Educational video for self-care with arteriovenous fistula in renal patients: randomized clinical trial.

OBJECTIVE: to evaluate the effect of an educational video on the knowledge, attitude, and practice of self-care with arteriovenous fistula in patients undergoing hemodialysis treatment. METHOD: randomized controlled clinical trial, with two arms and single-blind. The intervention used an educational video on arteriovenous fistula self-care. The Fistula Self-Care Knowledge, Attitude, and Practice Scale was applied to 27 renal patients on hemodialysis in the control group and 28 in the intervention group at baseline, after seven and fourteen days. The data was analyzed using the Statistical Package for the Social Sciences software, using the chi-square test, Student's t-test, Mann-Whitney test, and Friedman's test with post-hoc analysis for multiple comparisons. RESULTS: there were statistically significant differences in the knowledge and practice of self-care with the fistula at 0, 7 and, 14 days in the intervention (p= 0.004 and p<0.001, respectively) and control groups (p<0.001 for knowledge and practice). Attitude showed a significant difference at follow-up (p<0.001), but the post-hoc analysis did not confirm the significance obtained. CONCLUSION: patients' knowledge and practice showed significant increases at follow-up in the control and intervention groups, while the increase in attitude was not significant in either group. Clinical trial, registration number: U1111-1241-6730.

Development and Psychometric Testing of Scales of Knowledge, Attitude, and Practice of Self-Care for Patients With Arteriovenous Fistula.

Background and Purpose: To validate the scales of knowledge, attitude, and practice of self-care for arteriovenous fistulas in renal patients on hemodialysis. Methods: A methodological study verified the evidence of validity based on the content, response processes, and internal structure of the scales. The content was evaluated by six judges, and the response processes were verified with six patients. In the evaluation of the internal structure, the scales were applied to 220 patients for exploratory factor analysis with evaluation of McDonald's omega adjustment and calculation indexes. Results: The scales explained variance and McDonald's omega values of 40.4%/0.896, 60.7%/0.843, and 36.9%/0.702 for the knowledge (19 items), attitude (4 items), and practice (8 items), respectively. Conclusions: The scale of attitude was valid after the analysis of the content evidence, response processes, and internal structure. The arteriovenous fistula self-care knowledge and practice scales explained less than 50% of the constructs. Therefore, it is recommended that new studies be conducted to validate scales of knowledge and practice of fistula self-care.

Hemodialysis vascular access coordinator: Three-level model for access management.

Management of vascular access is a challenge for the dialysis team, particularly to keep the arteriovenous access working. The vascular access coordinator can positively contribute to increase the number of arteriovenous fistulas and reduce central venous catheters. In this article, we introduce a new approach to vascular access management centered on (the results of setting up) the role of vascular access coordinator. We described the three-level model (3Level_M) for vascular access management organized in three levels: vascular access nurse manager, vascular access coordinator, and vascular access consultant. We defined the instrumental skills and training required to be developed by each element and clarify the articulation between the model and all members of the dialysis team related to vascular access.

Educational video for self-care with arteriovenous fistula in renal patients: randomized clinical trial / Video educativo para el autocuidado de la fístula arteriovenosa en pacientes renales: ensayo clínico aleatorizado / Vídeo educacional para autocuidado com a fístula arteriovenosa de pacientes renais: ensaio clínico randomizado

Objective: to evaluate the effect of an educational video on the knowledge, attitude, and practice of self-care with arteriovenous fistula in patients undergoing hemodialysis treatment. Method: randomized controlled clinical trial, with two arms and single-blind. The intervention used an educational video on arteriovenous fistula self-care. The Fistula Self-Care Knowledge, Attitude, and Practice Scale was applied to 27 renal patients on hemodialysis in the control group and 28 in the intervention group at baseline, after seven and fourteen days. The data was analyzed using the Statistical Package for the Social Sciences software, using the chi-square test, Student's t-test, Mann-Whitney test, and Friedman's test with post-hoc analysis for multiple comparisons. Results: there were statistically significant differences in the knowledge and practice of self-care with the fistula at 0, 7 and, 14 days in the intervention (p= 0.004 and p<0.001, respectively) and control groups (p<0.001 for knowledge and practice). Attitude showed a significant difference at follow-up (p<0.001), but the post-hoc analysis did not confirm the significance obtained. Conclusion: patients' knowledge and practice showed significant increases at follow-up in the control and intervention groups, while the increase in attitude was not significant in either group. Clinical trial, registration number: U1111-1241-6730.

