In the meantime, I've tried it two tools that have some sort of integration with vim.
The first is Rope, a python refactoring library that comes with a Vim (and emacs) plug-in. I tried it for a few renames, and that definitely worked as expected. It allowed me to preview the refactoring as a diff, which is nice. It is a bit text-driven, but that's alright for me, just takes longer to learn.
The second is Bicycle Repair Man which I guess wins points on name. Also plugs into vim and emacs. Haven't played much with it yet, but I remember trying it a long time ago.
Haven't played with both enough yet, or tried more types of refactoring, but I will do some more hacking with them.