Table 3 Themes in Patient Responses Regarding AVF Placement
From: A mixed-methods investigation of incident Hemodialysis access in a safety-net population
Stress & Emotional Barriers | Limited Resources | Patient Suggestions for Care |
|---|---|---|
Emotional responses to surgery: fear, denial, depression, frustration | Lack of information, misinformation regarding disease | Address emotional needs of pre dialysis patients |
Anxiety regarding pain of surgery / fistula cannulation | Lack of health insurance coverage or primary care | Individualize delivery of information for each patient’s learning style |
Difficulty engaging in care and processing information due to depression / anxiety | Missed appointments due to lack of transportation or illness | Provide opportunities to interact with experienced HD patients |
Lack of control and uncertainty | Limited English proficiency | Provide clear explanation of what fistula entails and potential complications |
Doctor patient trust | Housing instability, drug use, and poverty in living environment | Improve engagement with own medical care |
Concerns regarding appearance of fistula | Late diagnosis / urgent hemodialysis start | Build trust / relationship with doctor |