Objetivo: evaluar el efecto de un video educacional en el conocimiento, actitud y práctica del autocuidado de la fístula arteriovenosa de pacientes en tratamiento de hemodiálisis. Método: ensayo clínico aleatorio controlado, con dos brazos y simple ciego. La intervención utilizó un video educacional sobre el autocuidado de la fístula arteriovenosa. Fue aplicada la Escala de conocimiento, actitud y práctica del autocuidado de la fístula en 27 pacientes renales en hemodiálisis del grupo control y en 28 del grupo intervención en la línea de base, después de siete y catorce días. Los datos fueron analizados con el software Statistical Package for the Social Sciences , con la aplicación de las pruebas Chi-cuadrado, T de Student, Mann-Whitney y Test de Friedman, con análisis post-hoc para comparaciones múltiples. Resultados: se verificaron diferencias estadísticamente significativas en el conocimiento y práctica del autocuidado de la fístula en el seguimiento de 0, 7 y 14 días de los grupos intervención (p= 0,004 y p<0,001, respectivamente) y control (p<0,001 para el conocimiento y práctica). La actitud presentó diferencia significativa en el seguimiento (p<0,001), pero el análisis post-hoc no confirmó la significación obtenida. Conclusión: el conocimiento y práctica de los pacientes presentaron aumentos significantes en el seguimiento en los grupos control e intervención, en cuanto que el aumento de la actitud no fue significativo en ninguno de los grupos. Ensayo clínico, número de registro: U1111-1241-6730.

Objetivo: avaliar o efeito de um vídeo educacional no conhecimento, atitude e prática de autocuidado com a fístula arteriovenosa de pacientes em tratamento hemodialítico. Método: ensaio clínico randomizado controlado, com dois braços e unicego. A intervenção utilizou um vídeo educacional sobre o autocuidado com a fístula arteriovenosa. Foi aplicada a Escala de conhecimento, atitude e prática de autocuidado com a fístula em 27 pacientes renais em hemodiálise do grupo controle e 28 do grupo intervenção na linha de base, após sete e quatorze dias. Os dados foram analisados no software Statistical Package for the Social Sciences , com a aplicação dos testes qui-quadrado, T de Student, Mann-Whitney e Teste de Friedman com análise post-hoc para comparações múltiplas. Resultados: verificaram-se diferenças estatisticamente significantes no conhecimento e prática de autocuidado com a fístula no seguimento de 0, 7 e 14 dias dos grupos intervenção (p= 0,004 e p<0,001, respectivamente) e controle (p<0,001 para o conhecimento e prática). A atitude apresentou diferença significativa no seguimento (p<0,001), mas a análise post-hoc não confirmou a significância obtida. Conclusão: o conhecimento e prática dos pacientes apresentaram aumentos significativos no seguimento nos grupos controle e intervenção, enquanto o aumento da atitude não foi significativo em nenhum dos grupos. Ensaio clínico, número de registro: U1111-1241-6730.

How to choose the appropriate cannulation technique for vascular access in hemodialysis patients.

The cannulation technique is important for the survival of the arteriovenous access. Choosing the appropriate technique is a complex decision. Such choice must be customized to patients, considering their characteristics, the type of arteriovenous access and the experience of the hemodialysis team. We describe seven items that can help nurses to identify the appropriate cannulation technique: type of arteriovenous access; drainage vein; hygienic self-care profile; experience of the nursing staff in the cannulation technique and nurse-to-patient ratio; hemodialysis treatment method; patient's condition; and patient's decision. Such items can help nurses in decision-making on the "ideal" cannulation technique for each patient.

