August-September 2019, Volume 14, Issue 3 DOI: 10.21859/ijnr-14306
Iranian Journal of Nursing Research (IJNR) Original Article
Comparing the Effect of Cryotherapy and Acupressure on
Pain Intensity of Arteriovenous Fistula Cannulation in
Patients Hemodialysis
Fatemeh Hosseinzadeh
1
, Nasrin Alaee
2,*
, Nahid Rejeh
3
,
Seyedeh Nafiseh Alemohammad
4
1
Master of Science in Intensive Care Nursing of Shahed University; Nurse at Sina Hospital, Kerman, Iran
2
Assistant Professor, Nursing Department, College Nursing and Midwifery, Shahed University, Tehran, Iran
3
Professor, Nursing Department, College Nursing and Midwifery, Shahed University, Tehran, Iran
4
Assistant Professor, Faculty of Basic Sciences, Shahed University, Tehran, Iran
* Corresponding author: Nasrin Alaee, Assistant Professor, Nursing Department, College Nursing and
Midwifery, Shahed University, Tehran, Iran. E-mail: alaei@shahed.ac.ir
Received: 19 Apr 2019 Accepted: 30 Jun 2019
© 2019 Iranian Nursing Scientific Association (INA)
Abstract
Introduction: Patients with kidney failure undergoing hemodialysis are frequently exposed to the
hemodialysis needles are inserted into the arteriovenous fistulas; one of the important interventions in
nursing care is use of nonpharmacological interventions for relief pain. Therefore, this study was conducted
to compare the effect of cryotherapy and acupressure on the pain intensity of needle insertion into arterial-
venous fistula in hemodialysis patients.
Methods: This research is a single-group, quasi-experimental study by census sampling which was
performed on 42 hemodialysis women patients at selected hospitals in Kerman city in 2017.Data collection
conducted by demographic questionnaire and pain numerical pain scale. A measurement of pain was done
during three consecutive hemodialysis sessions, the first day no intervention, cryotherapy and acupressure
intervention was done on the second and third day. In every stage, after being fixed the needle into the
arteriovenous fistula vessels, pain was measured using numerical scale. Each cryotherapy and acupressure
intervention was performed for 10 minutes on the Hugo point of hand not having A-V fistula (contralateral
arm).
Results: Most of patients experienced moderate pain without intervention (52.38%), mild pain with
cryotherapy intervention (52.38%), and moderate pain after acupressure intervention (54.77%). The mean
score of pain was decreased in both acupressure methods (4.19 ± 2.43) and cryotherapy (3.16 ± 2.17)
compared to the no intervention technique (6.52 ± 1.82). This difference was significant so that the
cryotherapy with mean ordinal score of (1.38) was more effective in reducing pain (P = 0.001).
Conclusions: Applying cryotherapy on Hugo point of contralateral hand A-V fistula more than the
acupressure has reduced pain of needle insertion. It is recommended to take into account comfort and
relaxation of the patient, nurses using cryotherapy method to reduce pain for hemodialysis patients.
Keywords: Cryotherapy, Acupressure, Arteriovenous Fistula, Pain, Hemodialysis