Qualitative study on obstacle factors for inadequate utilization rate of autologous arteriovenous fistula in dialysis patients

JING Yuejuan; DU Haiying; LU Huali

doi:10.12102/j.issn.1009-6493.2025.15.007

Abstract：Objective:To analyze the obstacle factors for inadequate utilization rate of autologous arteriovenous fistula(AVF)during the first dialysis of dialysis patients.Methods:Using the focus group interview method,interviews were conducted with 16 medical and nursing staff from the nephrology department and dialysis room of Second Hospital of Shanxi Medical University,as well as 20 patients diagnosed with end-stage kidney disease who underwent hemodialysis treatment for less than 3 months.Colaizzi's 7-step analysis method was used for data analysis.Results:The obstacle factors for inadequate utilization rate of autologous AVF during the first dialysis of dialysis patients included three aspects:evidence,adopters,and practice environment.In terms of evidence:lack of relevant data support,difficult execution.Nurses lack authority.Lack of research results from other fields to assist patients in making active decisions.In terms of adopters:patients do not attach importance to the disease and have insufficient awareness.The patient refuses to establish an arteriovenous fistula in advance.The patient's emotions was confusion and fear.In terms of practical environment:a lack of standardized operating procedures for autologous arteriovenous fistula.A lack of a comprehensive vascular access specialist management team.And a lack of established multidisciplinary cooperation mechanisms.Conclusions:Guided by the Ottawa research application model,this study identified 9 major obstacle factors for inadequate utilization rate of autologous AVF during the first dialysis of dialysis patients from three aspects:evidence,potential adopters,and practical environment.It provided a basis for constructing intervention strategies and promoting the early establishment of autologous arteriovenous fistulas in the future.