{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T18:09:51Z","timestamp":1790791791711,"version":"4.1.0"},"reference-count":20,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2025,5,7]],"date-time":"2025-05-07T00:00:00Z","timestamp":1746576000000},"content-version":"vor","delay-in-days":6,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Health Science Reports"],"published-print":{"date-parts":[[2025,5]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background and Aims<\/jats:title>\n                    <jats:p>The majority of complications arising from the arteriovenous fistula (AVF) site for hemodialysis (HD) can be prevented through the implementation of a daily self\u2010care plan. This study aimed to assess the knowledge, attitude, and practice (KAP) of hemodialysis patients with end\u2010stage kidney disease (ESKD) regarding AVF self\u2010care preoperative, postoperative, and during follow\u2010up.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      This prospective cohort study was conducted at a tertiary referral center in Nepal. It included ESKD patients over 18 years with AVF. Patients were interviewed preoperative, postoperative, and at 2, 4, and 6 weeks. KAP was assessed as percentages, and associations were analyzed using the\n                      <jats:italic>\u03c7<\/jats:italic>\n                      <jats:sup>2<\/jats:sup>\n                      test. Score comparisons over time used the paired\n                      <jats:italic>t<\/jats:italic>\n                      \u2010test, with\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.05 considered significant.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Among 173 AVF patients, 98.8% had poor knowledge preoperative, while 98.3% had good knowledge postoperative, with significant improvement in the overall score of knowledge (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001). Initially, 97.1% were motivated towards self\u2010care, but this dropped to 78.0% by the 6th week. Most patients practiced weight\u2010bearing prevention, cleaning, and drying, but fewer practiced daily verification of fluid thrill and exercise with malleable balls. Postoperative knowledge acquisition significantly correlated with male sex and higher socioeconomic status.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Although the majority of patients undergoing HD planned for AVF exhibited a favorable attitude towards fistula care, their knowledge was poor. Knowledge significantly improved with follow\u2010ups, but motivation for self\u2010care decreased over time. Patients' practices generally aligned with knowledge scores, emphasizing the importance of regular reminders and periodic evaluations by healthcare workers for practical aspects of AVF care for all ESKD patients undergoing HD.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/hsr2.70823","type":"journal-article","created":{"date-parts":[[2025,5,8]],"date-time":"2025-05-08T02:38:51Z","timestamp":1746671931000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Knowledge, Attitude, and Practice on Arteriovenous Fistula Care Among End\u2010Stage Kidney Disease Patients Receiving Maintenance Hemodialysis: A Single\u2010Center, Prospective Cohort Study in Nepal"],"prefix":"10.1002","volume":"8","author":[{"given":"Santosh","family":"Dev","sequence":"first","affiliation":[{"name":"Department of General Surgery, Maharajgunj Medical Campus Tribhuvan University Teaching Hospital Kathmandu Nepal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6725-5575","authenticated-orcid":false,"given":"Prajjwol","family":"Luitel","sequence":"additional","affiliation":[{"name":"Maharajgunj Medical Campus, Institute of Medicine Tribhuvan University Teaching Hospital Kathmandu Nepal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Birendra","family":"Sah","sequence":"additional","affiliation":[{"name":"Maharajgunj Medical Campus, Institute of Medicine Tribhuvan University Teaching Hospital Kathmandu Nepal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bivek Kumar","family":"Yadav","sequence":"additional","affiliation":[{"name":"Maharajgunj Medical Campus, Institute of Medicine Tribhuvan University Teaching Hospital Kathmandu Nepal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Barsha","family":"Dev","sequence":"additional","affiliation":[{"name":"Nepalgunj Medical College Teaching Hospital Nepalgunj Nepal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-4980-0186","authenticated-orcid":false,"given":"Ishwor","family":"Thapaliya","sequence":"additional","affiliation":[{"name":"Maharajgunj Medical Campus, Institute of Medicine Tribhuvan University Teaching Hospital Kathmandu Nepal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kajan Raj","family":"Shrestha","sequence":"additional","affiliation":[{"name":"Department of Cardiothoracic and Vascular Surgery, Maharajgunj Medical Campus Tribhuvan University Teaching Hospital Kathmandu Nepal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Uttam Krishna","family":"Shrestha","sequence":"additional","affiliation":[{"name":"Department of Cardiothoracic and Vascular Surgery, Maharajgunj Medical Campus Tribhuvan University Teaching Hospital Kathmandu Nepal"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,5,7]]},"reference":[{"key":"e_1_2_13_2_1","doi-asserted-by":"publisher","DOI":"10.1159\/000514550"},{"key":"e_1_2_13_3_1","doi-asserted-by":"publisher","DOI":"10.31729\/jnma.4971"},{"issue":"09","key":"e_1_2_13_4_1","first-page":"1426","article-title":"Arteriovenous Fistula Care: Knowledge, Attitude and Practice in ESRD Patients on Hemodialysis","volume":"25","author":"Iqbal Q. T. A.","year":"2018","journal-title":"Professional Medical Journal"},{"key":"e_1_2_13_5_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41581-022-00542-7"},{"key":"e_1_2_13_6_1","doi-asserted-by":"publisher","DOI":"10.3126\/jaim.v12i1.56678"},{"key":"e_1_2_13_7_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41598-019-47065-z"},{"key":"e_1_2_13_8_1","doi-asserted-by":"publisher","DOI":"10.1681\/ASN.2012070643"},{"key":"e_1_2_13_9_1","doi-asserted-by":"publisher","DOI":"10.1093\/qjmed\/hcg155"},{"key":"e_1_2_13_10_1","unstructured":"K. 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