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Effect of Mirror Therapy on Arteriovenous Fistula Cannulation-Related Pain and Anxiety: Randomized Controlled Trial
Nurten Ozen1, Aysun Ünal2, Tuba Çomez İkican3
1Department of Internal Medicine Nursing, Faculty of Nursing, Istanbul University, Süleymaniye Mahallesi, Bozdoğan Kemer Caddesi, İstanbul, Türkiye.
Aim:
To investigate the effects of mirror therapy (MT) on reducing arteriovenous fistula cannulation-related pain and anxiety undergoing hemodialysis.
Design:
A parallel-group, assessor-blind randomized controlled trial was performed according to CONSORT guidelines.
Methods:
This study was conducted between October 2024 and January 2025 among 54 hemodialysis patients in a dialysis center. The participants were randomly divided into an experimental (MT) group (n = 27) or a control group (n = 27). Both groups received routine care, and the experimental group also received 2 weeks (6 sessions) of MT. In the experimental group, after the patient watched his or her arm in the mirror for 15 minutes, the cannulation procedure was performed. The control group was subjected to a routine procedure. The primary outcome was the cannulation-related pain score, and the secondary outcome was the anxiety score. Pain was measured a total of six times at each session, while the anxiety score was measured twice.
Results:
Compared with those in the control group, the participants in the intervention group had significantly lower average pain scores during the third, fourth, fifth, and sixth sessions in the nonadaptive phase (p < .001). The results of the ANCOVA revealed that when the STAI-I pretest score was statistically controlled, there was no significant difference between the mean STAI-I posttest scores of the intervention group and the control group according to the covariance analysis results (p = .089).
Conclusions:
MT was found to be effective in reducing fistula-related cannulation pain, but it did not reduce anxiety. Hemodialysis nurses need to provide and implement routines for pain control during arteriovenous fistula cannulation. Cannulation with MT is a nonpharmacological, easy-to-apply and cost-effective method.
