Negotiating living with an arteriovenous fistula for hemodialysis.

摘要: nd stage renal disease (ESRD),a chronic condition requiringcomplex, technically oriented,expensive care, is a publichealth problem that over-represent-ed in minority, low-income, and eld-erly populations. In 2007, 526,343clients the U.S. had ESRD at costof $23.9 billion dollars (U.S. RenalData System [USRDS], 2009). At thestart of 2008, approximately 367,604clients were on dialysis,and most these, 341,264, receivedhemodialysis (USRDS, A vascular access required forhemodialysis, an arteriovenousfistula medical choicebecause it has longer patency rate,has fewer complications, more cost-effective, associated with lessmortality than other accesses(Centers for Medicare & MedicaidServices [CMS], 2004; NationalKidney Foundation [NKF], 2006;USRDS, The CMS (2006),NKF (2006), Healthy People2010 Department Health andHuman Services [USDHHS], 2000)set goal 66% prevalentclients 50% new clients to havea fistula.Establishing maintaining avascular one biggestproblems hemodialysis (Bonello,Levin, Ronco, 2004); 20% hospi-tal admissions dialysisare complications,with annual cost ofover (Saran,Pisoni, Weitzel, 2004). Although fis-tulas are preferred over grafts orcatheters, client must continuallymonitor fistula because its careand protection integral fis-tula’s survival. However, these activi-ties have not been systematically stud-ied from client’s perspective. This