Comparing Mirror and Music for Dialysis Needle Pain

NCT07320859 | Completed

• 1 other identifier: 22.10.2025/2544
• Study Type: interventional
• Target: 75
• Locations: 1 country
• Sites: 1

Brief Summary

Inserting needles into the vascular access (fistula) is a major source of pain and anxiety for many hemodialysis patients. This study compared two simple, non-drug techniques to reduce this pain: listening to music and looking into a mirror during the needle insertion. A total of 75 adult patients receiving regular hemodialysis at Izmir Özel Can Dialysis Center were randomly divided into three groups: a music group, a mirror group, and a control group. Patients in the music group listened to calming, instrumental Turkish classical music (makam) via headphones during cannulation. Patients in the mirror group looked at the reflection of their healthy arm in a mirror. The control group received standard care without these interventions. Pain intensity was measured immediately after needle insertion using a 10-cm Visual Analogue Scale (VAS), where 0 means "no pain" and 10 means "the worst imaginable pain." Pain scores were compared between the groups to determine which method was more effective. The results of this study may provide nurses and patients with easy-to-use, evidence-based options to make hemodialysis needle procedures less painful and stressful.

Conditions

Chronic Kidney Disease; Pain, Procedural; Arteriovenous Fistula

Keywords

Mirror Therapy; Music Therapy; Non-pharmacological Pain Management; Hemodialysis; Vascular Access; Cannulation Pain

Outcome Measures

Primary Outcomes (1)

• Procedural pain intensity during arteriovenous fistula cannulation

  Pain intensity experienced by the patient immediately following the needle insertion for hemodialysis. This primary outcome is measured during the second and third hemodialysis sessions following randomization (the first session post-randomization served as a runin with no intervention). Pain is measured using a 10-cm Visual Analogue Scale (VAS). Scores range from 0 to 10, where 0 cm represents 'no pain' and 10 cm represents 'the worst pain imaginable,' and higher scores indicate worse pain (greater pain intensity). The patient marks their pain level on the line, and the score is recorded in centimeters.

  Procedure (during cannulation)

Study Arms (3)

Mirror group

EXPERIMENTAL

During arteriovenous fistula cannulation, patients viewed the reflection of their healthy arm in a 40-cm mirror placed approximately 30 cm away. They focused on this image for 10 minutes before cannulation (adaptation phase), and the procedure was performed while they continued to look at the mirror. The visual illusion aimed to modulate pain perception.

Device: Mirror Therapy (Visual Illusion Therapy)

Music group

EXPERIMENTAL

During arteriovenous fistula cannulation, patients listened to pre-selected, calming instrumental Turkish classical music (Nihavend and Muhayyerkürdi maqams) via headphones and an MP3 player at a comfortable volume. The music started before cannulation and continued throughout the procedure.

Other: Music Therapy

Control group

NO INTERVENTION

Patients received routine, standard cannulation care as per the hemodialysis unit protocol, without any additional non-pharmacological intervention such as mirror or music therapy.

Interventions

Music Therapy OTHER

A non-pharmacological, complementary therapy. Patients listen to pre-recorded, instrumental Turkish classical music (specifically Nihavend and Muhayyerkürdi maqams) via headphones during the cannulation procedure. The music is selected for its calming properties and starts before needle insertion. The intervention aims to reduce pain and anxiety through auditory distraction, emotional modulation, and relaxation.

Music group

Mirror Therapy (Visual Illusion Therapy) DEVICE

A non-pharmacological, behavioral intervention. A standard mirror (40 cm diameter) is positioned to allow the patient to view the reflection of their non-cannulated, healthy arm during arteriovenous fistula cannulation. The patient focuses on this visual illusion for an adaptation period (10 minutes) before the needle insertion. The intervention is based on the principles of graded motor imagery and aims to reduce procedural pain by modulating cortical representation and attention.

Mirror group

Eligibility Criteria

• Age: 18 Years - 85 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• Being 18-85 years of age or older
• Receiving HD treatment 3 days a week
• Being able to read and write
• Having no hearing impairment
• Having Turkish as their native language
• Having received HD treatment for at least 6 months
• Having a VAS pain score \>3
• Agreeing to listen to music

You may not qualify if:

• Having a psychological disorder
• Having communication problems
• Having cancer
• Not wanting to participate in the study

Sponsors & Collaborators

• Izmir Kavram Vocational School: lead
• Izmir Bakircay University: collaborator

Study Sites (1)

Izmir Kavram Vocational School

Konak, İzmir, Turkey (Türkiye)

Location

MeSH Terms

Conditions

Renal Insufficiency, Chronic; Pain, Procedural; Arteriovenous Fistula

Interventions

Mirror Movement Therapy; Music Therapy

Condition Hierarchy (Ancestors)

Renal Insufficiency; Kidney Diseases; Urologic Diseases; Female Urogenital Diseases; Female Urogenital Diseases and Pregnancy Complications; Urogenital Diseases; Male Urogenital Diseases; Chronic Disease; Disease Attributes; Pathologic Processes; Pathological Conditions, Signs and Symptoms; Pain; Neurologic Manifestations; Signs and Symptoms; Arteriovenous Malformations; Vascular Malformations; Cardiovascular Abnormalities; Cardiovascular Diseases; Vascular Fistula; Vascular Diseases; Congenital Abnormalities; Congenital, Hereditary, and Neonatal Diseases and Abnormalities; Fistula; Pathological Conditions, Anatomical

Intervention Hierarchy (Ancestors)

Physical Therapy Modalities; Rehabilitation; Therapeutics; Sensory Art Therapies; Complementary Therapies; Aftercare; Continuity of Patient Care; Patient Care; Psychotherapy; Behavioral Disciplines and Activities

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: NONE
• Masking Details: Due to the nature of the interventions (music listening and mirror viewing), participants and the nurses providing care were not blinded to group assignment. However, the statistician who performed the final data analysis was blinded to group allocation.
• Purpose: SUPPORTIVE CARE
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Assistant Professor Dr

Model Details: Participants were randomly assigned in a 1:1:1 ratio to one of three parallel groups for the duration of the study.

Study Record Dates

• First Submitted: December 15, 2025
• First Posted: January 6, 2026
• Study Start: December 1, 2025
• Primary Completion: December 1, 2025
• Study Completion: December 6, 2025
• Last Updated: January 8, 2026

Record last verified: 2026-01

Data Sharing

• IPD Sharing: Will not share

Locations

TU (1)