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Effects Of Virtual Reality Glasses And Stress Ball On Distress And Pain During Arteriovenous Fistula Cannulation

Yıl 2025, Cilt: 20 Sayı: Özel Sayı, 1 - 13, 31.12.2025

Öz

Aim: This study was conducted as a pretest-posttest randomized controlled trial to determine the effect of virtual reality goggles and stress ball application on distress and pain levels during arteriovenous fistula cannulation in patients undergoing hemodialysis.
Materials and Methods: The research was carried out in three private dialysis centers located in İstanbul between November 2023 and March 2024 with a total of 77 patients, including 31 patients in the stress ball group, 15 in the virtual reality goggles group, and 31 in the control group. Data were collected using the “Patient Information Form, Distress Thermometer, and Visual Analog Scale.”
Results: The mean post-procedure distress thermometer scores for the control group, stress ball group, and virtual reality goggles group were 5.37±1.7, 3.48±2.4, and 2.78±1.96, respectively. The post-procedure distress thermometer score of the control group was significantly higher than that of the stress ball and virtual reality groups (p=0.001). The mean post-procedure pain scores for the control group, stress ball group, and virtual reality goggles group were 5.77±2.1, 4.46±2.3, and 3.02±2.36, respectively. The post-procedure pain score of the control group was significantly higher than that of the stress ball and virtual reality groups (p=0.001).
Conclusion: The findings demonstrated that the use of stress balls and virtual reality goggles during arteriovenous fistula cannulation effectively reduced pain intensity and distress levels. The use of nonpharmacological interventions such as virtual reality goggles and stress balls should be encouraged during arteriovenous fistula cannulation procedures in hemodialysis units, and healthcare professionals should be informed accordingly.

Etik Beyan

Araştırmanın yürütülmesi için İstanbul Sabahattin Zaim Üniversitesi Etik Kurul Başkanlığı’ndan (22.12.2023 tarih, 2023/08 sayı) onay alınmıştır.

