Educational or Behavioural Interventions to Improve Long-Term Haemodialysis Vascular Access Self-Management: A Systematic Review

IF 1.5 4区医学 Q3 NURSING

Journal of renal care Pub Date : 2025-01-28 DOI:10.1111/jorc.70005

Colette Wembenyui, Nicole Marsh, Emily Larsen, Ann Bonner

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引用次数: 0

Abstract

Background

Globally, haemodialysis is the most frequent type of kidney replacement therapy and necessitates access to the bloodstream either through a native arteriovenous fistula, arteriovenous graft or central venous catheter. Vascular access complications are a major cause of morbidity and mortality in adults receiving haemodialysis, and effective vascular access self-management is required.

Objective

To examine the effectiveness of educational or behavioural interventions designed to improve self-management of long-term vascular access in adults receiving haemodialysis.

Design

Systematic review.

Method

English language publications from January 2013 to May 2023 retrieved from PubMed, Embase, CINAHL, Cochrane Library, PsycINFO and Joanna Briggs Institute (JBI) databases were undertaken. Two independent reviewers identified studies for full-text review, data extraction and quality assessment. Data synthesis and quality assessment followed the JBI guidelines for quantitative reviews.

Results

Seven studies involving 540 participants were included: two studies were randomised control trials and five were quasiexperimental. All studies involved patient education, predominantly provided by nurses, and employed a variety of teaching resources, such as education booklets, practical demonstrations and videos. Outcomes measured included vascular access self-management behaviours, self-efficacy and vascular access knowledge although there was no consistency between studies. Overall, vascular access self-management significantly improved following education.

Conclusion

Educational interventions led to improvements in self-management behaviours in adults with long-term haemodialysis vascular access. However, there was insufficient evidence for the delivery and duration of intervention education. Further research is needed. An evidence-based nurse-led codesign intervention could lead to improvements in vascular access self-management.

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教育或行为干预改善长期血液透析血管通路自我管理：系统综述。

背景：在全球范围内，血液透析是最常见的肾脏替代治疗类型，需要通过原生动静脉瘘、动静脉移植物或中心静脉导管进入血液。血管通路并发症是接受血液透析的成人发病和死亡的主要原因，需要有效的血管通路自我管理。目的：探讨教育或行为干预的有效性，旨在提高接受血液透析的成人长期血管通路的自我管理。设计：系统回顾。方法：检索PubMed、Embase、CINAHL、Cochrane Library、PsycINFO和Joanna Briggs Institute （JBI）数据库中2013年1月至2023年5月的英文出版物。两名独立审稿人确定了研究的全文审查、数据提取和质量评估。数据综合和质量评估遵循JBI定量审查指南。结果：纳入7项研究，涉及540名受试者：2项研究为随机对照试验，5项为准实验。所有研究都涉及患者教育，主要由护士提供，并采用各种教学资源，如教育小册子，实践演示和视频。测量的结果包括血管通路自我管理行为、自我效能和血管通路知识，尽管研究之间没有一致性。总体而言，教育后血管通路自我管理显著改善。结论：教育干预导致长期血液透析血管通路成人自我管理行为的改善。然而，关于干预教育的提供和持续时间的证据不足。需要进一步的研究。循证护士主导的协同设计干预可以改善血管通路自我管理。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of renal care Nursing-Advanced and Specialized Nursing

CiteScore

3.50

自引率

5.30%

发文量

期刊介绍： The Journal of Renal Care (JORC), formally EDTNA/ERCA Journal, is the official publication of the European Dialysis and Transplant Nursing Association/European Renal Care Association (EDTNA/ERCA). The Journal of Renal Care is an international peer-reviewed journal for the multi-professional health care team caring for people with kidney disease and those who research this specialised area of health care. Kidney disease is a chronic illness with four basic treatments: haemodialysis, peritoneal dialysis conservative management and transplantation, which includes emptive transplantation, living donor & cadavaric transplantation. The continuous world-wide increase of people with chronic kidney disease (CKD) means that research and shared knowledge into the causes and treatment is vital to delay the progression of CKD and to improve treatments and the care given. The Journal of Renal Care is an important journal for all health-care professionals working in this and associated conditions, such as diabetes and cardio-vascular disease amongst others. It covers the trajectory of the disease from the first diagnosis to palliative care and includes acute renal injury. The Journal of Renal Care accepts that kidney disease affects not only the patients but also their families and significant others and provides a forum for both the psycho-social and physiological aspects of the disease.