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‘Pinholes in my arms’: the vicious cycle of vascular access

Kelly, Linda; Snowden, Austyn


Linda Kelly


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).

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

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.

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.

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.


Kelly, L., & Snowden, A. (2021). ‘Pinholes in my arms’: the vicious cycle of vascular access. British Journal of Nursing, 30(14),

Journal Article Type Article
Acceptance Date Apr 6, 2021
Online Publication Date Jul 21, 2021
Publication Date 2021-07
Deposit Date Apr 7, 2021
Publicly Available Date Jul 21, 2021
Print ISSN 0966-0461
Publisher Mark Allen Healthcare
Peer Reviewed Peer Reviewed
Volume 30
Issue 14
Keywords Central venous access devices, Patient experience, Peripherally inserted central catheter (PICC), Tunneled central venous catheter, Totally implanted vascular access device
Public URL


The Vicious Cycle Of Vascular Access: An Interpretative Phenomenological Study (accepted version) (427 Kb)

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