Anupreethi, S (2018) A study to assess the effectiveness of cold application on arteriovenous fistula puncture pain among hemodialysis patients at Erode and Namakkal District. Masters thesis, Vivekanandha College of Nursing, Tiruchengode.
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Abstract
This thesis titled “A study to assess the effectiveness of cold application on arteriovenous fistula puncture pain among hemodialysis patients at Erode and Namakkal District” is conducted by S. Anupreethi in partial fulfillment of the requirement for the degree of Master of Science in Nursing during the year 2016-2018. OBJECTIVES: 1. To assess the arteriovenous fistula puncture pain among haemodialysis patients in Experimental and Control group. 2. To compare the effectiveness of cold application on arteriovenous fistula puncture pain among haemodialysis patients between experimental and control group. 3. To find out the post-test score of arteriovenous fistula puncture pain with Socio-demographic variables in Experimental and Control group. 4. To find out the post-test score of arteriovenous fistula puncture pain with selected Clinical data in Experimental and Control group. The conceptual frame work adopted for this study was Modified Orlando’s Nursing Process of research use, which addresses the implementation of existing research knowledge. The review of literature helped the investigator to develop conceptual frame work, determine the methodology for the study, and plan for analysis of the data in the most effective and efficient way. The research approach adopted for the study was Non-randomized control group post-test only design. Quasi experimental design is the powerful tool for testing of hypothesis, causes, effect and relationship between the variables. In this study, the investigator test the relationship between independent and dependent variables, the independent variable is cold application and dependent variable is arteriovenous fistula puncture pain. The study was conducted in Dr. K.M.Nallasamy Hoapital, Erode and VMCH hospital, Namakkal District, