Improvement of Arteriovenous Fistula Self-Care in Hemodialysis Patients

Abstract

Introduction: chronic kidney disease (CKD) represents a growing public health issue that demands replacement therapies such as hemodialysis. Proper self-care of the arteriovenous fistula (AVF) is essential to maintain vascular access effectiveness and prevent complications. However, a lack of knowledge regarding self-care practices increases the risk of infections and thrombosis, compromising the continuity of treatment. Objective: to evaluate the impact of a structured educational intervention on the level of knowledge, self-care practices, and the incidence of complications related to the arteriovenous fistula in hemodialysis patients and their primary caregivers. Methods: a quasi-experimental pretest-posttest study without a control group was conducted at the CENAG S.A. Hemodialysis Center, Ecuador. Fifty CKD patients and thirty caregivers, selected by convenience sampling, participated. The intervention included face-to-face educational sessions, adapted printed materials, and follow-up telephone calls. Statistical analysis was performed using Student's t-test for related samples, with significance established at p<0,05. Results: following the intervention, the level of self-care knowledge increased from 4,5 ± 1,2 to 8,6 ± 1,0 points (p<0,001), adherence to self-care practices rose from 48 % to 87 % (p<0.01), and the identification of warning signs improved from 38 % to 85 %. The incidence of complications decreased from 32 % to 12 %, reflecting a 62 % reduction. Participants reported greater confidence and autonomy in managing their vascular access. Conclusions: the educational intervention significantly improved knowledge, enhanced self-care practices, and reduced complications associated with AVF in hemodialysis patients. These findings underscore the importance of integrating continuous education programs as an essential component of nephrological care, particularly in resource-limited settings.