Validação de conteúdo do hemodialysis safety checklist para o português brasileiro: um estudo metodológico / Content validation of the hemodialysis safety checklist for brazilian portuguese: a methodological study

OBJETIVO: Realizar adaptação transcultural e validação do conteúdo do HemodialysisSafetyChecklist para uso no Brasil. MÉTODO: Este estudo metodológico foi dividido em seis etapas: i) tradução para o português; ii) comparação e síntese; iii) retrotradução cega; iv) comparação e análise das equivalências conceituais, semânticas e de conteúdo; v) teste piloto com a população-alvo; e vi) validação de conteúdo por meio do cálculo do índice de validade de conteúdo (IVC). RESULTADOS: O processo de adaptação transcultural realizado resultou em um instrumento considerado claro pela população-alvo após a realização do teste piloto. Após duas rodadas de avaliação pelos especialistas, o instrumento foi considerado válido, obtendo um IVC por item (I-IVC) ≥ 0,88 para cada item, e um IVC da escala (S-IVC/Ave) = 0,97. CONCLUSÃO: A versão em português do Hemodialysis Safety Checklist apresenta um conteúdo válido para utilização na realidade da hemodiálise brasileira.

OBJECTIVE: To perform cross-cultural adaptation and content validation of the Hemodialysis Safety Checklist for use in Brazil. METHODS: This methodological study was divided into six stages: i) translation into Portuguese; ii) comparison and synthesis; iii) blind back-translation; iv) comparison and analysis of conceptual, semantic, and content equivalence; v) pilot testing with the target population; and vi) content validation by calculating the Content Validity Index (CVI). RESULTS: The cross-cultural adaptation process resulted in an instrument that was considered precise by the target population after the pilot test. After two rounds of evaluation by experts, the instrument was considered valid, obtaining an Item-Level Content Validity Index (I-CVI) ≥ 0.88 for each item and a Scale-Level Content Validity Index (S-CVI/Ave) = 0.97. CONCLUSION: The Portuguese version of the Hemodialysis Safety Checklist presents valid content for use in Brazilian hemodialysis.

Effects of Long-term Administration of Inhaled Lavender During Hemodialysis on Patients' Invasive Pain, Anxiety, and Comfort During Cannulation: A Single-blind Randomized Controlled Trial.

Context: Although a number of studies have shown that lavender administered via inhalation can decrease the invasive pain and anxiety experienced by hemodialysis (HD) patients during cannulation, the evaluation has mostly been on the short-term effectiveness of lavender oil. Also, no study has evaluated the effects of lavender on comfort level. Objective: The study aimed to investigate the long-term effectiveness of lavender oil, when administered via an inhaler during HD sessions, on a patient's experience of invasive pain, anxiety, and comfort during access to the fistula. Design: The research team designed a prospective, single-blind, randomized, controlled clinical trial. Setting: The study took place in an HD unit of a public hospital in Kirklareli, Turkey. Participants: Participants were 24 patients receiving HD in the unit between January and March 2021. Intervention: Participants were randomly assigned to the intervention or control group. Pure lavender essence was diluted with sweet almond oil at a ratio of 1:10. Before the cannulation procedure at 12 HD sessions, three drops of a 1:10 mixture were placed on sterile gauze and held at a distance of about 10 cm from the participant's nose to ensure its inhalation before the fistula puncture with the needle. No extra procedure was performed for the control group. Outcome Measures: Participants completed a visual analogue scale (VAS) right after puncture of the fistula during each HD session. The STAI and HD Comfort Scale were scored at baseline prior to the first HD session and postintervention at the twelfth HD session. Results: The VAS (P < .001) and state anxiety scores (P = .027) were significantly lower in the intervention group than in the control group at all time points, except at baseline. The comfort scale in the intervention group was significantly higher than that in the control group (P < .05). Conclusions: Lavender aromatherapy could be a good option for reducing the pain, anxiety, and discomfort level of HD patients.