Kaynakça

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  • 3. Schmidli J, Widmer MK, Basile C, de Donato G, Gallieni M, Gibbons CP, et al. Vascular access: 2018 clinical practice guidelines of the European Society for Vascular Surgery (ESVS). Eur J Vasc Endovasc Surg. 2018;55(6):757-818. doi:10.1016/j.ejvs.2018.02.001
  • 4. Santoro D, Benedetto F, Mondello P, Pipitò N, Barillà D, Spinelli F, et al. Vascular access for hemodialysis: current perspectives. Int J Nephrol Renovasc Dis. 2014;7:281-94. doi:10.2147/IJNRD.S46643
  • 5. Thurlow JS, Joshi M, Yan G, Norris KC, Agodoa LY, Yuan CM, et al. Global epidemiology of end-stage kidney disease and disparities in kidney replacement therapy. Am J Nephrol. 2021;52(2):98-107. doi:10.1159/000514550
  • 6. Noto-Kadou-Kaza B, Sabi KA, Amekoudi EY, Imangue G, Badibanga J, Tsevi CM, et al. Pain during arterio-venous fistula (AVF) cannulation. Am J Intern Med. 2014;2(5):87-9. doi:10.11648/j.ajim.20140205.12
  • 7. Kosmadakis G, Amara I, Costel G. Pain on arteriovenous fistula cannulation: A narrative review. Semin Dial.2021;34(4):275-84. doi:10.1111/sdi.12979
  • 8. Jafari-Koulaee A, Moosazadeh M, Bagher Nesami M, Goudarzian AH. Effect of cryotherapy on arteriovenousfistula puncture-related pain in hemodialysis patients: A systematic review and meta-analysis. Complement Ther Med. 2020;49:102326. doi: 10.1016/j.ctim.2020.102326
  • 9. Becker WC, Dorflinger L, Edmond SN, Islam L, Heapy AA, Fraenkel L. Barriers and facilitators to use of non-pharmacological treatments in chronic pain. BMC Fam Pract. 2017;18(1):41. doi: 10.1186/s12875-017-0608-2
  • 10. Mahdavi A, Gorji MA, Gorji AM, Yazdani J, Ardebil MD. Implementing Benson's relaxation training in hemodialysis patients: changes in perceived stress, anxiety, and depression. North Am J Med Sci. 2013;5(9):536-40. doi:10.4103/1947-2714.118917
  • 11. Yeşilyurt M, Faydalı S. Ağrı değerlendirmesinde tek boyutlu ölçeklerin kullanımı. Journal of Anatolia Nursing and Health Sciences. 2020;23(3):444-51. doi: 10.17049/ataunihem.508877
  • 12. Aghbolagh MG, Bahrami T, Rejeh N, Heravi-Karimooi M, Tadrisi SD, Vaismoradi M, et al. Comparison of the effects of visual and auditory distractions on fistula cannulation pain among older patients undergoing hemodialysis: A randomized controlled clinical trial. Geriatrics. 2020;5(3):53. doi: 10.3390/geriatrics5030053
  • 13. El Geziry A, Toble Y, Al Kadhi F, Pervaiz M, Al Nobani M. Non-pharmacological pain management. In: Pain Management - Special Circumstances. IntechOpen. 2018:1-14. doi: 10.5772/intechopen.79689
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  • 17. Hoffman HG, Chambers TG, Meyer WJ 3rd, Arceneaux LL, Russell WJ, Seibel EJ, et al. Virtual reality as an adjunctive non-pharmacologic analgesic for acute burn pain during medical procedures. Ann Behav Med. 2011;41(3):183-91. doi:10.1007/s12160-010-9248-7
  • 18. Indovina P, Barone D, Gallo L, Chirico A, De Pietro G, Giordano A. Virtual reality as a distraction intervention to relieve pain and distress during medical procedures: A Comprehensive Literature Review. Clin J Pain. 2018;34(9):858-77. doi: 10.1097/AJP.0000000000000599
  • 19. Genç H, Korkmaz M, Akkurt A. The effect of virtual reality glasses and stress balls on pain and vital findings during transrectal prostate biopsy: a randomized controlled trial. J Perianesth Nurs. 2022;37(3):344-50. doi:10.1016/j.jopan.2021.09.006
  • 20. Li A, Montaño Z, Chen JV, Gold J. Virtual reality and pain management: Current trends and future directions. Pain Manag. 2011;1(2):147- 57. doi:10.2217/pmt.10.15
  • 21. Yeşilot SB, Çiftçi H, Yener MK. Lipom eksizyonu sırasında stres küpü kullanımının ağrı ve anksiyete üzerine etkisi. Ege Tıp Dergisi. 2021;60(3):219-29. doi:10.19161/etd.990564
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  • 27. Dinis M, Sousa JP. A pilot randomised controlled trial on the effectiveness of an anti-stress ball technique for pain reduction during vascular access cannulation in haemodialysis patients. Nurs Rep. 2023;13(2):731-9. doi:10.3390/nursrep13020064
  • 28. Özalp E, Cankurtaran ES, Soygür H, Geyik PO, Jacobsen PB. Screening for psychological distress in Turkish cancer patients. Psycho- Oncology. 2007;16(4):304-11. doi:10.1002/pon.1059
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  • 30. Yıldız A, Şahan S. Effect of aromatherapy on the pain of arteriovenous fistula puncture in patients on hemodialysis: a systematic review. J Health Res. 2021;35(5):455-65. doi:10.1108/JHR-05-2021-0280
  • 31. Arab V, Bagheri-Nesami M, Mousavinasab SN, Afazali J, Baradari AG, Mousavi SA. Comparison of the effects of hegu point ice massage and 2% lidocaine gel on arteriovenous fistula puncture-related pain in hemodialysis patients: a randomized controlled trial. J Caring Sci. 2017;6(2):141-8. doi: 10.15171/jcs.2017.014
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Arteriyovenöz Fistül Kanülasyonu Sırasında Uygulanan Sanal Gerçeklik Gözlüğünün ve Stres Topunun Distress ve Ağrı Üzerine Etkisi

