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Abstract
Introduction: Pain during puncture of the arteriovenous fistula is a constant in all hemodialysis patients. Objective: The purpose of the study was to explore the perception of pain during puncture in hemodialysis patients, analyzing both emotions and ideas about their quality of life. Material and Method: A qualitative study with a phenomenological approach was carried out at the Reina Sofía University Hospital in Córdoba, at the Nephrology Unit and at the External Consultation Service “El Perpetuo Socorro” (which also belongs to the same hospital). Semi-structured interviews were conducted with ten patients, men and women suffering from chronic renal failure on hemodialysis. Results: A content analysis was carried out from which three main categories associated with different subcategories emerged: 1) It hurts, it hurts, huh? But ... (Improves over time; When it hurts, it does; Does it hurt? You don't even know); 2) Anxiety and fears related to the intervention (Question of make aware; Anticipatory anxiety; Despair and insecurity in the face of complications and misinformation; For God's sake, do not break the fistula!; The nurse’s hands); 3) A compromised quality of life (Many limitations; But it doesn't have that much impact; catheter or fistula?). Conclusions: The study allowed describing the perceptions of hemodialysis patients regarding puncture, context and consequences, allowing, first, a greater understanding and empathy in health professionals and, later, a basis for other approaches to the phenomenon.
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References
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- ERA-EDTA Registry [Internet]. [Consultado 5 mar 2019]. Disponible en: https://www.era-edta-reg.org/files/annualreports/pdf/AnnRep2013.pdf.
- Siddiky A, Sarwar K, Ahmad N, Gilbert J. Management of arteriovenous fistulas. BMJ. 2014;349:g6262. DOI: https://doi.org/10.1136/bmj.g6262
- Roca-Tey R. El acceso vascular para hemodiálisis: la asignatura pendiente. Nefrología 2010;30(3):280-7.
- Martín IJ, Minguela JI, Ocharan-Corcuera J, Chena A, Ruiz-de-Gauna R. Indicaciones y tipos de accesos para Hemodiálisis. Dial Trasplant 2008;29(4): 173-6. DOI: https://doi.org/10.1016/S1886-2845(08)75061-6
- Van Tricht I, De Wachter D, Tordoir J, Verdonck P. Hemodynamics and complications encountered with arteriovenous fistulas and grafts as vascular access for hemodialysis: a review. Ann Biomed Eng. 2005;33(9):1142-57. DOI: https://doi.org/10.1007/s10439-005-5367-X
- Ibeas J, Roca-Tey R. Guía Clínica Española del Acceso Vascular para Hemodiálisis. Enfermer Nefrol 2018;37(Supl 1):S1-177. DOI: https://doi.org/10.4321/S2254-28842018000500001
- Ocak G, Rotmans JI, Vossen CY, Rosendaal FR, Krediet RT, Boeschoten EW, etal. Type of arteriovenous vascular access and association with patency and mortality. BMC Nephrol. 2013;14:79. DOI: https://doi.org/10.1186/1471-2369-14-79
- Granados I, Abril D, Alcaraz F, Mañé N, Padilla J, Real J et al. Una actuación de enfermería: intentar aliviar el dolor en las punciones de hemodiálisis. Rev Soc Esp Enferm Nefrol 2005;8(3):55-60. DOI: https://doi.org/10.4321/S1139-13752005000300006
- Blanco-Mavillard I, Rodríguez-Calero MA, Sánchez-Rojas C. Evaluación de complicaciones de la fístula arteriovenosa para hemodiálisis según la técnica de canalización. Enferm Nefrol 2017;20 (2):167-77. DOI: https://doi.org/10.4321/S2254-288420170000200010
- MacRae JM, Ahmed SB, Atkar R, Hemmelgarn BR. A randomized trial comparing buttonhole with rope ladder needling in conventional hemodialysis patients. Clin J Am Soc Nephrol. 2012;7(10):1632-8. DOI: https://doi.org/10.2215/CJN.02730312
- Aitken E, McLellan A, Glen J, Serpell M, Mactier R, Clancy M. Pain resulting from arteriovenous fistulae: prevalence and impact. Clin Nephrol. 2013;80(5):328-33. DOI: https://doi.org/10.5414/CN107917
- Delgado A, Ruiz-García E, Latorre LI, Crespo R. Factores que influyen en la supervivencia de la fístula arteriovenosa interna y su relación con la técnica de punción. Enferm Nefrol 2016;19(3): 215-30. DOI: https://doi.org/10.4321/S2254-28842016000300004
- Sanz M, Garrido-Pérez L, Caro C. Factores que influyen en la satisfacción del paciente de diálisis con enfermería. Enferm Nefrol 2017;20(1):66-75. DOI: https://doi.org/10.4321/S2254-28842017000100009
- Guerra-Guerrero VT, Sanhueza-Alvarado OI. Investigación Cualitativa: ¿método de investigación para la población en hemodiálisis? Index Enferm 2013;22(3):161-5. DOI: https://doi.org/10.4321/S1132-12962013000200010
- Berenguera A, Fernández de Sanmamed M, Pons M, Pujol E, Rodríguez D, Saura S. Escuchar, observar y comprender. Recuperando la narrativa en las Ciencias de la Salud. Barcelona: Institut Universitari d’Investigació en Atenció Primària Jordi Gol (IDIAP J. Gol); 2014.
