维持动静脉瘘患者自我护理行为的整合性综述

Self-care actions for the maintenance of the arteriovenous fistula:An integrative review

目的对肾脏病维持动静脉瘘患者的自我护理行为研究进行整合性综述。方法采用整合性综述方法,以“慢性肾功能不全”“动静脉瘘管”,和“自我护理知识”等检索词在Medline/PubMed,Scopus,CINAHL,LILACS,BDENF和SciELO数据库中进行检索。纳入文献包括在过去5年中以葡萄牙语英语和西班牙语发表的相关论文,排除无研究设计或未遵循研究方法学的论文。采用IRAMUTEQ软件分析数据。结果最终15篇论文纳入研究。文本片段分析产生了7组自我护理行为词汇,归纳为3个类别:维持动静脉瘘的自我护理措施;预防和监测动静脉瘘并发症的自我护理措施;针对动静脉瘘术前准备的自我护理措施。结论研究结果有助于明确动静脉瘘功能维持的重要自我护理措施,可为制订针对肾脏患者的自我护理行为和相关资助实施方案提供参考。仍有必要开展更多可提供高水平证据的研究,确定动静脉瘘自我护理行为及实施过程中涉及的因素。

Objective:To identify self-care actions for the maintenance of arteriovenous fistula of renal patients.Method:An integrative review study was conducted and literature were searched in Medline/PubMed,Scopus,CINAHL LILACS,BDENF and SciELO Library databases using the descriptors chronic renal insufficiency,arteriovenous fistula,self-care,and knowledge.The inclusion criteria were that the documents be written in Portuguese,English,and Spanish,full text available,published in the last five years,and that they address the research question.Reflection articles,theses,dissertations,editorials of nonscientific journals,and research studies that did not follow the necessary methodological rigor were excluded.Data were analyzed with the IRAMUJTEQ software.Results:Fifteen articles were selected and comprised the final sample.Seven classes of self-care actions emerged from the text segments analysis and grouped into three categories:(1)Self-care actions that maintain the arteriovenous fistula;(2)Self-care actions for the prevention and the monitoring of complications with arteriovenous fistula;(3)Self-care actions directed at the perioperative period of arteriovenous fistula preparation.Conclusion:The results allowed us to identify important care for the maintenance of arteriovenous fistula functionality.The self-care actions identified in this study can guide a nursing care policy for implementation with protocols that help identify problems related to self-care actions and,thus,subsidize the development of actions aimed at the renal patient.However,more studies with high levels of evidence that identify self-care actions with arteriovenous fistula and the factors involved in its implementation are needed.