Knowledge, attitude, and practice toward arteriovenous fistula self-care among maintenance hemodialysis patients with diabetic kidney disease

Background This study aimed to examine the knowledge, attitude, and practice toward arteriovenous fistula (AVF) self-care among diabetic kidney disease (DKD) patients who received maintenance hemodialysis. Methods This cross-sectional study was carried out from 1st January to 31st March, 2024 among patients with DKD who received maintenance hemodialysis. A self-administered questionnaire was utilized to collect demographic information and evaluate knowledge, attitude, and practice related to AVF self-care. Results A total of 757 valid surveys were collected for this study; average age of participants was 59.70 ± 10.7 years. The scores for knowledge, attitude, and practice were 29.59 ± 7.96 (ranging from 0 to 38), 41.89 ± 4.02 (ranging from 9 to 45), and 67.57 ± 7.44 (ranging from 15 to 75), respectively. Multivariate logistic regression revealed that knowledge (odds ratio [OR] = 5.044, 95% confidence interval [CI]: [3.052–8.335], P < .001) and attitude (OR = 14.17, 95% CI: [8.328–24.12], P < .001) were independently associated with proactive practice. The Structural Equation Model showed that knowledge had a direct and positive impact on attitude (β = 0.527, P < .001) and practice (β = 0.243, P < .001). Attitude also had a direct and positive influence on practice (β = 0.692, P < .001). Conclusions Patients with DKD who received maintenance hemodialysis showed positive attitude and proactive practice towards AVF self-care, even if their level of knowledge was inadequate. Targeted education was recommended to improve patients’ knowledge.