Adaptação e validação do Kidney Transplant Understanding Tool para o contexto brasileiro / Adaptación y validación del Kidney Transplant Understanding Tool para el contexto brasileño / Adaptation and validation of the Kidney Transplant Understanding Tool for the Brazilian context

Resumo Objetivo Realizar a adaptação transcultural e validar o conteúdo do instrumento Kidney Transplant Understanding Tool para o cenário brasileiro. Métodos Estudo metodológico realizado na capital pernambucana, que executou cinco etapas de um protocolo canadense de adaptação transcultural. A versão pré-final do instrumento foi avaliada por 36 participantes em terapia renal substitutiva e sete especialistas em Nefrologia. Resultados Para cada item, atingiu-se o I-IVC ≥ 0,85; e 0,99 para a escala S-IVC/Ave em equivalência conceitual e de conteúdo. O teste binomial apresentou o p-valor ≥ 0,05 para todos os itens; e o Coeficiente de Concordância de Kappa foi de 0,90. Conclusão O instrumento adaptado foi considerado claro pelos participantes e o conteúdo foi validado pelos especialistas. O Kidney Transplant Understanding Tool (K-TUT-Br) foi validado para utilização no contexto do transplante renal no Brasil. A sua aplicação poderá instrumentalizar a enfermagem na implementação de mudanças estratégicas nas estruturas técnico-assistenciais em uso de práticas baseadas em evidências ressaltando o conhecimento e o Letramento em Saúde.

Resumen Objetivo Realizar la adaptación transcultural y validar el contenido del instrumento Kidney Transplant Understanding Tool para el escenario brasileño. Métodos Estudio metodológico realizado en la capital del estado de Pernambuco, donde se ejecutaron cinco etapas de un protocolo canadiense de adaptación transcultural. La versión preliminar del instrumento fue evaluada por 36 participantes en terapia de reemplazo renal y siete especialistas en Nefrología. Resultados En cada ítem se alcanzó el I-IVC ≥ 0,85; y 0,99 en la escala S-IVC/Ave en equivalencia conceptual y de contenido. La prueba binominal presentó el p-valor ≥ 0,05 en todos los ítems; y el coeficiente de concordancia de Kappa fue de 0,90. Conclusión El instrumento adaptado fue considerado claro por los participantes y el contenido fue validado por los especialistas. El Kidney Transplant Understanding Tool (K-TUT-Br) fue validado para su utilización en el contexto del trasplante renal en Brasil. Su aplicación podrá servir de instrumento para enfermeros en la implementación de cambios estratégicos en las estructuras técnico-asistenciales en uso de prácticas basadas en evidencia, destacando el conocimiento y la alfabetización en salud.

Abstract Objective To perform a cross-cultural adaptation and content validation of the Kidney Transplant Understanding Tool for the Brazilian context. Methods A methodological study conducted in the city of Pernambuco, Brazil, which performed the five steps of a Canadian cross-cultural adaptation protocol. The pre-final version of the instrument was evaluated by 36 participants in renal replacement therapy and seven specialists in nephrology Results For each item, the Item Content Validity Index - I-CVI ≥ 0.85 was achieved; and 0.99 for the mean Scale Content Validity Index - S-CVI/Ave in conceptual and content equivalence. The binomial test showed a p-value ≥ 0.05 for all items; and the Kappa Coefficient of Agreement was 0.9. Conclusion The adapted instrument was found to be clear by the participants, and the content was validated by the experts. The Kidney Transplant Understanding Tool (K-TUT-Br) was validated for use in the context of kidney transplantation in Brazil. Its application may enable nurses to implement of strategic changes in technical and care structures using evidence-based practices focusing on knowledge and health literacy.

Radio-cephalic fistula recovered with drainage to median basilic vein by straightening of the forearm cephalic vein: A case report.

The distal arteriovenous fistula (AVF) has less complications and better patency than the proximal fistula, when it works properly. The complications of outflow of the fistula are complex, and it is necessary to analyze all solutions to solve the problem. We introduce a novel approach to solve outflow problems of a radio-cephalic AVF by straightening of the forearm cephalic vein with drainage into the median basilic vein.

The COVID-19 Pandemic and Professional Nursing Practice in the Context of Hospitals.

