Cryotherapy for reducing pain in arteriovenous fistula puncture sites in hemodialysis patients

Abstract

Overview: Renal patients from all around the world which undergo hemodialysis, constantly experience pain , fear and anxiety in regards to the needling part required during hemodialysis hence the author felt triggered by such factor in addition to a personal experience to research about this. A study carried out in South Australia showed that 36% of patients undergoing dialysis fear needle and 37% of such patients are influenced by this decision in regards to choice of treatment possibly leading them to refuse treatment, (Radisic et al, 2022). Application of ice packs have been used for a long time as a method of pain relief hence the author combined the two factors together to create a research question: s Cryotherapy Effective in Reducing Pain Intensity at the Puncture Sites of Arteriovenous Fistula in Patients undergoing Hemodialysis?”:. Objectives: The main aims of this dissertation include; to retrieve credible data and successfully appraise the studies and their findings in order to answer the chosen research question. Methods: The researcher structured the research question into a PICO framework with the PICO elements being as follows: P: Patients undergoing hemodialysis, I: Cryotherapy, C: No cryotherapy . O: decreased pain intensity at the AVF fistula. A detailed systematic search through the literature using various search engines and search techniques, was carried out to obtain the chosen studies within this dissertation. Inclusion and Exclusion criteria were as follows: studies with participants of age 18 and older, published in English and in full text whilst being at high positions in the hierarchy of evidence were included whilst those with participants younger than 18 years, not published in English or in full text and being of low positions according to hierarchy of. evidence were excluded Outcome of search activity: 1 RCT, 1 SR & MA and 4 QuasiExperimental studies were obtained which were then appraised using 2 versions of the CASP tool and the JBI Quasi-Experimental tool respectively. Results: The selected studies show that cryotherapy was found to be effective in reducing pain intensity at the arteriovenous fistula site. Implication: Such implications for research include patients having reduced pain levels and anxiety possibly reducing stress and fear and hence being more compliant to the treatment. Recommendations: After assessing the findings of the retrieved studies the main recommendations for this dissertation included further research to determine whether such therapy would be suitable in the local context, providing adequate training to staff members which are then willing to teach others and also providing educational programs to the patient to gain further compliancy.