Latent Profile Analysis of Autologous Arteriovenous Fistula Self-Management in Patients Undergoing Maintenance Hemodialysis

Purpose: At present, no studies have systematically classified patients into distinct subgroups through comprehensive analysis of autologous arteriovenous fistula (AVF) self-management behaviors. This study aims to determine the characteristics of potential profiles in AVF self-management and identify influencing factors for each profile, and provide evidence for individualized nursing interventions. Methods: Patients receiving maintenance hemodialysis (MHD) with AVF were recruited from a tertiary hospital between April 2024 and December 2025. 335 patients completed the questionnaire that included socio-demographic questionnaire, Barthel Index, Autologous Arteriovenous Fistula Self-Management Scale, Health Literacy Scale for Patients with Chronic Diseases, Chronic Disease Resource Scale, Chinese Acceptance and Action Questionnaire, guided by the "Capacity, Opportunity, Motivation-Behavior" model. Latent profile analysis (LPA) was carried out, after which univariate and multivariate logistic regression analyses were conducted. Results: Participants were divided into three groups: Proactive-Prevention Group (66.6%), Action-Insufficient Group (12.5%), and Knowledge-Limited Group (20.9%). Multivariate logistic regression identified the following as significant factors influencing self-management across profiles: Barthel index; Duration of arteriovenous fistula use; Highest level of education; Number of comorbid conditions; Experiential avoidance; The use of chronic illness resources; Health literacy for chronic diseases. Conclusion: Our study found that AVF self-management among MHD patients exhibits significant heterogeneity, providing valuable information for tailoring interventions to individual needs, particularly for the Action-Insufficient Group. Clinicians should also comprehensively acknowledge the factors including educational background, length of AVF usage, and coexisting comorbidities on patients' AVF self-management. Brief validated tools for routine screening can aid in the early detection of at-risk patients and facilitate preference-adapted, personalized care, thereby enhancing the AVF self-management outcomes. Future longitudinal and intervention studies should prioritize this framework to develop scientifically robust, profile-tailored adherence support programs that align with patient preferences and optimize therapeutic outcomes.