COMPORTAMENTOS DE AUTOCUIDADO COM FÍSTULA ARTERIOVENOSA ENTRE PESSOAS EM TRATAMENTO HEMODIALÍTICO

Abstract

Introduction: Chronic kidney disease affects approximately 10% of the world's population, representing a significant concern for global public health. Patients with chronic kidney disease depend on hemodialysis and use the arteriovenous fistula as a vascular access, which requires constant care to prevent infections and even the loss of this access. The main objective of this study was to analyze the relationship between self-care behavior with the arteriovenous fistula and anxiety, depression, stress and resilience among hemodialysis patients. Methodology: This was an observational, cross-sectional, descriptive-analytical study carried out in four hemodialysis services in the Midwest region of Brazil, in two municipalities in the state of Mato Grosso do Sul. Data was collected from May to July 2024. The study population consisted of people aged 18 or over with chronic kidney disease who had been undergoing hemodialysis treatment with an arteriovenous fistula for six months or more. Exclusion criteria were people with a central venous catheter, double vascular access (central venous catheter and arteriovenous fistula) and hospitalized at the time of data collection. As the aim was to identify factors related to self-care behaviors with the fistula, a sociodemographic and clinical questionnaire was applied, as well as these three scales: “Resilience”, “Depression, Anxiety and Stress” and “Assessment of Self-Care Behaviors with Arteriovenous Fistula in Hemodialysis”. This last instrument is divided into two important sub-scales: Management of Signs and Symptoms and Prevention of Complications. The study was approved by the UFMS Human Research Ethics Committee under opinion no. 6.721.932, respecting the precepts of Resolution no. 466/2012. The questions asked were recorded on a cell phone in Google Forms format. The data obtained was migrated to Stata software version 14.0, where the statistical analysis was carried out. This study analyzed the data of all 112 people eligible by the inclusion and exclusion criteria cited. Results: The results were obtained from the preparation of three articles, as follows: People on hemodialysis for more than 24 months were 31% less likely to have no self-care for their arteriovenous fistula than people on hemodialysis for less than 24 months. The majority had been on treatment for more than 24 months, and there was a balance between the sexes in the sample, with participants having a high literacy rate. There were associations between the sociodemographic variables for the General Self-Care, Management of Signs and Symptoms and Prevention of Complications subscales. There was no significant association between self-care behaviors and the variables studied. Final considerations: Although no association was identified between self-care and the four variables analyzed, the research revealed that anxiety is prevalent among hemodialysis patients. This highlights the need to implement more educational actions in order to provide patients with adequate information and thus promote increased levels of self-care. The study also helped to reinforce the relevance of self-care with the fistula, highlighting its fundamental role in promoting comprehensive health care and supporting the mental health of these patients. Keywords: Renal dialysis. Arteriovenous fistula. Self-care. Nursing care.