Development Of The Self-management Scale For Autologous Dynamic And Static Internal Fistula In Patients With Maintenance Hemodialysis

Objective:The purpose of this study was to develop a self-management scale of arteriovenous internal fistula in patients with maintenance hemodialysis and to test the reliability and validity of the scale.Methods(1)In this study,Orem self-care theory was used as the theoretical basis to form the basic framework of the scale;(2)The initial self-management scale of arteriovenous internal fistula in patients with maintenance hemodialysis was developed by reviewing literature and referring to the guidelines for the quality of life of patients with nephropathy and dialysis(KDOQI)and the expert consensus on vascular access for hemodialysis in China(version 1)through semi-structured interview and expert consultation for patients with maintenance hemodialysis.The initial scale with 18 items in 3 dimensions was formed after preliminary investigation.(3)The initial scale was used to investigate 305 patients with maintenance hemodialysis.Epidata software was used to establish the database of the survey data.The data were imported into SPSS23.0 software for statistical analysis.The homogeneity reliability was divided into half reliability test and retest reliability test.The content validity and structure validity were used to evaluate the validity.Results:(1)The self-management scale of arteriovenous internal fistula in patients with maintenance hemodialysis was preliminarily developed by referring to relevant guidelines and consensus literature review and combining with the interview results of 17 patients with maintenance hemodialysis,including 3 dimensions and 20 items;(2)After 2 rounds of expert consultation,1 item was deleted,3 items were combined,and 1 item was added to form the initial self-management scale of arteriovenous internal fistula in patients with maintenance hemodialysis with 3 dimensions and 18 items.(3)After item analysis and exploratory factor analysis,a total of 18 items were deleted,and the final version of the scale consisted of 3 dimensions and 16 items,namely,identification of complications(9 items),management of complications(4 items)and prevention of complications(3 items).(4)Reliability test:the Cronbach coefficient of the total table was 0.905,and the three dimensions were 0.893,0.809 and 0.774,respectively.The odd-even half-reliability coefficient of the total table was 0.800,and the three dimensions were 0.848 0.784 0.721,respectively.The retest coefficient of the scale was 0.897,and the three dimensions were 0.787,0.786,and 0.718 respectively,all of which had statistical significance(p<0.05).Conclusion:In this study,the self-management scale of arteriovenous internal fistula for maintenance hemodialysis patients has good reliability and validity.Scale for measuring content conforms to our country's social and cultural background and the characteristics of arteriovenous fistula in patients self management,can accurately reflect the maintenance hemodialysis patients of arteriovenous fistula in self management level,can be used to measure the maintenance hemodialysis patients with arteriovenous fistula in the ability of self management,to provide reference for subsequent conduct in-depth study.