The effect of cryotherapy applied to hemodialysis patients on pain experiencedduring fistula puncture

The study was conducted as a randomized, controlled, and experimental study between 2 November and 30 December 2017for the purpose of evaluating the effect of cryotherapyon pain experienced during access to veinin patients undergoing hemodialysis (HD). Permissions were obtained from the ethics committee, institution and patients before the study. The sample size was calculated anddetermined by using the power analysis and patients meeting the study criteria were divided into intervention (40) and control (40) groups. The data of the study were collected using a questionnaire and the Visual Analog Scale (VAS). Cryotherapy was applied to patients in the intervention group starting one minute before the fistula puncture until the puncture was completed (for averagely 1-2 minutes). The process was applied to the same patient in three consecutive dialysis sessions and the pain levels of patients were evaluated with VAS after every needle puncture. The process of cryotherapy was applied by the researcher to the site one cm above the fistula with a cold gel compress of 13x27 cm. The patients in the control group did not receive any intervention outside of the clinic's routine and the pain levels of the patients in this group during the needle puncture was measured by using VAS at the end of the three consecutive HD sessions. The data obtained from the study were analyzed with Chi-square, Student t, Mann Whitney U and Friedman tests. It was determined that the pain mean score of the intervention group which was 3.5±0.2 before the application ofcryotherapydecreased to 2.3±0.2 after the first HD session, to 2.1±0.2 after the second HD session, and to 1.5±0.1 after the third HD session following the application (p>0.05). It was found that the pain mean score of the control group which was 3.0±0.3 decreased to 2.3±0.2 after the first HD session, to 2.2±0.2 after the second HD session, and to 1.8±0.2 after the third HD session (p>0.05). It was determined that there was a significant difference between the intervention and control groups in terms of pain mean scores that were obtained in four different periods (p<0.05). In accordance the results of the study; it is recommended to usecryotherapy in decreasing the pain experienced by HD patients during access to veins. Keywords: Cryotherapy, hemodialysis, nurse,pain