Comparison of the Effects of Visual and Auditory Distractions on Fistula Cannulation Pain among Older Patients Undergoing Hemodialysis: A Randomized Controlled Clinical Trial

Abstract

Pain associated with fistula cannulation is a challenge for nurses who provide care to older patients undergoing hemodialysis. Several non-pharmacological methods have been suggested for relieving fistula cannulation pain, but the benefits of visual and auditory distraction methods among older patients undergoing hemodialysis have not been investigated yet. Therefore, this study aimed to compare the effects of visual and auditory distractions on fistula cannulation pain among older patients undergoing hemodialysis. This randomized controlled clinical trial was conducted on 120 older patients undergoing hemodialysis. They were randomly assigned to three groups of visual distraction, auditory distraction, and the control (n = 40 in each group) using a simple random assignment method. The distraction interventions continued for three consecutive sessions and the numeric rating scale of pain severity was used for data collection. Descriptive and inferential statistics were used for data analysis using SPSS. It was found that pain severity significantly reduced after the distraction interventions in either the auditory or visual distraction groups and also after all three distraction sessions (p = 0.001). However, visual distraction had a better effect on the reduction of pain severity. Therefore, while both visual and auditory distractions reduced pain severity in older patients undergoing hemodialysis, visual distraction was more effective. Nurses are encouraged to incorporate visual distraction as a safe and non-pharmacologic technique into routine nursing care for reducing older patients’ suffering and improving their wellbeing when fistula cannulation is performed.

Effects of music intervention on physical and psychological problems in adults receiving haemodialysis treatment: A systematic review and meta‐analysis

“…The results of the risk of bias of the included studies are showed in Table 2. The randomisation process was rated low risk in eight studies because the randomisation was performed by sealed envelopes or coin toss or software random number table or block randomisation in the included studies (Aghbolagh et al, 2020; Babamohamadi et al, 2015; Burrai et al, 2019; Lin et al, 2012; Melo et al, 2018; Momennasab et al, 2018; Pothoulaki et al, 2008; Shabandokht‐Zarmi et al, 2017). This criterion was rated some concern in six studies due to no information about randomisation process (Babamohamadi et al, 2017; Burrai et al, 2014; Cantekin & Tan, 2013; Hou et al, 2017; Karadag & Karadakovan, 2015; Koca Kutlu & Eren, 2014).…”

“…Two studies were examined the effect of music on AVF puncturerelated pain (Aghbolagh et al, 2020;Shabandokht-Zarmi et al, 2017).…”

“…Haemodialysis is the most frequently used renal replacement treatment in adults with end-stage renal disease (Aghbolagh et al, 2020).…”

A Pilot Randomised Controlled Trial on the Effectiveness of an Anti-Stress Ball Technique for Pain Reduction during Vascular Access Cannulation in Haemodialysis Patients

“…Three strategies have been identified in reducing pain during cannulation of the arteriovenous fistula for haemodialysis: (1) puncture technique, indicating the buttonhole technique as the one that translates a lower level of pain during cannulation; (2) use of non-pharmacological therapies, such as transcutaneous electrical stimulation, placing the users’ feet in hot water ten minutes before puncture, cryotherapy at the puncture site, acupuncture, audio-visual distraction techniques, and aromatherapy with lavender essence, or thermotherapy of the vascular access (of these, cryotherapy was identified as the technique that produced the best results in reducing the pain at the puncture of the vascular access); and (3) application of local anaesthetic before puncturing the venous access, identifying creams based on lidocaine and prilocaine (EMLA ® ) as ones that had the most effective results in reducing pain [ 8 , 9 , 10 ].…”

Comparing Auditory and Visual Distractions for Reducing Pain Severity and Pain Anxiety in Older Outpatients with Burn: A Randomized Controlled Trial

“…Distraction as a simple complementary and non-pharmacological approach can reduce pain severity and anxiety by drawing patients’ attention to pleasant stimuli [ 19 , 20 , 21 ]. Distraction inhibits the activity of the thalamus, insular cortex, and anterior cingulate cortex (ACC) and ultimately reduces pain [ 22 ].…”