The Heavy Toll of Lifeline: An Analysis of the Multidimensional Experience and Interaction Mechanisms of Establishing Arteriovenous Fistula in Patients Receiving Haemodialysis.

BACKGROUND

The arteriovenous fistula, while serving as a vital 'lifeline' for haemodialysis, poses significant clinical challenges; it can extend beyond local dysfunction to adversely affect patients' physiological, psychological and social well-being.

OBJECTIVE

This study explored the multidimensional experiences of patients receiving haemodialysis regarding the creation and maintenance of an arteriovenous fistula, based on the biopsychosocial model.

DESIGN

This study employed the biopsychosocial model as a theoretical framework and an interpretive phenomenological qualitative analysis methodology.

PARTICIPANTS

Participants (N = 23) were recruited from two haemodialysis centres and a nephrology department.

APPROACH: Data were collected through semi-structured interviews and analysed using interpretive phenomenological analysis. NVivo 11 was used to manage the qualitative data.

FINDINGS: The arteriovenous fistula experience was interconnected across biological, psychological and social domains. Physically, patients reported frequent somatic symptoms and arteriovenous fistula-related complications. Psychologically, they underwent a process of cognitive restructuring while contending with persistent negative emotions. Socially, the arteriovenous fistula impaired daily functioning and challenged trust in healthcare, yet also highlighted the crucial role of social support.

CONCLUSION

For patients receiving haemodialysis, the arteriovenous fistula represents both a lifeline and a source of ongoing distress. A multidimensional understanding of this experience is essential for guiding more patient-centred, targeted and humane clinical management.