METHODS: A convenience sample of 134 hemodialysis patients was obtained from three community-based clinics. The sample was predominantly male (64.9%), ethnically diverse (48.4% White, 42.1% African American, 18.8% Hispanic), with mean age = 59.6 years and mean time on dialysis = 2.70 years. The majority of patients (97, 72.4%) dialyzed with a permanent access and 37 dialyzed with a catheter. This study administered a survey that contained 33 items developed by the researchers and the 17-item Blood-Injection Symptom Scale (BISS; Page et al., 1997). Four dialysis needle fear questions were used: (1) fear of “seeing” needles, (2) fear of “handling” needles, (3) fear of “cannulation by other”, and (4) fear of “self-cannulation.”
RESULTS: About 26% of patients reported fears of “seeing” needles and 29% reported fears of “handling” needles. More than twice as many catheter patients (30.5%) reported moderate to severe cannulation-by-other fear compared to patients with a permanent vascular access (12.4%), X (2, N = 120) = 6.97, p = 0.03. With regard to self-cannulation, the majority of patients using a catheter (66.7%) and permanent access (62.8%) reported moderate to severe fear. Further, a greater proportion of women than men reported moderate to severe self-cannulation fear in the total sample [X (2, N = 118) = 5.86, p = 0.05] and permanent access subsample [X (2, N = 94) = 6.52, p = 0.04].
CONCLUSIONS AND IMPLICATIONS: Dialysis needle fears interfere with patients getting a permanent vascular access or electing a dialysis modality such as home hemodialysis that can involve self-cannulation. These pilot findings will inform the development of clinical interventions to reduce dialysis needle fear in an effort to decrease the risks of catheter-related infections and even death. Social workers can play a key role in providing clinical interventions to help patients overcome their needle fear so that they are more likely to obtain and use a permanent vascular access for their dialysis treatment.