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Background <p>Cannulation of vascular access for haemodialysis is essential when using arteriovenous access. However, this can be a painful and distressing procedure for patients. There is no current measure that enables inclusion of patients’ experiences of cannulation as an outcome in research comparing interventions to improve cannulation. This study aimed to develop a patient reported outcome measure of cannulation for haemodialysis, focusing on the physical and psychological experiences of patients. This was named the ‘Patient’s Perspective of Needling’ (PPN) questionnaire.</p> Methodology <p>The PPN was developed with six patient representatives. Face validity assessed understandability, relevance and comprehensiveness of the PPN. Convergent validity assessed the correlation of the PPN results to the Short-Form Vascular Access Questionnaire (SF-VAQ). Internal consistency and test-retest reliability tested the reliability of the PPN. Floor and ceiling effects were examined and the interpretation of the results of the PPN were explored by: (a) using an item discrimination index; (b) calculating the smallest detectable change. Free text comments were analysed using basic thematic analysis.</p> Results <p>The first version of the PPN underwent face validity testing with 12 participants from two renal centres, which led to further amendments of the PPN. The final PPN contained three sections with 17 questions, on pain, worry and problems. Internal consistency of the final PPN was 0.937 (<i>n</i> = 98, 95% CI 0.917–0.954, <i>p</i> &lt; 0.0001). For convergent validity, a correlation to Question 3 of SF-VAQ was − 0.347 (95% CI -0.146 - -0.521, <i>p</i> &lt; 0.001) and Question 4–15 of SF-VAQ was 0.613 (95% CI 0.450–0.736, <i>p</i> &lt; 0.001). Test-retest reliability was 0.856 (95% CI 0.788–0.904, <i>p</i> &lt; 0.001). The smallest detectable change was 0.135. The Pain section of the PPN scored the highest, with the Worry and Problems sections scoring lower. Free text comments from the PPN expanded on difficulties with cannulation, showing that cannulation experience varied over time and how patients cope with cannulation.</p> Conclusions <p>The PPN behaved in a valid and reliable manner for the tests completed, enabling patients’ experiences of cannulation to be included as an outcome in research studies into cannulation for haemodialysis.</p>

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Developing and evaluating the patient’s perspective of needling questionnaire for haemodialysis

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  • 发表日期：

    2026年1月12日

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  • Catherine Fielding,
  • Sarah Brand,
  • Apostolos Fakis,
  • Nicholas M. Selby,
  • Heather Buchanan

摘要

Background

Cannulation of vascular access for haemodialysis is essential when using arteriovenous access. However, this can be a painful and distressing procedure for patients. There is no current measure that enables inclusion of patients’ experiences of cannulation as an outcome in research comparing interventions to improve cannulation. This study aimed to develop a patient reported outcome measure of cannulation for haemodialysis, focusing on the physical and psychological experiences of patients. This was named the ‘Patient’s Perspective of Needling’ (PPN) questionnaire.

Methodology

The PPN was developed with six patient representatives. Face validity assessed understandability, relevance and comprehensiveness of the PPN. Convergent validity assessed the correlation of the PPN results to the Short-Form Vascular Access Questionnaire (SF-VAQ). Internal consistency and test-retest reliability tested the reliability of the PPN. Floor and ceiling effects were examined and the interpretation of the results of the PPN were explored by: (a) using an item discrimination index; (b) calculating the smallest detectable change. Free text comments were analysed using basic thematic analysis.

Results

The first version of the PPN underwent face validity testing with 12 participants from two renal centres, which led to further amendments of the PPN. The final PPN contained three sections with 17 questions, on pain, worry and problems. Internal consistency of the final PPN was 0.937 (n = 98, 95% CI 0.917–0.954, p < 0.0001). For convergent validity, a correlation to Question 3 of SF-VAQ was − 0.347 (95% CI -0.146 - -0.521, p < 0.001) and Question 4–15 of SF-VAQ was 0.613 (95% CI 0.450–0.736, p < 0.001). Test-retest reliability was 0.856 (95% CI 0.788–0.904, p < 0.001). The smallest detectable change was 0.135. The Pain section of the PPN scored the highest, with the Worry and Problems sections scoring lower. Free text comments from the PPN expanded on difficulties with cannulation, showing that cannulation experience varied over time and how patients cope with cannulation.

Conclusions

The PPN behaved in a valid and reliable manner for the tests completed, enabling patients’ experiences of cannulation to be included as an outcome in research studies into cannulation for haemodialysis.