwelling catheters, temporary catheters, Arterio-Venous Fistula (AVF) and Arterio-Venous Grafts (AVG). The choice of vascular access route may differ in each country. According to the Turkish Society of Nephrology 2022 report, the preferred vascular access routes in 2021 were AVFs with a rate of 72.44%, AVGs with a rate of 0.96%, permanent (tunneled) catheters with a rate of 23.63% and temporary (tunnelless) catheters with a rate of 2.97%. AVF is a surgical operation to create an anastomosis between a suitable artery and a selected vein. AVF cannulation procedure, which is performed in every session during HD, provides vascular access and is one of the standard methods, is performed at least 10 times a month and an average of 300 times a year. The most common causes of death and hospitalisation in HD patients are infection, stenosis, aneurysm, coagulation, bleeding, insufficient flow, high flow fistula, venous escape, and neurological complications. AVF complications should be prevented in order to increase dialysis efficiency, patient compliance-self-care, quality of life and comfort, decrease mortality and morbidity, and reduce costs. Patient education is very important for this. In addition to preventing complications, patient education is one of the practices that help to reduce the cost of health expenditures and to help patients gain comfort, quality of life and self-care behaviours. Nurses are health professionals who play an important role in patient education. Orem (2001) defined self-care as self-care performed by the individual by exhibiting controlled, purposeful and effective behaviours while maintaining health and well-being. Maintaining quality of life, comfort and self-care for AVF ensures the continuity of HD treatment without complications.
This study will be conducted to evaluate the effect of Arterio-Venous Fistula (AVF) care training given to hemodialysis patients on quality of life, comfort and self-care behaviours.
Hypotheses:
H0: AVF care training given to hemodialysis patients has no effect on patients' quality of life, comfort and self-care behaviours.
H1: AVF care training given to hemodialysis patients affects patients' quality of life.
H1: AVF care training given to hemodialysis patients affects patients' comfort. H1: AVF care training given to hemodialysis patients affects patients' self-care behaviours.
Place and Time of the Study: The research will be conducted in Kars Harakani State Hospital Dialysis Unit between September 2025 and September 2026.
The population of the study consists of a total of 67 patients receiving HD treatment and having AVF in the Dialysis Unit of Harakani State Hospital. The sample of the study will include individuals who volunteered to participate in the study among these patients and who meet the study criteria. Similar study data were taken into consideration in the selection of the study sample. As a result of the power analysis performed in the G*Power version 3.1.9.7 programme, it was determined that a total of 52 participants, at least one person for each of the intervention and control groups, should be included in the sample size, 95% confidence interval, 95% test power (1-ß), 0.05% margin of error level. However, assuming that there would be losses, 10% of the sample size was added to the research sample and it was planned to conduct the research with a total of 60 patients, 30 in the intervention group and 30 in the control group.
Randomisation and Blinding Simple random sampling method will be used for randomisation of the study. In order to avoid interactions between the patients participating in the study, they will be grouped according to the days of HD treatment sessions. In Group I: Patients receiving HD treatment on Mondays, Wednesdays and Fridays, and in Group II; patients receiving HD treatment on Tuesdays, Thursdays and Saturdays. Which group will be the control group and which will be the intervention group will be decided by drawing lots.
Inclusion Criteria:
Exclusion Criteria:
Intervention Procedures Intervention group: AVF care training will be given to the patients in the intervention group. The trainings will last for 8 weeks and are planned to be given 1 session per week. In the first session, the patients in the intervention group will be introduced. Afterwards, general information about the purpose and applications of AVF training will be given and the importance of participation in the training will be emphasised. Afterwards, the informed consent form will be signed by the patients who agree to participate in the study. In addition, Patient Information Form, SF-12 Quality of Life Short Form, Comfort Scale for Hemodialysis Patients and Scale for Evaluation of Self-Care Behaviours Regarding Arteriovenous Fistula in Hemodialysis Patients will be given and asked to answer. For illiterate patients, the questionnaire forms will be read by the investigators. In the first session, the pre-test data of the patients will be collected and then the training books will be given.
Control Group: HD patients who fulfil the inclusion criteria for the study will be met face to face. Patients who agree to participate in the study will sign an informed consent form. Afterwards, Patient Information Form, Quality of Life Index for Dialysis Patients, Comfort Scale for Hemodialysis Patients and Scale for Evaluation of Self-Care Behaviours Related to Arteriovenous Fistula in Hemodialysis Patients will be given to the patients and those who can read and write will be asked to fill them in by themselves. For illiterate women, pre-test data will be collected by reading the questionnaire forms by the investigations. No treatment will be applied to the women in this group. At the end of 8 weeks, all participants will be asked to fill in the Patient Information Form, SF-12 Quality of Life Short Form, Comfort Scale for Hemodialysis Patients and Self-Care Behaviour Assessment Scale for Arteriovenous Fistula in Hemodialysis Patients as a post-test application. In addition, after the post-test questionnaire forms are completed, each patient will be given a training booklet and their questions will be answered.
Training Booklet Content The training booklet will be prepared by utilising literature reviews, research results, evidence-based practice guidelines. After the training booklet is prepared, it will be sent to expert opinion. Expert opinions will be obtained according to DISCERN measurement tool. In the training booklet, it was used to ensure the compliance of individuals on hemodialysis with non-compliance with fluid control, diet and medication management and to improve the quality of life by providing individuals with healthy lifestyle behaviours.
Training Presentations The power point presentations used in the training programme and the training booklet will be created from the same content. Training contents will be divided into eight sections. Posters mentioned in the training booklet and considered important for AVF care will be prepared. It will be posted in the waiting room and training room for patients to see.
Aim of the Training Programme It is aimed to provide quality of life, comfort and self-care behaviours by enabling patients to perform AVF care.
Objectives of the Training Programme
Agenda:
What are the treatment options for CKD?
What is hemodialysis?
What is peritoneal dialysis?
In which cases is kidney transplantation performed? Agenda:
What are the vascular access routes used in haemodialysis?
What are the characteristics of AVF, AV graft and tunnelled and untunnelled catheters?
AVF What are hemodialysis and its complications?
What are thrombosis, aneurysm, infection, stenosis, haematoma?
Agenda:
Enrollment
Sex
Ages
Volunteers
Inclusion criteria
Exclusion criteria
Not consenting to participate in the study
Primary purpose
Allocation
Interventional model
Masking
60 participants in 1 patient group
Loading...
Central trial contact
Zümrüt Akgün Şahin, Doctorate
Data sourced from clinicaltrials.gov
Clinical trials
Research sites
Resources
Legal