The COVID-19 pandemic has imposed challenges to health systems and institutions, which had to quickly create conditions to meet the growing health needs of the population. Thus, this study aimed to assess the impact of COVID-19 on professional nursing practice environments and to identify the variables that affected their quality. Quantitative, observational study, conducted in 16 Portuguese hospitals, with 1575 nurses. Data were collected using a questionnaire and participants responded to two different moments in time: the pre-pandemic period and after the fourth critical period of COVID-19. The pandemic had a positive impact on the Structure and Outcome components, and a negative trend in the Process component. The variables associated with the qualification of the components and their dimensions were predominantly: work context, the exercise of functions in areas of assistance to COVID-19 patients, length of professional experience and length of experience in the service. The investment in professional practice environments impacted the improvement of organizational factors, supporting the development of nurses' work towards the quality of care. However, it is necessary to invest in nurses' participation, involvement and professional qualifications, which are aspects strongly dependent on the institutions' management strategies.

Environments of professional nursing practice in the context of the COVID-19 pandemic.

BACKGROUND: Although COVID-19 attracted attention to the environments of professional nursing practice, triggering a series of responses to address some of the most pressing problems, it is important to identify the size and scope of other weaknesses that have emerged. METHODS: In an observational and cross-sectional study, using the Scale for the Evaluation of the Environment of Professional Nursing Practice, 752 nurses from a Portuguese university hospital, provided socio-demographic and professional data about the components structure, process and outcome of their professional nursing environment. Data collection took place from June 1-30, 2020, immediately after the first critical period of the COVID-19 pandemic in Portugal. RESULTS: In the analysed environment of professional nursing practice, Process factors were favourable to the quality of care, while the Structure and Outcome factors had a moderately favourable effect. Structure factors related to work contexts (P < .001) and nursing functions in patient care areas with COVID-19 (P = .001). Process factors related significantly to work contexts (P < .001). A significant association was found between Outcome factors and work contexts (P < .001) and nursing functions in patient care areas with COVID-19 (P = .005). CONCLUSION: The environments of professional nursing practice in the hospital under study are moderately favourable to the quality of care. However, the need to invest in nurses' participation, involvement and professional qualification is clear. Maintenance of a sustainable nursing workforce requires attention to be given to ensuring that practice environments are conducive to the quality of care and geared to promoting professional involvement and job satisfaction among nurses.

Noise levels in the dialysis unit and its relationship with sleep quality and anxiety in patients receiving HD: A pilot study.

INTRODUCTION: HD unit is a noisy environment for patients, and noise can affect anxiety levels and sleep quality. METHODS: The aim of the study is to determine noise level, the relationship between noise levels, and sleep quality and anxiety in patients in HD unit. A descriptive and observational study design was used. Three Benetech GM1351 manual sound-level meters were used to measure noise. A patient information form, the State Anxiety Inventory, and the modified Post-Sleep Inventory were used for data collection. RESULTS: The noise range detected in the HD unit ranges from 48.40 to 72 dB(A). Our findings show that patients in the HD unit are exposed to high noise levels and the noise significantly negatively impacts quality of sleep and anxiety level of the patients. CONCLUSIONS: It is important to be aware that HD patients are constantly exposed to high levels of noise and to plan nursing interventions to reduce this noise level.

Effects of demographic and clinical character on differences in self-care behavior levels with arteriovenous fistula by hemodialysis patients: An ordinal logistic regression approach.

INTRODUCTION: Hemodialysis (HD) patients should be trained to develop self-care behaviors in order to prevent and preserve their arteriovenous fistula (AVF). The aim of this study was identifying the factors that affect the levels of self-care behavior with AVF by HD patients. METHODS: A cross-sectional study was conducted involving 89 patients. RESULTS: Self-care levels were negatively affected by patients' location (Azores) and positively affected by marital status, education, employment, AVF duration, and absence of complications with the AVF. Concerning the management of signs and symptoms, self-care levels were negatively affected by patients' location. Regarding prevention of complications, self-care levels were negatively affected by age and marital status and positively affected by marital status, employment, chronic kidney disease etiology, AVF duration, and previous AVF. CONCLUSION: Further studies are required in order to confirm whether the considered factors affect levels of self-care behaviors with AVF, or whether other factors are needed as well.

Ruptured arteriovenous fistula pseudoaneurysm treatment by balloon-assisted direct percutaneous thrombin injection.