Yıl 2025, Cilt: 20 Sayı: Özel Sayı, 1 - 13, 31.12.2025

Öz

Amaç: Bu çalışma, hemodiyaliz uygulanan hastalarda arteriovenöz fistül kanülasyonu işlemi sırasında uygulanan sanal gerçeklik gözlüğü ve stres topunun distres ve ağrı düzeyine etkisi etkisini belirlemek amacıyla ön test son test randomize kontrollü olarak yapılmıştır.
Gereç ve Yöntem: Araştırma, İstanbul’da bulunan üç farklı özel diyaliz merkezinde Kasım 2023-Mart 2024 tarihleri arasında 31’i stres topu grubu, 15’i sanal gerçeklik gözlüğü grubu, 31’i kontrol grubu olmak üzere 77 hasta ile tamamlanmıştır. Veriler “Hasta Bilgi Formu, Distres Termometresi ve Visual Analog Skalası” ile toplanmıştır.
Bulgular: İşlem sonrası kontrol grubu, stres topu grubu ve sanal gerçeklik gözlüğü grubu distres termometresi ortalaması sırasıyla 5,37±1,7, 3,48±2,4, 2,78±1,96’dır. Kontrol grubunun distres
termometresi ortalaması işlem sonrası değerinin, stres topu grubuna ve sanal gerçeklik gözlük grubuna göre yüksek olması istatistiksel açısından anlamlıdır (p=0,001). İşlem sonrası kontrol grubu, stres topu grubu ve sanal gerçeklik gözlük grubu distres ağrı ortalaması sırasıyla 5,77±2,1, 4,46±2,3, 3,02±2,36’dır. Kontrol grubunun ağrı ortalaması işlem sonrası değerinin, stres topu grubuna ve sanal gerçeklik gözlük grubuna göre yüksek olması istatistiksel açısından anlamlıdır (p=0,001).
Sonuç: Arteriovenöz fistül kanülasyonu işlemi sırasında uygulanan stres topu ve sanal gerçeklik gözlük uygulamalarının ağrı şiddeti ve stres düzeyini azaltmada etkisi olduğu görülmüştür. Hemodiyaliz ünitelerinde arteriovenöz fistül kanülasyonu işlemi sırasında sanal gerçeklik gözlük ve stres topu gibi non-farmakolojik yöntemlerin kullanımı teşvik edilmeli ve sağlık çalışanları bu konuda bilgilendirilmelidir.

Etik Beyan

Araştırmanın yürütülmesi için İstanbul Sabahattin Zaim Üniversitesi Etik Kurul Başkanlığı’ndan (22.12.2023 tarih, 2023/08 sayı) onay alınmıştır.

Destekleyen Kurum

Bu çalışma, Türkiye Bilimsel ve Teknolojik Araştırma Kurumu (TÜBİTAK) 2209-A tarafından [1919B012309056] numaralı proje kapsamında desteklenmiştir.

