The effect of ice application on hoku point and kaleidoscope application on cannulation related pain management in dialysis patients with arteriovenous fistula

The cannulation of arteriovenous fistulas is a painful and frequently performed procedure. Nurses can employ non-pharmacological interventions to reduce patient pain during these procedures. The aim of the study was to evaluate the effectiveness of ice application to the Hoku point and kaleidoscope application in managing needle-cannulation pain in hemodialysis patients, and to assess factors influencing pain. The study was conducted in a randomized controlled single-blind design. The population consisted of patients undergoing hemodialysis treatment in three different dialysis centers from March to June 2023 (N=158), with a sample of 102 patients meeting inclusion criteria determined by G Power analysis. Data were collected using a Patient Identification Form, Numeric Rating Scale, and Quality of Life Follow-up Form. Pain levels associated with cannulation during routine dialysis sessions were assessed. Interventions commenced during the subsequent dialysis session, and pain levels were evaluated over two consecutive sessions thereafter. Data were analyzed using IBM SPSS V23 and R Program. Prior to interventions, mean pain scores related to fistula cannulation, as measured on the Numeric Rating Scale, were above average. In the kaleidoscope group, pain scores were 6.12±1.98, in the ice application group 5.76±1.95, and in the control group 5.56±2.02, with no significant differences found among them. Post-intervention pain scores revealed that during the first kaleidoscope application, pain related to cannulation was 4.76±1.54, and during the second session it was 4.65±1.63. In the ice application group, pain scores were 4.32±1.63 during the first session and 4.26±1.83 during the second session. The control group reported pain scores of 5.26±2.03 and 5.5±2.14 during the second and third sessions, respectively. Compared to the control group, both the kaleidoscope and ice application groups showed statistically lower pain scores during the first and second applications (p=0.045). In conclusion, ice application to the Hoku point and kaleidoscope application were found effective in reducing pain associated with cannulation. Therefore, due to their cost-effectiveness and ease of application, kaleidoscope and ice application are recommended for managing needle-cannulation pain in hemodialysis treatment.