Abstract
Members of the hemodialysis staff are continuously trying to improve his or her puncture skills, for example, aiming at maintaining vascular access for extended periods. It is also of great importance that patients are satisfied with the overall process of puncture and there may be contributing factors not only the staff's technical skill level but also his/her interaction with the patient. However, the components of puncture skills may be unclear, and we need to establish a construct of their evaluating factors from both technical and patient perspectives. For this purpose, we conducted a questionnaire-based survey in which 37 and 116 responses were collected from hemodialysis staff members and patients, respectively. Similar but slightly different constructs of seven factors evaluating staff skills were elicited with 60.8% and 65.5% of cumulative variance accounted for by applying factor analysis independently to both the patient and staff samples. Common factors shared by both samples were overall skills and performance stability ; ease of contact from patients ; sincere attitudes ; skill-directed attitudes ; attention to infection avoidance ; and patient-centered attitudes. We also applied factor analysis to the staff sample which included responses to additional statements related to individual skills that may be required by hemodialysis staff. This analysis yielded factors of component skills such as decision performance ; thoughtful observation ; leadership ; and positive attitudes to skill seeking. To identify factors contributing to patients' evaluation of overall staff skills, multiple regression analysis was applied to the patient sample with a score of “overall skill evaluation” as the objective variable and scores for seven factors identified from the patient sample as independent variables. As a result, only the factor,“overall skills and performance stability” yielded a significant effect on the objective variable (t=15.9, p<0.001 ; R2=0.928). From these results, it is suggested that patients are most likely to be satisfied with hemodialysis staff based on the high quality of his/her overall skills and stable performance of puncture.
