Investigation of the effect of breathing exercise on invasive pain associated with arteriovenous fistula cannulation in hemodialysis patients: Randomized controlled, single-blind study

Abstract

Background: Pain due to puncture during arteriovenous fistula (AVF) cannulation is a very important symptom that affects the quality of life in patients undergoing continuous hemodialysis (HD) therapy. The aim in this study is to examine the effect of breathing exercise applied for long-term on invasive pain experienced during AVF cannulation in HD patients. Methods: This randomized controlled, single-blind design study was conducted in a private dialysis center in Istanbul between November 2021 and April 2022. The patients in the intervention group were given breathing exercises before fistula cannulation during 12 HD sessions. Before the dialysis nurse performed the cannulation procedure, the patient was told by the researcher to perform breathing exercises and the exercise was completed after intervention for the cannulation. No intervention was made for the patients in the control group. Pain was assessed with the Visual Analog Scale (VAS) by a nurse who is not involved in the study. Mann-Whitney U Test, Chi-Square Test, Fisher’s Exact Test, Friedman Test for repeated measurements were used in statistical analysis of data. Findings: The study was completed with a total of 112 patients, 59 in the intervention group and 53 in the control group. It was determined that the VAS scores of the patients in the intervention group were statistically significantly lower than the patients in the control group from the first measurement to the twelfth measurement ( p < 0.001). Conclusion: It was determined that the breathing exercise applied before the AVF cannulation reduced the invasive pain experienced during cannulation.