- Griva K, Seow PS, Seow TY-Y, Goh ZS, Choo JCJ, Foo M, et al. Patient-Related Barriers to Timely Dialysis Access Preparation: A Qualitative Study of the Perspectives of Patients, Family Members, and Health Care Providers. Kidney Med 2020;2(1):29-41. DOI: https://doi.org/10.1016/j.xkme.2019.10.011
- Kopple JD, Shapiro BB, Feroze U, Kim JC, Zhang M, Li Y, et al. Hemodialysis treatment engenders anxiety and emotional distress. Clin Nephrol 2017;88(4):205-17. DOI: https://doi.org/10.5414/CN109112
- Gencer N. Does religiosity affect subjective well-being? A cross-sectional study on hemodialysis (hd) patients. Cumhuriyet Ilahiyat Dergisi. 2019;23(3):1419-44. DOI: https://doi.org/10.18505/cuid.601055
- Kim S, Kim E, Ryu E. Illness Perceptions, Self-Care Management, and Clinical Outcomes According to Age-Group in Korean Hemodialysis Patients. Int J Environ Res Public Health.2019;16(22):4459. DOI: https://doi.org/10.3390/ijerph16224459
- Cassidy BP, Harwood L, Getchell LE, Smith M, Sibbald SL, Moist LM. Educational Support Around Dialysis Modality Decision Making in Patients With Chronic Kidney Disease: Qualitative Study. Can J Kidney Health Dis. 2018;5:2054358118803323. DOI: https://doi.org/10.1177/2054358118803323
- Field M, Tullett K, Khawaja A, Jones R, Inston NG. Quality improvement in vascular access: The role of patient-reported outcome measures. J Vasc Access. 2020;21(1):19-25. DOI: https://doi.org/10.1177/1129729819845624
- Biggar P, Hidde D, Ketteler M. Needs Around Dialysis Treatment from Different Perspectives (NADIP): Results of the Exploratory German Multicenter Survey. Kidney Blood Press Res. 2019;44(5):1233-46. DOI: https://doi.org/10.1159/000502716
- Axelsson L, Benzein E, Lindberg J, Persson C. End-of-life and palliative care of patients on maintenance hemodialysis treatment: a focus group study. BMC Palliat Care. 2019;18(1):89. DOI: https://doi.org/10.1186/s12904-019-0481-y
- Delmas P, Antonini M, Berthoud L, O’Reilly L, Cara C, Brousseau S, et al. A comparative descriptive analysis of perceived quality of caring attitudes and behaviours between haemodialysis patients and their nurses. Nursing Open. 2020;7(2):563-70. DOI: https://doi.org/10.1002/nop2.421
- Jacobson J, Ju A, Baumgart A, Unruh M, O’Donoghue D, Obrador G, et al. Patient Perspectives on the Meaning and Impact of Fatigue in Hemodialysis: A Systematic Review and Thematic Analysis of Qualitative Studies. Am J Kid Dis. 2019;74(2):179-92. DOI: https://doi.org/10.1053/j.ajkd.2019.01.034
- Hole B, Selman L. Illness as Transformative Experience: Implications of Philosophy for Advance Care Planning. J Pain Symptom Manage. 2020;59(1):172-7. DOI: https://doi.org/10.1016/j.jpainsymman.2019.02.025
- Özdemir AA, Sayin CB, Erdal R, Özcan C, Haberal M. Quality of life through gender role perspective in candidate renal transplant recipients: A report from baskent university using the short form 36 health survey. Exp Clin Transplant.2018;16:28-34.
