Effect of Mirror Therapy on the Arteriovenous Fistula Cannulation-related Pain and Anxiety

Istanbul University

Status: Completed

Conditions: Hemodialysis Complication; Fistula; Pain, Chronic

Treatments: Other: Mirror Therapy

Study type: Interventional

Funder types: Other

Identifiers

NCT06683495

2025

Details and patient eligibility

About

Pharmacological and non-pharmacological methods are frequently used to reduce cannulation-related pain in patients with fistulas. Non-pharmacological approaches have been more favored than pharmacological approaches for some reasons, including ease of use and fewer side effects. Patients describe worry about the success of needling and resigned acceptance of pain and anxiety about dialysis needles. With this background in mind, mirror therapy has been introduced as one of the non-pharmacological interventions in the domain of pain management.

Full description

Patients undergoing hemodialysis experience pain, anxiety and stress due to large-gauge needle punctures necessary to ensure efficient arteriovenous fistula flow. In addition, anxiety disorders are prevalent in hemodialysis patients, primarily caused by invasive procedures and dialysis machine alarm sounds. Patients describe worry about the success of needling and resigned acceptance of pain and anxiety about dialysis needles. Therefore, when performing an AVF puncture, nursing care should prioritise the management of pain and anxiety. With this background in mind, mirror therapy has been introduced as one of the non-pharmacological interventions in the domain of pain management. It has been reported that viewing the picture of a healthy limb could moderate pain perception in the affected one

Enrollment: 54 patients

Sex: All

Ages: 18 to 75 years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Patients aged 18 years and older
• Patients who received hemodialysis (HD) treatment with an arteriovenous fistula (AVF) for at least 3 months
• Patients receiving HD treatment 3 days a week for 4 hours each session
• Patients with a pain score of ⩾1 during AVF cannulation, measured by a visual analog scale (VAS)
• Patients able to communicate in Turkish
• Patients without psychiatric disorders that impair communication
• Patients who agreed to participate in the study

Exclusion criteria

• Patients who were known to present difficulties with fistula cannulation (requiring multiple cannulations)
• Patients with a history of hematoma or stenosis in the arteriovenous fistula (AVF)
• Patients with an infection at the fistula site
• Patients who took painkillers within 3 hours prior to treatment
• Patients unable to maintain a sitting position on the bed
• Patients with low vision or visual disturbances (30 cm or less)
• Patients who did not wish to participate in the study

Trial design

Primary purpose: Prevention

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Single Blind

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54 participants in 2 patient groups

Mirror Therapy

Experimental group

Description:

For mirror therapy, a 50×40 cm mirror will be used. The patient will be positioned in a semi-sitting position at a 45° angle in bed, with the mirror placed on the side of the body where the access will be made. The arm with the fistula will be positioned behind the mirror. The position will be standardized so that the patient's thumb is 30 cm away from the mirror. The arm without the fistula will be supported with a pillow underneath to facilitate the patient's view in the mirror, positioned next to the patient. After observing their arm in the mirror for 15 minutes, the cannulation procedure will be performed.

Treatment:

Other: Mirror Therapy

Routine Therapy

No Intervention group

Description:

The routine procedure was performed. The fistula puncture was performed by the same nurse throughout the study.