Effect of Cryotherapy on Arteriovenous Fistula Puncture Related Pain among Patients Undergoing Hemodialysis at Selected Hospital, Coimbatore

Pain is not just a physical sensation. It is influenced by attitude, beliefs, personality and social factors and can affect emotional and mental wellbeing. Pain during arteriovenous fistula (AVF) cannulation remains a common problem in hemodialysis patients that leads to noncompliance to lifetime maintenance hemodialysis. Cryotherapy is the non-pharmacological therapy which helps to reduce the pain among patients undergoing hemodialysis. The aim of the study was to identify the effect of cryotherapy on arteriovenous fistula puncture related pain among patients undergoing hemodialysis. Repeated measures cross over design was adopted in this study. A total of 38 patients undergoing hemodialysis through AVF were selected in hemodialysis unit at Sri Ramakrishna hospital, Coimbatore. Among 38 samples, 19 patients were allotted in Group I who were given routine care first alternated by cryotherapy on subsequent visits and other 19 patients were allotted to Group II who were given cryotherapy first alternated by routine care for a period of two weeks. Objective pain assessment was done using Modified Abbey pain scale during AVF puncture and subjective pain assessment was done using Numerical Pain Rating scale after AVF puncture. Finding revealed that the mean score of objective pain during routine care and cryotherapy was 4.03 and 1.83 with standard deviation was 1.31 and 0.84 among patients in Group I. Whereas, the mean score of objective pain during cryotherapy and routine care was 1.76 and 3.82 with standard deviation was 0.64 and 0.88 among patients in Group II. The mean score of subjective pain after routine care and cryotherapy was 6.07 and 2.04 with standard deviation was 1.76 and 1.58 among patient in Group I. Whereas, the mean score of subjective pain after cryotherapy and routine care was 2.08 and 6 with standard deviation was 0.89 and 0.94 among patients in Group II. There was a significant difference in the arteriovenous fistula puncture related objective type pain between the interventions in Group I and II (t = 5.8 and 7.9, p<0.001). There was a significant difference in the arteriovenous fistula puncture related subjective type pain between the interventions in Group I and II (t = 6.95 and 12.65, p