References
Registro de Diálisis y Trasplante. Sociedad Española de Nefrología. [Consultado 5 mar 2019]. Disponible en http://www.senefro.org/modules.php?name=webstructure&idwebstructure=293.
ERA-EDTA Registry [Internet]. [Consultado 5 mar 2019]. Disponible en: https://www.era-edta-reg.org/files/annualreports/pdf/AnnRep2013.pdf.
Siddiky A, Sarwar K, Ahmad N, Gilbert J. Management of arteriovenous fistulas. BMJ. 2014;349:g6262. DOI: https://doi.org/10.1136/bmj.g6262
Roca-Tey R. El acceso vascular para hemodiálisis: la asignatura pendiente. Nefrología 2010;30(3):280-7.
Martín IJ, Minguela JI, Ocharan-Corcuera J, Chena A, Ruiz-de-Gauna R. Indicaciones y tipos de accesos para Hemodiálisis. Dial Trasplant 2008;29(4): 173-6. DOI: https://doi.org/10.1016/S1886-2845(08)75061-6
Van Tricht I, De Wachter D, Tordoir J, Verdonck P. Hemodynamics and complications encountered with arteriovenous fistulas and grafts as vascular access for hemodialysis: a review. Ann Biomed Eng. 2005;33(9):1142-57. DOI: https://doi.org/10.1007/s10439-005-5367-X
Ibeas J, Roca-Tey R. Guía Clínica Española del Acceso Vascular para Hemodiálisis. Enfermer Nefrol 2018;37(Supl 1):S1-177. DOI: https://doi.org/10.4321/S2254-28842018000500001
Ocak G, Rotmans JI, Vossen CY, Rosendaal FR, Krediet RT, Boeschoten EW, etal. Type of arteriovenous vascular access and association with patency and mortality. BMC Nephrol. 2013;14:79. DOI: https://doi.org/10.1186/1471-2369-14-79
Granados I, Abril D, Alcaraz F, Mañé N, Padilla J, Real J et al. Una actuación de enfermería: intentar aliviar el dolor en las punciones de hemodiálisis. Rev Soc Esp Enferm Nefrol 2005;8(3):55-60. DOI: https://doi.org/10.4321/S1139-13752005000300006
Blanco-Mavillard I, Rodríguez-Calero MA, Sánchez-Rojas C. Evaluación de complicaciones de la fístula arteriovenosa para hemodiálisis según la técnica de canalización. Enferm Nefrol 2017;20 (2):167-77. DOI: https://doi.org/10.4321/S2254-288420170000200010
MacRae JM, Ahmed SB, Atkar R, Hemmelgarn BR. A randomized trial comparing buttonhole with rope ladder needling in conventional hemodialysis patients. Clin J Am Soc Nephrol. 2012;7(10):1632-8. DOI: https://doi.org/10.2215/CJN.02730312
Aitken E, McLellan A, Glen J, Serpell M, Mactier R, Clancy M. Pain resulting from arteriovenous fistulae: prevalence and impact. Clin Nephrol. 2013;80(5):328-33. DOI: https://doi.org/10.5414/CN107917
Delgado A, Ruiz-García E, Latorre LI, Crespo R. Factores que influyen en la supervivencia de la fístula arteriovenosa interna y su relación con la técnica de punción. Enferm Nefrol 2016;19(3): 215-30. DOI: https://doi.org/10.4321/S2254-28842016000300004
Sanz M, Garrido-Pérez L, Caro C. Factores que influyen en la satisfacción del paciente de diálisis con enfermería. Enferm Nefrol 2017;20(1):66-75. DOI: https://doi.org/10.4321/S2254-28842017000100009
Guerra-Guerrero VT, Sanhueza-Alvarado OI. Investigación Cualitativa: ¿método de investigación para la población en hemodiálisis? Index Enferm 2013;22(3):161-5. DOI: https://doi.org/10.4321/S1132-12962013000200010
Berenguera A, Fernández de Sanmamed M, Pons M, Pujol E, Rodríguez D, Saura S. Escuchar, observar y comprender. Recuperando la narrativa en las Ciencias de la Salud. Barcelona: Institut Universitari d’Investigació en Atenció Primària Jordi Gol (IDIAP J. Gol); 2014.
