RESUMO
BACKGROUND: Dialysis vascular access complications are considered as significant causes of morbidity in chronic hemodialysis patients. OBJECTIVES: The aim of the present study was a comparison of axillary loop and straight grafts patency and its complications in hemodialysis access. PATIENTS AND METHODS: In this cohort study conducted at Shahid Beheshti Medical University, 77 patients who underwent placement of loop or straight access grafts were included. Demographics, primary and secondary patency rates and complications like thrombosis, infection, bleeding, steal syndrome and other complications were compared in these two groups. The collected data was analyzed by chi-square test, t-test, and logistic regression. RESULTS: Primary patency rate in straight and loop groups after 1 month were 88.9% and 92.3% respectively (P = 0.721), and after 24 months were 31% and 55.5% respectively (P = 0.058). Secondary patency rate in straight and loop groups after 3 months were 75.6% and 92.3% respectively (P = 0.189), and after 24 months were 37.9% and 66.7% respectively (P = 0.044). The frequency of complications were the same among two methods of graft replacement and mal incidence of thrombosis, infection, delayed infection, pseudoaneurysm formation and steal syndrome occurrence ultimate graft failure and venous hypertension were not significantly different (P > 0.05). CONCLUSIONS: Polytetrafluorethylene (PTFE) vascular graft seems to be an appropriate vascular access and is a promising alternative when upper extremity arteriovenous fistulas cannot be constructed. Additionally, there was no significant difference between the two groups for complications and early patency, but late patency was improved in loop group. More study is necessary for a conclusive assessment.
RESUMO
BACKGROUND: Having a child in hospital is a stressful experience for most parents. Support from nurses can assist parents to maintain their parenting role and promote quality pediatric nursing care. AIMS AND OBJECTIVES: The aim of the study is to describe the quality of nurse-parent support in Iranian parents of hospitalized children in pediatric sites. METHODS: This was a descriptive study using a convenience sample. Two hundred and thirty parents (183 mothers and 47 fathers) with hospitalized children took part in this survey that used the Nurse Parent Support Tool (NPST). This validated instrument has 21 items and 4 subscales (Informational Giving and Communication Support; Emotional Support; Appraisal Support and Instrumental Support), and was translated into Farsi. RESULTS: The total mean of the NPST was M = 4.1 (SD = 0.7). There was a significant difference between gender of the parents and the Instrumental Support subscale. Also, there was significant difference between among education level of parents and Emotional Support. In addition, there was significant difference related to the gender of the child and Information Giving and Communication Support and Appraisal Support. There was no significant difference in any of the subscales when analyzed for length of hospitalization, kind of diseases and age of children. CONCLUSIONS: The findings indicate that parents received a high level of support from nurses. Nurses can promote the quality of family care and should be aware of the importance of the several types of nursing support in meeting the requests of parents. It is important that nurses continue to develop their knowledge about types of communication with the family, especially in providing support for the parent role.