We present the case of a male patient on hemodialysis with a ruptured pseudoaneurysm in a brachiocephalic arteriovenous fistula (AVF) and with edema and pain in the right arm attended to in the emergency department. An ultrasonographic scan identified a ruptured pseudoaneurysm with hemorrhagic infiltration of the arm muscular tissues. We performed a percutaneous ultrasound-guided thrombin injection with an angioplasty balloon inflated in the lumen of the AVF achieving the pseudoaneurysm thrombosis. After 6 months of follow-up, the patient's arteriovenous access remains functional. Percutaneous ultrasound-guided thrombin injection assisted by an angioplasty balloon may be a good alternative to surgical intervention in the treatment of symptomatic growing pseudoaneurysms of the arteriovenous fistula with the benefit of preserving the vascular access.

Ambientes de trabalho de enfermagem durante a covid-19: contribuições para desenvolver uma ferramenta tecnológica / Ambientes de trabajo de enfermería durante covid-19: contribuciones para desarrollar una herramienta tecnológica / Nursing work environments during covid-19: contributions to develop a technological tool

Objetivo: avaliar o impacto da COVID-19 nos ambientes de trabalho de enfermagem e desenvolver uma ferramenta tecnológica para avaliar sistematicamente a qualificação desses contextos. Método: pesquisa de método misto realizada em seis hospitais portugueses, com participação de 442 enfermeiros. Utilizou-se um questionário com caracterização sociodemográfica e profissional, a Scale for the Environments Evaluation of Professional Nursing Practice e questões abertas. Resultados: a COVID-19 teve impacto negativo nos componentes Estrutura (ƿ<0,001), Processo (ƿ<0,001) e Resultado (ƿ=0,009) dos ambientes de trabalho de enfermagem. A monitorização da qualidade dos ambientes de trabalho foi apontada como uma estratégia de melhoria. A ferramenta tecnológica desenvolvida permite identificar precocemente as dimensões mais fragilizadas e priorizar melhorias. Conclusão: a COVID-19 repercutiu negativamente nos ambientes de trabalho. A ferramenta tecnológica construída, que tornou mais dinâmica a avaliação dos ambientes de trabalho, além de garantir o envolvimento dos enfermeiros, constitui uma importante ferramenta de gestão.

Objetivo: evaluar el impacto de COVID-19 en los entornos de trabajo de enfermería y desarrollar una herramienta tecnológica para evaluar sistemáticamente la calificación de estos contextos. Método: investigación de método mixto realizada en seis hospitales portugueses, con participación de 442 enfermeros. Se utilizó un cuestionario con caracterización sociodemográfica y profesional, la Scale for the Environments Evaluation of Professional Nursing Practice y cuestiones abiertas. Resultados: La COVID-19 tuvo impacto negativo en los componentes Estructura (ƿ<0,001), Proceso (ƿ<0,001) y Resultado (ƿ=0,009) de los ambientes de trabajo de enfermería. La monitorización de la calidad de los entornos de trabajo fue apuntada como una estrategia de mejora. La herramienta tecnológica desarrollada permite identificar precozmente las dimensiones más fragilizadas y priorizar mejoras. Conclusión: COVID-19 tuvo un impacto negativo en los entornos de trabajo. La herramienta tecnológica construida, que hizo más dinámica la evaluación de los ambientes de trabajo, además de garantizar la participación de los enfermeros, constituye una importante herramienta de gestión.

Objective: to evaluate the impact of COVID-19 on nursing work environments and to develop a technological tool to assess systematically the qualification of these contexts. Method: mixed method research conducted in six Portuguese hospitals, with the participation of 442 nurses. The questionnaire used contained sociodemographic and professional characterization, which was the Scale for the Environments Evaluation of Professional Nursing Practice and open questions. Results: COVID-19 had a negative impact on the components Structure (ƿ<0,001), Process (ƿ<0,001) and Result (ƿ=0,009) of nursing work environments. The monitoring of the quality of the work environments was pointed out as an improvement strategy. The technological tool developed allows identifying the most fragile dimensions early and prioritizing improvements. Final considerations: COVID-19 had a negative impact on work environments. The technological tool built, which made the evaluation of work environments more dynamic, in addition to ensuring the involvement of nurses, is an important management tool.

Scale for the Environment Evaluation of Professional Nursing Practice: Construct validation.

