{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,10]],"date-time":"2026-08-10T06:31:37Z","timestamp":1786343497811,"version":"build-2736575974"},"reference-count":46,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2026,8,9]],"date-time":"2026-08-09T00:00:00Z","timestamp":1786233600000},"content-version":"vor","delay-in-days":220,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100021171","name":"Basic and Applied Basic Research Foundation of Guangdong Province","doi-asserted-by":"publisher","award":["2025A1515011049"],"award-info":[{"award-number":["2025A1515011049"]}],"id":[{"id":"10.13039\/501100021171","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal of Nursing Management"],"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>Arteriovenous fistula (AVF) is the preferred vascular access for hemodialysis, yet postoperative exercise recommendations are often inconsistent and support after discharge is limited. This study aimed to develop, validate, and preliminarily evaluate a nurse\u2010led perioperative staged exercise management program after AVF creation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This sequential multiphase study included a structured evidence review, Delphi expert consultation, pilot testing, and a single\u2010center prospective controlled evaluation. Adults undergoing forearm radiocephalic AVF creation were enrolled from July 2024 to February 2025 and allocated by temporal phase to usual care or intervention. The intervention included a staged exercise program, standardized inpatient instruction, discharge\u2010day confirmation, WeChat milestone reminders, and follow\u2010up checks. Ultrasound outcomes were assessed before surgery and at 8\u2009weeks; maturation outcomes and process indicators were recorded. TREND guided reporting of the nonrandomized evaluation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Two Delphi rounds achieved high authority and consensus (Cr\u2009&gt;\u20090.90;\n                      <jats:italic>W<\/jats:italic>\n                      \u2009=\u20090.271,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001). Eighty\u2010two patients were enrolled, 41 per group, and all completed follow\u2010up. In the intervention group, completion of standardized exercise instruction reached 100.0%, mean instruction time was 12.4\u2009min, and 82.9% of patients passed discharge\u2010day confirmation at the first check. Home exercise adherence increased over time. At 8\u2009weeks, higher brachial artery blood flow (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001), larger brachial artery diameter (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.007), and larger radial artery diameter (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.039) were observed in the intervention group. The intervention group was also associated with higher 8\u2010week maturation (95.1% vs. 75.6%,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.012), higher 12\u2010week maturation (100.0% vs. 82.9%,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.012), and shorter time to maturation (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001), with no serious exercise\u2010related adverse events through 12\u2009weeks.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The nurse\u2010led perioperative staged exercise management program was feasible in ward practice and was associated with more favorable ultrasound and maturation\u2010related outcomes after AVF creation. Multicenter studies with stronger designs are needed to confirm generalizability and long\u2010term value.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Implication for Nursing Management<\/jats:title>\n                    <jats:p>High\u2010quality nursing management is crucial to patient recovery. In AVF care, postoperative support should not be reduced to one\u2010time education, but incorporated into a structured and continuous nursing management process to strengthen care transition, behavioral maintenance, and recovery support. This managerial implication may also be relevant to other clinical contexts requiring sustained postoperative management.<\/jats:p>\n                    <jats:p>\n                      <jats:bold>Trial Registration:<\/jats:bold>\n                      International Traditional Medicine Clinical Trial Registry: ITMCTR2024000038\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1155\/jonm\/1430814","type":"journal-article","created":{"date-parts":[[2026,8,10]],"date-time":"2026-08-10T06:22:29Z","timestamp":1786342949000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Development, Validation, and Evaluation of a Nurse\u2010Led Perioperative Staged Exercise Management Program for Arteriovenous Fistula: A Sequential Multiphase Study"],"prefix":"10.1155","volume":"2026","author":[{"ORCID":"https:\/\/orcid.org\/0009-0006-6837-8730","authenticated-orcid":false,"given":"Yang","family":"Tang","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-6031-3115","authenticated-orcid":false,"given":"Mengya","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-3888-1488","authenticated-orcid":false,"given":"Mengyao","family":"Liu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3385-9607","authenticated-orcid":false,"given":"Pinli","family":"Lin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-1957-8581","authenticated-orcid":false,"given":"Xu","family":"Deng","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-4276-1168","authenticated-orcid":false,"given":"Jialu","family":"Xu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-4399-0541","authenticated-orcid":false,"given":"Mei","family":"Ling","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-3152-5840","authenticated-orcid":false,"given":"Yao","family":"Fang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-7285-0075","authenticated-orcid":false,"given":"Yuan","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-3936-6998","authenticated-orcid":false,"given":"Yu","family":"Gao","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2217-0962","authenticated-orcid":false,"given":"Fang","family":"Tang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-5055-4077","authenticated-orcid":false,"given":"Yucheng","family":"Cao","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3035-3718","authenticated-orcid":false,"given":"Lili","family":"Deng","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,8,9]]},"reference":[{"key":"e_1_2_15_1_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(25)01853-7"},{"key":"e_1_2_15_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(21)00519-5"},{"key":"e_1_2_15_3_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2024.16338"},{"key":"e_1_2_15_4_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12882-025-04374-y"},{"key":"e_1_2_15_5_2","doi-asserted-by":"publisher","DOI":"10.3760\/cma.j.cn441217-20240809-00808"},{"key":"e_1_2_15_6_2","doi-asserted-by":"publisher","DOI":"10.1001\/jamasurg.2021.4527"},{"key":"e_1_2_15_7_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejvs.2017.06.024"},{"key":"e_1_2_15_8_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2024.0535"},{"key":"e_1_2_15_9_2","doi-asserted-by":"publisher","DOI":"10.1093\/ckj\/sfz194"},{"key":"e_1_2_15_10_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ekir.2022.12.019"},{"key":"e_1_2_15_11_2","doi-asserted-by":"publisher","DOI":"10.1002\/14651858.CD013327.pub2"},{"key":"e_1_2_15_12_2","doi-asserted-by":"publisher","DOI":"10.5301\/jva.5000123"},{"key":"e_1_2_15_13_2","doi-asserted-by":"publisher","DOI":"10.1111\/jorc.70005"},{"key":"e_1_2_15_14_2","doi-asserted-by":"publisher","DOI":"10.1111\/jocn.17193"},{"key":"e_1_2_15_15_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12912-023-01444-0"},{"key":"e_1_2_15_16_2","doi-asserted-by":"publisher","DOI":"10.1186\/1748-5908-6-42"},{"key":"e_1_2_15_17_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijnss.2020.06.007"},{"key":"e_1_2_15_18_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12882-025-04518-0"},{"key":"e_1_2_15_19_2","doi-asserted-by":"publisher","DOI":"10.1080\/17437199.2026.2618195"},{"key":"e_1_2_15_20_2","doi-asserted-by":"publisher","DOI":"10.3760\/cma.j.cn441217-20210819-00067"},{"key":"e_1_2_15_21_2","doi-asserted-by":"publisher","DOI":"10.3870\/j.issn.1001-4152.2021.23.029"},{"key":"e_1_2_15_22_2","doi-asserted-by":"publisher","DOI":"10.3969\/j.issn.1671-4091.2019.06.001"},{"key":"e_1_2_15_23_2","doi-asserted-by":"publisher","DOI":"10.1053\/j.ajkd.2019.12.001"},{"key":"e_1_2_15_24_2","doi-asserted-by":"publisher","DOI":"10.5535\/arm.2014.38.5.648"},{"key":"e_1_2_15_25_2","doi-asserted-by":"publisher","DOI":"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