Kaynakça

  • 1. Himmelfarb J, Vanholder R, Mehrotra R, Tonelli M. The current and future landscape of dialysis. Nat Rev Nephrol. 2020;16(10):573-85. doi:10.1038/s41581-020-0315-4
  • 2. Canaud B, Chazot C, Koomans J, Collins A. Fluid and hemodynamic management in hemodialysis patients: challenges and opportunities. Braz J Nephrol. 2019;41(4):550-9. doi:10.1590/2175-8239-jbn-2019-0135
  • 3. Schmidli J, Widmer MK, Basile C, de Donato G, Gallieni M, Gibbons CP, et al. Vascular access: 2018 clinical practice guidelines of the European Society for Vascular Surgery (ESVS). Eur J Vasc Endovasc Surg. 2018;55(6):757-818. doi:10.1016/j.ejvs.2018.02.001
  • 4. Santoro D, Benedetto F, Mondello P, Pipitò N, Barillà D, Spinelli F, et al. Vascular access for hemodialysis: current perspectives. Int J Nephrol Renovasc Dis. 2014;7:281-94. doi:10.2147/IJNRD.S46643
  • 5. Thurlow JS, Joshi M, Yan G, Norris KC, Agodoa LY, Yuan CM, et al. Global epidemiology of end-stage kidney disease and disparities in kidney replacement therapy. Am J Nephrol. 2021;52(2):98-107. doi:10.1159/000514550
  • 6. Noto-Kadou-Kaza B, Sabi KA, Amekoudi EY, Imangue G, Badibanga J, Tsevi CM, et al. Pain during arterio-venous fistula (AVF) cannulation. Am J Intern Med. 2014;2(5):87-9. doi:10.11648/j.ajim.20140205.12
  • 7. Kosmadakis G, Amara I, Costel G. Pain on arteriovenous fistula cannulation: A narrative review. Semin Dial.2021;34(4):275-84. doi:10.1111/sdi.12979
  • 8. Jafari-Koulaee A, Moosazadeh M, Bagher Nesami M, Goudarzian AH. Effect of cryotherapy on arteriovenousfistula puncture-related pain in hemodialysis patients: A systematic review and meta-analysis. Complement Ther Med. 2020;49:102326. doi: 10.1016/j.ctim.2020.102326
  • 9. Becker WC, Dorflinger L, Edmond SN, Islam L, Heapy AA, Fraenkel L. Barriers and facilitators to use of non-pharmacological treatments in chronic pain. BMC Fam Pract. 2017;18(1):41. doi: 10.1186/s12875-017-0608-2
  • 10. Mahdavi A, Gorji MA, Gorji AM, Yazdani J, Ardebil MD. Implementing Benson's relaxation training in hemodialysis patients: changes in perceived stress, anxiety, and depression. North Am J Med Sci. 2013;5(9):536-40. doi:10.4103/1947-2714.118917
  • 11. Yeşilyurt M, Faydalı S. Ağrı değerlendirmesinde tek boyutlu ölçeklerin kullanımı. Journal of Anatolia Nursing and Health Sciences. 2020;23(3):444-51. doi: 10.17049/ataunihem.508877
  • 12. Aghbolagh MG, Bahrami T, Rejeh N, Heravi-Karimooi M, Tadrisi SD, Vaismoradi M, et al. Comparison of the effects of visual and auditory distractions on fistula cannulation pain among older patients undergoing hemodialysis: A randomized controlled clinical trial. Geriatrics. 2020;5(3):53. doi: 10.3390/geriatrics5030053
  • 13. El Geziry A, Toble Y, Al Kadhi F, Pervaiz M, Al Nobani M. Non-pharmacological pain management. In: Pain Management - Special Circumstances. IntechOpen. 2018:1-14. doi: 10.5772/intechopen.79689
  • 14. Arane K, Behboudi A, Goldman RD. Virtual reality for pain and anxiety management in children. Can Fam Physician.[Internet]. 2017 [cited 2025 Oct 31]; 63(12):932-4.Available from:https://pmc.ncbi.nlm.nih.gov/articles/PMC5729140/
  • 15. Gupta A, Scott K, Dukewich M. Innovative technology using virtual reality in the treatment of pain: Does it reduce pain via distraction, or is there more to it?. Pain Med. 2018;19(1):151-9. doi:10.1093/pm/pnx109
  • 16. Fuchs P, Moreau G, Guitton P, eds. Virtual Reality: Concepts and Technologies. 1st ed. Boca Raton: CRC Press; 2011. doi:10.1201/b11612
  • 17. Hoffman HG, Chambers TG, Meyer WJ 3rd, Arceneaux LL, Russell WJ, Seibel EJ, et al. Virtual reality as an adjunctive non-pharmacologic analgesic for acute burn pain during medical procedures. Ann Behav Med. 2011;41(3):183-91. doi:10.1007/s12160-010-9248-7
  • 18. Indovina P, Barone D, Gallo L, Chirico A, De Pietro G, Giordano A. Virtual reality as a distraction intervention to relieve pain and distress during medical procedures: A Comprehensive Literature Review. Clin J Pain. 2018;34(9):858-77. doi: 10.1097/AJP.0000000000000599
  • 19. Genç H, Korkmaz M, Akkurt A. The effect of virtual reality glasses and stress balls on pain and vital findings during transrectal prostate biopsy: a randomized controlled trial. J Perianesth Nurs. 2022;37(3):344-50. doi:10.1016/j.jopan.2021.09.006
  • 20. Li A, Montaño Z, Chen JV, Gold J. Virtual reality and pain management: Current trends and future directions. Pain Manag. 2011;1(2):147- 57. doi:10.2217/pmt.10.15
  • 21. Yeşilot SB, Çiftçi H, Yener MK. Lipom eksizyonu sırasında stres küpü kullanımının ağrı ve anksiyete üzerine etkisi. Ege Tıp Dergisi. 2021;60(3):219-29. doi:10.19161/etd.990564
