<b>Influência dos acessos vasculares na autoimagem e sexualidade dos pacientes em hemodiálise: contribuição para enfermagem/Influence of vascular accesses on the self-image and sexuality of patients undergoing hemodialysis: contribution to nursing<b>

Abstract

O estudo teve como objetivos identificar a percepção dos pacientes em tratamento hemodialítico acerca da influência dos cateteres ou da fístula arteriovenosa em sua autoimagem e sexualidade; e descrever as repercussões biopsicossociais do uso do cateter de hemodiálise ou da fístula arteriovenosa na vida dos pacientes em tratamento hemodialítico. Pesquisa qualitativa, descritiva e exploratória, desenvolvida no setor de hemodiálise de um hospital público no Rio de Janeiro. Os participantes foram 16 pacientes com fístula arteriovenosa ou cateter em tratamento hemodialítico. Os dados foram coletados mediante a entrevista semiestruturada, no mês de junho de 2016, e após submetidos à análise de conteúdo temática, que fez emergir três categorias empíricas: Percepções do acesso vascular: a ótica de pacientes em terapia dialítica; Repercussões do acesso vascular para o cotidiano dos pacientes com doença renal crônica; e Influências do acesso vascular na autoimagem e sexualidade do portador de doença renal crônica. Conclui-se que os cateteres ou a fístula arteriovenosa influenciam negativamente na autoimagem, sexualidade e na qualidade de vida, pois geram modificações corporais que limitam a vida da pessoa que realiza hemodiálise.

Relationship between the comfort level of chronic renal patients and sociodemographic and clinical variables

“…The presence of apparent vascular accesses such as the catheter causes significant damage to patient self-image and sexuality, as well as discomfort in a sensitive region when inserted in the jugular or in an intimate region like the femoral vein. The fact of having a chronic disease with no possibility of cure and needing dialysis associated with an AVF or catheters to survive ends up generating social isolation and disinterest in affective relationships (17) , a fact that can compromise comfort in the environment.…”

Quality of life of elderly in dialytic treatment: a reflective theoretical study

“…Elderly patients on hemodialysis face uncertainties about their own future, not only dealing with treatment-related complications such as left ventricular hypertrophy, joint sclerosis, and secondary hyperparathyroidism, among others but also with changes in their perceptions of self-esteem resulting, for example, from oral health problems and bone deformities. 14 Hemodialysis treatment is responsible for a restrictive daily life that causes limitations not only to patients but also to their families; during hemodialysis sessions, the patient may experience various intercurrences such as malaise, vomiting, hypotension, cramps, arrhythmias, among other conditions, including life-threatening ones, situations that clearly impact the conduct of one's own life. 23 It is also worth noting that most patients on hemodialysis have depressive symptoms related to the disease itself.…”

“…It is also possible that chronic kidney patients experience mood swings caused by the hemodialysis procedure and medications, which can cause irritability and depression, which in some way affect relationships with multidisciplinary teams in general. 14 CKD was identified as a risk factor and predictor of worsening quality of life for people with this condition, especially those undergoing hemodialysis treatment. 27 Quality of life can be affected by factors such as the chronicity of the disease, rigorous therapeutic schemes, changes in eating and living habits, social and work activities, the need for many medications, and dependence on a machine for survival.…”

“…13 When the individual is diagnosed with CKD and is in an aggravated stage of the disease, that is, the kidneys are unable to perform their vital functions, it is necessary to start some modality of Renal Replacement Therapy (RRT), which can be hemodialysis, peritoneal dialysis or kidney transplantation; however, it is the physician's responsibility to indicate the most appropriate type. 14 Among these types, the most used in Brazil is hemodialysis, 14 which consists of the process of blood filtration and ultrafiltration, through a dialysis machine, performing part of the functions that the kidneys are no longer able to perform. The purpose of this treatment is to reduce the serum levels of elements that can harm the body, such as excess sodium, liquid, urea, and creatinine, among others.…”

Duality of Living With Systemic Lupus Erythematosus: Fluctuating Between “Good Days” and “Bad Days”

“…Therefore, these changes are reflected in social life and social acceptance, which, in turn, has implications on sexuality, not as a sexual act in itself, but as a component of the individual's personality. Personal and social acceptance interferes with quality of life and requires adaptation, which involves complex processes of living with the disease that go beyond the health dimension 25 .…”