AIM: Testing the validity and reliability of the Scale for the Environments Evaluation of Professional Nursing Practice (SEE-Nursing Practice). BACKGROUND: The environment of professional nursing practice is key to achieve better results for clients, nurses and institutions. Therefore, instruments enabling the assessment of all its attributes are required. METHOD: Cross-sectional methodological study. The SEE-Nursing Practice, based on a previous qualitative study and literature review, was applied as a questionnaire. Exploratory and confirmatory factor analyses were used to assess construct validity. RESULTS: A total of 752 nurses participated in the study. Exploratory factor analysis of the SEE-Nursing Practice led to a factor solution with 93 items and three subscales. The Structure, Process and Outcome subscales, respectively, have 43, 37 and 13 items, loaded in 6 factors, 6 factors and 2 factors and explaining 62.6%, 59.2% and 67.4% of the total variance. Cronbach's alpha of the overall scale and of the 3 subscales was greater than 0.90. Confirmatory factor analysis showed a good fit. CONCLUSION: SEE-Nursing Practice is a good valid and reliable instrument. IMPLICATIONS FOR NURSING MANAGEMENT: The SEE-Nursing Practice enables assessing practice environments and is a tool for nursing managers in the definition of strategies ensuring favourable environments for nursing care quality.

Scale of Assessment of Self-Care Behaviors with Arteriovenous Fistula in Hemodialysis: A Psychometric Study in Brazil.

The purpose of this study was to evaluate the psychometric properties of the Brazilian Scale for the Assessment of Self-Care Behaviors with Arteriovenous Fistula in Hemodialysis. Cross-sectional validation study, followed the recommendation provided by Sousa and Rojjanasrirat. Content validity, explanatory and confirmatory factor analyses used to check validity and Cronbach's alpha was the reliability measure. Three hundred hemodialysis patients with arteriovenous fistula were included in the study. The expert committee assessed the content validity. Exploratory factor analysis confirmed the same two-factor structure found for the original scale, explaining 60.10% of the variance. Such solution was checked by confirmatory factor analysis with Cronbach's alpha equal to 0.920, 0.810, and 0.884 for the overall scale, the self-care in management of signs and symptoms and the self-care in prevention of complications subscales respectively. The scale has good psychometric properties to assess self-care behaviors and can be used with Brazilian patients on hemodialysis with arteriovenous fistula.

Does Adequate Hemodialysis Prevent Symptoms?: A National Cross-Sectional Survey.

The aim of this study was to identify the relationship between dialysis adequacy and the incidence of symptoms in subjects treated with HD. This descriptive and cross-sectional study was conducted at two HD centers. The data were collected with the 'Descriptive Characteristics Form of the Participants' and the 'Dialysis Symptom Index (DSI)'. The study was reported according to the STROBE Declaration. The study was completed with 120 patients. The most common symptom reported was feeling tired or decreased energy and the least common was difficulty concentrating. No statistically significant relationship was found between DSI results and the Kt/V or urea reduction rate levels used to evaluate dialysis adequacy. Dialysis-related symptoms can also be seen in patients with adequate dialysis levels. It is therefore necessary to query the symptoms experienced by the patients at regular intervals.

Investigating the Effect of a Structured Intervention on the Development of Self-Care Behaviors With Arteriovenous Fistula in Hemodialysis Patients.

This study aimed to assess the effectiveness of a structured intervention on the frequency of self-care behaviors with arteriovenous fistula (AVF) by patients on hemodialysis. This is a quasi-experimental study with pre- and post-measurements. Participants were assigned to an intervention group (IG) (n = 48) or to a control group (CG) (n = 41). IG patients were subject to a structured intervention on self-care with AVF (SISC-AVF) consisting of both a theoretical and a practical part. After SISC-AVF application, patients in the IG showed better overall self-care behaviors with AVF than patients in the CG (79.2% and 91.4%, respectively, p < .001) as well as better self-care concerning both the management of signs and symptoms (90.1% and 94.4% respectively, p = .004) and the prevention of complications (72.7% and 89.5%, respectively, p < .001). The study results suggest that the SISC-AVF had positive effects on patients in the IG.