Music-Assisted Acupressure for Pain During AVF Cannulation in Hemodialysis Patients

NCT07657923 | Completed

• 1 other identifier: GAÜN-SBF-PHD-001
• Study Type: interventional
• Target: 72
• Locations: 1 country
• Sites: 1

Brief Summary

This randomized controlled trial was conducted to evaluate the effect of music-assisted acupressure on pain experienced during arteriovenous fistula (AVF) cannulation in hemodialysis patients. The study was carried out with 72 patients receiving hemodialysis treatment three times per week via AVF in a state hospital in Gaziantep, Türkiye. Participants were randomly assigned to one of four groups: music-assisted acupressure, acupressure alone, music alone, and control group (routine care). The acupressure intervention was applied to the Hegu (LI4) point for approximately 3 minutes prior to needle insertion, while the music intervention consisted of listening to instrumental Classical Turkish Music in the Acemaşiran mode through headphones starting 5 minutes before cannulation and continuing until the end of the procedure. Pain intensity during AVF cannulation was measured using the Visual Analog Scale (VAS) during three consecutive dialysis sessions. The primary outcome was pain severity during needle insertion. The study aimed to determine whether combining music therapy and acupressure would provide greater pain relief compared to single interventions or routine care. Findings suggest that music-assisted acupressure may be an effective non-pharmacological nursing intervention for reducing procedural pain in hemodialysis patients.

Conditions

Procedural Pain; Hemodialysis; Arteriovenous Fistula Cannulation

Keywords

Hemodialysis; arteriovenous fistula; acupressure; music therapy; procedural pain; nursing care

Outcome Measures

Primary Outcomes (1)

• Pain Intensity During AVF Cannulation (VAS Score)

  Pain intensity experienced during arteriovenous fistula (AVF) cannulation was assessed using the Visual Analog Scale (VAS), ranging from 0 (no pain) to 10 (worst imaginable pain). Measurements were obtained immediately after each cannulation procedure across three consecutive hemodialysis sessions.

  During each hemodialysis session over 3 consecutive sessions (March-November 2024)

Secondary Outcomes (1)

• Change in Pain Scores Over Time

  Baseline and across 3 consecutive hemodialysis sessions

Study Arms (4)

Music-Assisted Acupressure Group

OTHER

Listening to instrumental Classical Turkish Music (Acemaşiran mode) via headphones starting 5 minutes before AVF cannulation and continuing throughout the procedure.

Other: Music-Assisted Acupressure

Acupressure

OTHER

Manual acupressure applied to the Hegu (LI4) point on the hand contralateral to the AVF site for approximately 3 minutes prior to AVF cannulation.

Other: Acupressure

Music Group

OTHER

Participants listened to instrumental Classical Turkish Music in the Acemaşiran mode through headphones starting 5 minutes before AVF cannulation and continuing until the end of the procedure.

Other: Music Therapy

Standard Care

OTHER

Routine hemodialysis care without additional music or acupressure intervention during AVF cannulation.

Other: Standard Care

Interventions

Music Therapy OTHER

Participants listened to instrumental Classical Turkish Music in the Acemaşiran mode through headphones starting 5 minutes before AVF cannulation and continuing until the end of the procedure.

Music Group

Acupressure OTHER

Manual acupressure applied to the Hegu (LI4) point on the hand contralateral to the AVF site for approximately 3 minutes prior to AVF cannulation.

Acupressure

Music-Assisted Acupressure OTHER

Listening to instrumental Classical Turkish Music (Acemaşiran mode) via headphones starting 5 minutes before AVF cannulation and continuing throughout the procedure.

Music-Assisted Acupressure Group

Standard Care OTHER

Routine hemodialysis care without additional music or acupressure intervention during AVF cannulation.

Standard Care

Eligibility Criteria

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

You may qualify if:

• Age ≥ 18 years
• Receiving hemodialysis treatment three times per week
• Presence of an arteriovenous fistula (AVF) for vascular access
• Ability to communicate in Turkish
• No use of analgesic medication prior to AVF cannulation
• No pain or pathology in the upper extremities that could affect intervention application or pain assessment
• Willingness to participate in the study and provide informed consent

You may not qualify if:

• Diagnosis of neuropathy
• History of upper extremity surgery or soft tissue injury
• Presence of bleeding disorders or coagulation disorders
• Diagnosis of heart failure
• Presence of a pacemaker
• Inability to comply with study procedures or complete data collection
• Any condition that could interfere with pain perception or the application of acupressure or music intervention

Sponsors & Collaborators

• Gülsüm Gülşen: lead

Study Sites (1)

Gaziantep Şehir Hastanesi

Gaziantep, Şahinbey, 27470, Turkey (Türkiye)

Location

Related Links

• Pain on arteriovenous fistula cannulation: A narrative review
• KDOQI Clinical Practice Guideline for Vascular Access: 2019 Update
• Cannulation Technique of Vascular Access in Haemodialysis and the Impact on the Arteriovenous Fistula Survival: Protocol of Systematic Review
• How to needle: A mixed methods study on choice of cannulation technique for arteriovenous fistula

MeSH Terms

Conditions

Pain, Procedural; Arteriovenous Fistula

Interventions

Music Therapy; Acupressure; Standard of Care

Condition Hierarchy (Ancestors)

Pain; Neurologic Manifestations; Signs and Symptoms; Pathological Conditions, 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)

Sensory Art Therapies; Complementary Therapies; Therapeutics; Rehabilitation; Aftercare; Continuity of Patient Care; Patient Care; Psychotherapy; Behavioral Disciplines and Activities; Therapy, Soft Tissue; Musculoskeletal Manipulations; Physical Therapy Modalities; Quality Indicators, Health Care; Quality of Health Care; Health Services Administration; Health Care Quality, Access, and Evaluation

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: NONE
• Masking Details: No blinding was applied in this study. Due to the nature of the interventions (music therapy and acupressure), participants, care providers, and investigators were not blinded. Outcome assessment was performed by the same researcher who collected the data; therefore, no additional masked parties were included.
• Purpose: TREATMENT
• Intervention Model: FACTORIAL
• Sponsor Type: OTHER
• Responsible Party: SPONSOR INVESTIGATOR
• PI Title: Specialist Nurse (PhD Candidate)

Model Details: This study employed a 2×2 factorial randomized controlled design to evaluate the independent and combined effects of music therapy and acupressure on procedural pain during arteriovenous fistula (AVF) cannulation in hemodialysis patients. Participants were randomly assigned to one of four groups: music-assisted acupressure, acupressure only, music only, or routine care (control). This design allowed the assessment of main effects of each intervention as well as their potential interaction effect on pain intensity measured by the Visual Analog Scale (VAS).

Study Record Dates

• First Submitted: June 15, 2026
• First Posted: June 18, 2026
• Study Start: February 1, 2024
• Primary Completion: November 30, 2024
• Study Completion: November 30, 2024
• Last Updated: June 25, 2026

Record last verified: 2026-06

Data Sharing

• IPD Sharing: Will not share

Locations

TU (1)