  • 22. Hudson BF, Ogden J, Whiteley MS. Randomized controlled trial to compare the effect of simple distraction interventions on pain and anxiety experienced during conscious surgery. Eur J Pain. 2015;19(10):1447-55. doi:10.1002/ejp.675
  • 23. İtişgen V, Kara B. Hemodiyaliz hastalarında ağrı yönetimi. NefroHemDergi. [Internet]. 2016 [cited 2025 Oct 31];11(2):18-25. Available from: https://dergipark.org.tr/tr/pub/hemsire/article/378593
  • 24. Hiremath P, Mohite V, Pawar S, Naregal P, Bhosale T. A study to assess the knowledge, attitude and pre-procedure anxiety level of patient undergoing upper gastrointestinal endoscopy. Int J Sci Res.[Internet]. 2016 [cited 2025 Oct 31];5(6):242-9. Available from:https://www.semanticscholar.org/paper/A-Study-to-Assess-the-Knowledge%2C-Attitude-and-Level-Hiremath- Mohite/7ed5aa04c38ff5a857ab2351ba2a0e5ea9f48501
  • 25. Şen H. Arteriovenöz fistül kanülasyon işlemi sırasında uygulanan sanal gerçeklöikz lügğünün ağrı ve hasta memnuniyetine etk isi [dissertation]. Mersin: Mersin Üniversitesi Sağlık Bilimleri Enstitüsü; 2020.
  • 26. Alzaatreh MY, Abdalrahim MS. Management strategies for pain associated with arteriovenous fistula cannulation: an integrative literature review. Hemodial Int. 2020;24(1):3-11. doi:10.1111/hdi.12803
  • 27. Dinis M, Sousa JP. A pilot randomised controlled trial on the effectiveness of an anti-stress ball technique for pain reduction during vascular access cannulation in haemodialysis patients. Nurs Rep. 2023;13(2):731-9. doi:10.3390/nursrep13020064
  • 28. Özalp E, Cankurtaran ES, Soygür H, Geyik PO, Jacobsen PB. Screening for psychological distress in Turkish cancer patients. Psycho- Oncology. 2007;16(4):304-11. doi:10.1002/pon.1059
  • 29. Yılmaz D, Güneş ÜY. The effect on pain of three different nonpharmacological methods in peripheral intravenous catheterisation in adults. J Clin Nurs. 2018;27(5-6):1073-80. doi: 10.1111/jocn.14133
  • 30. Yıldız A, Şahan S. Effect of aromatherapy on the pain of arteriovenous fistula puncture in patients on hemodialysis: a systematic review. J Health Res. 2021;35(5):455-65. doi:10.1108/JHR-05-2021-0280
  • 31. Arab V, Bagheri-Nesami M, Mousavinasab SN, Afazali J, Baradari AG, Mousavi SA. Comparison of the effects of hegu point ice massage and 2% lidocaine gel on arteriovenous fistula puncture-related pain in hemodialysis patients: a randomized controlled trial. J Caring Sci. 2017;6(2):141-8. doi: 10.15171/jcs.2017.014
  • 32. Kasar KS, Erzincanli S, Akbas NT. The effect of a stress ball on stress, vital signs and patient comfort in hemodialysis patients: a randomized controlled trial. Complement Ther Clin Pract. 2020;41:101243. doi:10.1016/j.ctcp.2020.101243
  • 33. Nurdina G, Anggraini D, Herdiman, Novyanda H. Effect of stress ball on stress and anxiety in hemodialysis patients. J Keperawatan Komprehensif. 2022;8:71-8. doi: 10.4274/MNM.2024.24249
  • 34. Ozen N, Berse S, Tosun B. Effects of using a stress ball on anxiety and depression in patients undergoing hemodialysis: a prospective, balanced, single-blind, crossover study. Hemodial Int. 2023;27(4):411-8. doi:10.1111/hdi.13102
  • 35. Şahan S, Güler S, Ceyhan Y, Özdemir C. The effects of stress ball use on comfort and anxiety levels in hemodialysis patients: a randomized controlled trial. Mediterr Nurs Midwifery. 2025. doi:10.4274/MNM.2024.24249
  • 36. Sukesih, Suwarto T, Susilosari P. The effectiveness of stress ball therapy to reduce anxiety level in COVID-19 patients in Pati, Central Java. Presented at: The 8th International Conference on Public Health; November 17-18, 2021; Solo, Indonesia. doi: 10.26911/ICPHmedicine. FP.08.2021.05
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  • 38. Yiğit M. Hemodiyaliz hastalarına uygulanan sanal gerçekliğin yaşamınsal bulguları ve kaygı düzeyine etkisi [dissertation]. Ankara: Ankara Yıldırım Beyazıt Üniversitesi Sağlık Bilimleri Enstitüsü; 2024.
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Toplam 51 adet kaynakça vardır.

Ayrıntılar

Birincil Dil Türkçe
Konular Nefroloji Hemşireliği
Bölüm Konferans Bildirisi
Yazarlar

Buse Demircan 0009-0009-5791-0439

Dilara Avcı 0009-0005-8273-2604

Nurten İşik 0009-0005-6710-0748

Zülfünaz Özer 0000-0002-2431-2346

Gönderilme Tarihi 5 Kasım 2025
Kabul Tarihi 8 Aralık 2025
Yayımlanma Tarihi 31 Aralık 2025
Yayımlandığı Sayı Yıl 2025 Cilt: 20 Sayı: Özel Sayı

Kaynak Göster

Vancouver Demircan B, Avcı D, İşik N, Özer Z. Arteriyovenöz Fistül Kanülasyonu Sırasında Uygulanan Sanal Gerçeklik Gözlüğünün ve Stres Topunun Distress ve Ağrı Üzerine Etkisi. NefroHemDergi. 2025;20(Özel Sayı):1-13.

Nefroloji Hemşireliği Dergisi/ Journal of Nephrology Nursing Creative Commons Lisansı Creative Commons Atıf-GayriTicari-Türetilemez 4.0 Uluslararası Lisansı ile lisanslanmıştır.