'Pinholes in my arms': the vicious cycle of vascular access

Br J Nurs. 2021 Jul 22;30(14):S4-S13. doi: 10.12968/bjon.2021.30.14.S4.

Abstract

Background: Vascular access devices (VADs) are essential for delivery of intravenous therapies. There are notable gaps in the literature regarding a focus on patient experience and meaning-making related to living with a VAD, specifically a central venous access device (CVAD).

Aims: To explore how patients make sense of living with a CVAD.

Methods: This study followed an interpretive phenomenological analysis (IPA) approach. Purposive sampling was used to identify 11 cancer patients who had a CVAD in situ. One-to-one semi-structured interviews were performed. Interviews were digitally recorded, transcribed and analysed by the lead author.

Findings: Four superordinate themes were identified: the self under attack; being rescued/being robbed; protection of others/protection of self; bewilderment and dismay at lack of staff competence.

Conclusion: Having a CVAD affects the psychological, social, and personal self and impacts on self-esteem and self-image. Despite this, CVADs are accepted by patients and are eventually 'embodied' by them.

Keywords: Central venous access devices; Patient experience; Peripherally inserted central catheter (PICC); Totally implanted vascular access device; Tunneled central venous catheter.

MeSH terms

  • Adaptation, Psychological
  • Catheterization, Central Venous* / psychology
  • Humans
  • Neoplasms* / therapy
  • Self Concept