Griva K, Seow PS, Seow TY-Y, Goh ZS, Choo JCJ, Foo M, et al. Patient-Related Barriers to Timely Dialysis Access Preparation: A Qualitative Study of the Perspectives of Patients, Family Members, and Health Care Providers. Kidney Med 2020;2(1):29-41. DOI: https://doi.org/10.1016/j.xkme.2019.10.011
Kopple JD, Shapiro BB, Feroze U, Kim JC, Zhang M, Li Y, et al. Hemodialysis treatment engenders anxiety and emotional distress. Clin Nephrol 2017;88(4):205-17. DOI: https://doi.org/10.5414/CN109112
Gencer N. Does religiosity affect subjective well-being? A cross-sectional study on hemodialysis (hd) patients. Cumhuriyet Ilahiyat Dergisi. 2019;23(3):1419-44. DOI: https://doi.org/10.18505/cuid.601055
Kim S, Kim E, Ryu E. Illness Perceptions, Self-Care Management, and Clinical Outcomes According to Age-Group in Korean Hemodialysis Patients. Int J Environ Res Public Health.2019;16(22):4459. DOI: https://doi.org/10.3390/ijerph16224459
Cassidy BP, Harwood L, Getchell LE, Smith M, Sibbald SL, Moist LM. Educational Support Around Dialysis Modality Decision Making in Patients With Chronic Kidney Disease: Qualitative Study. Can J Kidney Health Dis. 2018;5:2054358118803323. DOI: https://doi.org/10.1177/2054358118803323
Field M, Tullett K, Khawaja A, Jones R, Inston NG. Quality improvement in vascular access: The role of patient-reported outcome measures. J Vasc Access. 2020;21(1):19-25. DOI: https://doi.org/10.1177/1129729819845624
Biggar P, Hidde D, Ketteler M. Needs Around Dialysis Treatment from Different Perspectives (NADIP): Results of the Exploratory German Multicenter Survey. Kidney Blood Press Res. 2019;44(5):1233-46. DOI: https://doi.org/10.1159/000502716
Axelsson L, Benzein E, Lindberg J, Persson C. End-of-life and palliative care of patients on maintenance hemodialysis treatment: a focus group study. BMC Palliat Care. 2019;18(1):89. DOI: https://doi.org/10.1186/s12904-019-0481-y
Delmas P, Antonini M, Berthoud L, O’Reilly L, Cara C, Brousseau S, et al. A comparative descriptive analysis of perceived quality of caring attitudes and behaviours between haemodialysis patients and their nurses. Nursing Open. 2020;7(2):563-70. DOI: https://doi.org/10.1002/nop2.421
Jacobson J, Ju A, Baumgart A, Unruh M, O’Donoghue D, Obrador G, et al. Patient Perspectives on the Meaning and Impact of Fatigue in Hemodialysis: A Systematic Review and Thematic Analysis of Qualitative Studies. Am J Kid Dis. 2019;74(2):179-92. DOI: https://doi.org/10.1053/j.ajkd.2019.01.034
Hole B, Selman L. Illness as Transformative Experience: Implications of Philosophy for Advance Care Planning. J Pain Symptom Manage. 2020;59(1):172-7. DOI: https://doi.org/10.1016/j.jpainsymman.2019.02.025
Özdemir AA, Sayin CB, Erdal R, Özcan C, Haberal M. Quality of life through gender role perspective in candidate renal transplant recipients: A report from baskent university using the short form 36 health survey. Exp Clin Transplant.2018;16:28-34.