Virtual Reality Distraction During Arteriovenous Fistula Puncture

Study Overview
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Brief Summary
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The cannulation of arteriovenous fistula is a painful procedure in hemodialysis patients. Previous studies have shown the effectiveness of virtual reality in reducing pain during needle-related procedures

Detailed Description
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Patients undergoing hemodialysis experience anxiety and pain related to the insertion of hemodialysis needles, estimated 320 times in total per year. The pain experienced is mostly caused by needle insertion into a fistula. Pain control is one of the main nursing tasks. Pain relief leads to the acceptance of the procedure and ultimately enhances the patients' quality of life. The use of virtual reality to reduce pain and anxiety during the arteriovenous fistula cannulation procedure is based on the concept that the perception of pain can be controlled because an individual is able to process only a limited amount of information at once. As such, the use of virtual reality during painful procedures may serve as a distraction.

Official Title
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The Effect of Virtual Reality Distraction on Pain and Anxiety During Arteriovenous Fistula Puncture Among Hemodialysis Patients: Randomized Controlled Trial

Conditions
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Pain Management, Hemodialysis, Virtual Reality

Intervention / Treatment
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* Procedure: virtual reality distraction


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: patients who are under- going conventional hemodialysis three times a week hemodialysis period of one month or more having a healthy AVF access with good function welling to participate in study Exclusion Criteria: patients who have psychiatric diseases panic disorder, anxiety disorder dysfunctional fistula vertigo, issues with sight, hearing, or perception or use painkillers within three hours before hemodialysis

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 60 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Supportive Care
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: study group<br> | Procedure: virtual reality distraction<br>* study group patients will view VR scene for 6 minutes before puncture .It involves a soothing nature experience and calming background music. Patients in intervention group will not able to see the puncture procedure due to the VR glasses.<br>|
| No Intervention: control group<br> | |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| change in patients pain scores | visual analogue scale which consists of a vertical line 100 mm long, one end of the line reads No pain and at the other is Unbearable pain | will be measured at baseline and immediately after intervention (after 6 minutes of VR distraction) | 
| change in patients anxiety scores | STAI includes two subscales with 20 items each that assess state and trait anxiety .The State Anxiety Scale requires individuals to describe their feelings at a specific moment under specific circumstances, while the Trait Anxiety Scale requires them to describe the way they feel in general. | will be measured at baseline and immediately after intervention (after 6 minutes of VR distraction) | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| change in patients satisfaction score | . The patients will be asked to rate procedure satisfaction placing a mark on a 100-mm vertical visual analogue scale | will be measured at baseline and immediately after intervention (after 6 minutes of VR distraction) | 
| change in patients heart rate | checklist will be used to assess heart rate after puncture | will be measured at baseline and immediately after intervention (after 6 minutes of VR distraction) | 
| change in patients respiratory rate | checklist will be used to assess respiratory rate after puncture | will be measured at baseline and immediately after intervention (after 6 minutes of VR distraction) | 
| change in patients systolic blood pressure | checklist will be used to assess systolic blood pressure after puncture | will be measured at baseline and immediately after intervention (after 6 minutes of VR distraction) | 
| change in patients diastolic blood pressure | checklist will be used to assess diastolic blood pressure after puncture | will be measured at baseline and immediately after intervention (after 6 minutes of VR distraction) | 
| change in patients Oxygen saturation (SpO2) | checklist will be used to assess Oxygen saturation after puncture | will be measured at baseline and immediately after intervention (after 6 minutes of VR distraction) |