[The effect of cutaneous stimulation on AV fistula puncture pain of hemodialysis patients].

Abstract

The cutaneous stimulation is an independent nursing intervention used in various painful conditions, and is explained by gate control theory. This study was aimed at identifying the effect of cutaneous stimulation on reduction of arteriovenous fistula puncture pain of hemodialysis patients. One group repeated measurement post test research was designed. Forty-five hemodialysis patients who received arteriovenous fistula puncture regularly in hemodialysis units of an attached D hospital to K university have been studied from August 16 to 21, 1993. First the arteriovenous fistula puncture pain of control period was measured, and then the arteriovenous fistula puncture pain of experimental period (with cutaneous stimulation) was measured. The instrument used for this study were visual analogue pain scale as subjective pain measurement, objective pain behavior checklist and Spielberger's Trait Anxiety Inventory as intervening variables. Analysis of data was done by use of paired t-test, t-test, ANOVA and Perarson correlation coefficient. The results of this study were summarized as follows; 1) The first hypothesis that the subjective pain score of arteriovenous fistula puncture pain in experimental period (with cutaneous stimulation) will be lower than in control period was partly supported. The subjective pain score of arterial line was rejected (paired t = -0.28, p = 0.77) and the subjective pain score of venous line was supported (paired t = 2.61, p = 0.01). 2) The second hypothesis that the objective pain behavior score of arteriovenous fistula pain in experimental period (with cutaneous stimulation) will be lower than in control period was rejected (arterial line paired t = -0.45, p = 0.65; venous line paired t = -0.36, p = 0.72). 3) The third hypothesis that the cardiopulmonary signs of arteriovenous fistula puncture pain in experimental period (with cutaneous stimulation) will be lower than in control period was rejected (pulse paired t = -0.8, p = 0.42; systolic BP paired t = 0.98, p = 0.33; diastolic BP paired t = 0.43, p = 0.66). Further experimental studies with simple intravenous injection patients will be recommended in order to identify the effect of cutaneous stimulation.