Effect of Guided Imagery Therapy on Arteriovenous Fistula Cannulation Pain during Hemodialysis: A Quasi-Experimental Study
DOI:
https://doi.org/10.23917/bik.v19i2.16508Keywords:
guided imagery, Pain Management, arteriovenous fistula, hemodialysis, nursing interventionAbstract
Arteriovenous fistula (AVF) cannulation is a routine but painful procedure for patients during hemodialysis, which can lead to pain, anxiety, discomfort, and reduced treatment adherence. Repeated painful cannulation may increase anxiety, reduce comfort, and negatively affect the overall treatment experience. Although guided imagery has shown potential for relieving pain in various clinical settings, its effectiveness during AVF cannulation has received limited attention, particularly among patients undergoing hemodialysis. Therefore, further research is necessary to establish its effectiveness in this context. The objective of this study was to evaluate the effect of guided imagery therapy on pain intensity during AVF cannulation among patients undergoing hemodialysis. A quasi-experimental study with intervention and control groups was conducted among 30 patients undergoing hemodialysis who were recruited using consecutive sampling from a hemodialysis unit. Participants in the intervention group received guided imagery therapy immediately before AVF cannulation, whereas those in the control group received routine nursing care. Pain intensity was assessed using the Numeric Rating Scale (0–10). Group differences were analyzed using an independent t-test, and the magnitude of the intervention effect was evaluated using Cohen's d. The results of this study, pain intensity before cannulation was similar between the two groups. After the intervention, patients who received guided imagery reported significantly lower pain scores (Mean = 1.27, SD = 1.03) than those receiving routine care (Mean = 4.27, SD = 0.88), with a mean difference of 3.00 (95% CI: 2.28–3.72; p < .001). The intervention produced a very large effect (Cohen's d = 3.12), indicating a substantial reduction in procedural pain. Guided imagery therapy may offer a simple and feasible non-pharmacological approach to reducing pain during AVF cannulation in patients undergoing hemodialysis. However, because this study involved a small sample and used a quasi-experimental design, the findings should be interpreted with caution. Further randomized controlled trials with larger samples are needed to confirm these results.
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