Effect of cognitive level on mastery of knowledge on arteriovenous fistula maintenance in maintenance hemodialysis patients

Objective This study was to investigate effect of cognitive level on mastery of knowledge on arteriovenous fistula maintenance in maintenance dialysis (MHD) patients. Methods This study investigated 327 patients with MHD enrolled and completed all surveys of 201 patients. The survey included general patient information, a cognitive function assessment of the patient using the Montreal Cognitive Assessment (MoCA) scale and mastery of knowledge on arteriovenous fistula maintenance (using self-developed survey assessment scale). According to the MoCA score, 201 patients were divided into normal cognition group (NC group) and cognitive impairment group (CI group), and then the effect of cognitive function on mastery of the knowledge on arteriovenous fistula were observed. Results Among the enrolled 201 patients with MHD, the incidence of cognitive impairment in MHD patients was 56.2%. The mean of MoCA scores was (23.4±5.3) points. Patients in the NC group had significantly higher abilities of abstract thinking and delayed memory recall than the CI group (P<0.05). The age and dialysis age of patients with MHD in the CI group were significantly higher than those in the NC group, and the educational level was significantly lower than that in the NC group (P<0.05). In the MHD patients in the CI group, the proportion of patients, mastering knowledge on "how to deal with the problem of arteriovenous fistula", "the cause of hypotension", "how to evaluate whether the arteriovenous fistula area was infected", "how to monitor side limb skin and its temperature" and "how to monitor infection symptoms and physical signs of arteriovenous fistula", was significantly lower than that in the NC group (P<0.05). Conclusions The prevalence of cognitive impairment in patients with MHD is high, which may affect the patient's mastery of knowledge on arteriovenous fistula maintenance. Clinicians should improve the recognition of cognitive dysfunction in patients with MHD and enhance their training in the maintenance of arteriovenous fistula.