Effectiveness of Cold Application on the Level of Pain During Arteriovenous Fistula Puncturing Among the Patients Undergoing Hemodialysis in the Hemodialysis Unit at Hassan Institute of Medical Sciences, Hassan

Abstract

Background and Objectives of the Study: Patients undergoing hemodialysis experience intense pain during arteriovenous fistula puncturing, which interferes with their readiness to the therapy and their quality of life, and they need an alternative therapy to reduce the pain during arteriovenous fistula puncturing. Cold application causes its effects both locally and at the spinal level. This study aims to test the effectiveness of cold application in the form of cutaneous stimulation in reducing the pain perception during arteriovenous fistula puncturing among patients receiving hemodialysis.

Material and Methods: Post-test-only control group design, a true experimental design, was adopted. Study participants were assigned to the experimental group (N=44) and control group (N=44) by using a simple random sampling (lottery) method. Arteriovenous fistula puncture pain was assessed by using a 0–10 numerical pain assessment scale.

Results: The data analysis findings show that the post-test mean pain score was 2.43 in the experimental group and 5.43 in the control group, with the calculated unpaired t-value of 11.04 (p<0.00001). Age (χ2 = 8.37, p=0.04) was significantly associated with pain level in the experimental group, while marital status (χ2 = 11.58, p=0.003), pulse rate (χ2 = 12.55, p=0.05) and systolic blood pressure (χ2 = 13.23, p=0.04) were significantly associated with pain level in the control group. A significant negative correlation was found between body temperature and pain scores in the control group (r=−0.299, p =0.048).

Interpretation and Conclusion: The study concluded that cold application, in the form of cutaneous stimulation, was effective in significantly decreasing pain level during AVF puncturing among patients on hemodialysis.