Effects of a self-care promotion program on the success of one day surgery and vascular thrill at 30 days post-operative in patients undergoing arteriovenous anastomosis at Mae Sot Hospital
Keywords:
arteriovenous fistula surgery, hemodialysis, one day surgery, vascular patencyAbstract
Introduction: Arteriovenous anastomosis surgery for hemodialysis is essential for patients with end-stage renal disease undergoing renal replacement therapy. A self-care promotion program for patients undergoing vascular access surgery, provided by operating room nurses, may enhance surgical success rates.
Objectives: To investigate the success rate of one day vascular access surgery, vascular patency 30 days post-surgery, and patient satisfaction in the self-care promotion program group.
Methods: A quasi-experimental study with a historical control group was conducted among patients undergoing single-day vascular access surgery for hemodialysis at Mae Sot Hospital, Tak Province. The experimental and control groups were matched on a 1:1 ratio. The control group data were collected retrospectively under standard care, while the experimental group data were collected from August 2024 to January 2025, included a self-care promotion program, instructional guidelines, and educational video materials. Data were analyzed using descriptive statistics, frequencies, percentages, and inferential statistics including chi-square test, exact probability test, Wilcoxon-Mann-Whitney test, and multivariate binary regression analysis.
Results: A total of 60 patients met the study criteria, with 30 in the control group and 30 in the experimental group. Baseline characteristics were comparable. The success rate of single-day vascular access surgery in the experimental group was 100%, not significantly higher than the control group (93.33%; p=0.492). Vascular patency at 30 days post-surgery was also higher in the experimental group (99.67% vs. 70.00%, p=0.012). Multivariable regression analysis was adjusted for differences in age, educational level, history of vascular surgery, hemoglobin levels, diabetes mellitus status, postoperative caregiver support, preoperative waiting time, duration of surgery, and surgical site, indicated that the experimental group had a 23.27% improvement in vascular patency (RD 23.27, 95%CI 9.55-39.99, p=0.001). Patient satisfaction in the experimental group was rated as very high.
Conclusion: The self-care promotion program increased the success rate of single-day vascular access surgery and improved vascular patency at 30 days post-surgery. Given the high patient satisfaction, the program should be considered for continued implementation in healthcare settings.
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