Breathing Exercise and Invasive Pain at Hemodialysis Patients

Non-pharmacological approaches applied in the prevention of invasive pain due to cannulation in patients treated with arteriovenous fistula and hemodialysis; It is also a cost-effective method that prevents the patient from feeling pain from the application. Breathing exercises are a method that can be easily applied before the cannulation procedure. Although it is seen that there are limited number of studies on the subject in the literature, it was observed that the duration of breathing exercise application was short (two weeks) in one study and the duration was not specified in the other.

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Key information

Conditions

Pain Arteriovenous Fistula Arteriovenous Malformations Breathing Exercise Cardiovascular Abnormalities Cardiovascular Diseases Congenital Abnormalities Congenital, Hereditary, and Neonatal Diseases and Abnormalities Fistula Neurologic Manifestations Pathological Conditions, Anatomical Pathological Conditions, Signs and Symptoms Signs and Symptoms Vascular Diseases Vascular Fistula Vascular Malformations

Age range

18 year–65 year

Sex eligibility

All sexes

Study type

Interventional

Phase

Not applicable

Primary location

Demiroglu Bilim University

Istanbul, 34384, Turkey (Türkiye)

About this study

An average of 312 cannulations per year is performed in a patient who is treated for chronic hemodialysis and has arteriovenous fistula. Patients state that they experience moderate to severe pain at a rate of 57-60.9% when accessing the arteriovenous. In cases where access to the fistula cannot be achieved at one time, patients may experience pain due to; patients experience non-compliance with dialysis treatment and their quality of life is adversely affected. This situation causes an increase in the mortality rate, especially with cardiovascular and respiratory system complications. In recent years, breathing exercise, which is one of the methods of distraction, has been used to reduce the invasive pain experienced during blood collection and cannulation procedures. By increasing lung ventilation with breathing, the amount of oxygen entering the body is maximized, and this causes relaxation in the patient. This relaxation also causes the person to relax and reduce the pain they will feel. Although studies have found that breathing exercise is effective in reducing invasive pain; No information was given about the exercise method and duration. Although in practice, holding the patient's breath during venipuncture and performing the cannulation procedure while giving it is a method frequently applied by the nurse, no study with high evidence supporting the situation has been found in the literature.

Who can participate

Healthy volunteers accepted: No

Only the study team can determine whether someone qualifies for participation.

Inclusion criteria

Hemodialysis treatment with arteriovenous for at least 3 months
Hemodialysis treatment is applied for 3 days and 4 hours a week.
Between the ages of 18-65
Pain score ≥ 2 as assessed by Visual Analogue Scale during cannulation of the arteriovenous fistula
Absence of advanced heart failure, asthma and chronic obstructive pulmonary disease
Able to communicate in Turkish
Not having any psychiatric disorder that prevents communication
Agreeing to participate in the research

Exclusion criteria

Inability to do breathing exercises properly
Presence of infection, edema and scar tissue in the area where the arteriovenous fistula is located
Using pain medication before hemodialysis treatment
Two or more cannulation attempts for arteriovenous fistula in the same session
Presence of neuropathy and peripheral vascular disease
Pregnancy
Withdrawal from the study at any stage of the research

Treatment and study plan

Breathing exercise

Other

The patient will be asked to close their eyes
He will be asked to relax his head and neck in a semi-sitting position in bed
The patient will be asked to breathe through the nose for 3 seconds by counting
Then he will be told to hold his breath for 3 seconds
As the last step, he will be asked to breathe out again in 3 seconds.

Primary outcomes

Change From Baseline Invasive Pain at 12 Dialysis Session

Time frame: At the end of the every dialysis session during one month (3 hemodialysis sessions are done every week)]

It will be assessed total 12 times at the end of the dialysis session with Visual Analogue. Pain intensity measured on a Visual Analog Scale with scores ranging from 0 - 10. Pain increases as the score increases. The high point describes bad outcome.

Sponsors and collaborators

Lead sponsor

Istanbul Demiroglu Bilim University

Other

Registry information

Official study title

Investigation of the Effect of Breathing Exercise on Invasive Pain Associated With Arteriovenous Fistula Cannulation in Hemodialysis Patients.

Important dates

Study start: 2022
Primary completion: 2022
Study completion: 2022
First posted: Feb 23, 2022
Registry last updated: Sep 9, 2022

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

Published trials that share one or more normalized conditions with this study.

Completed