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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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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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.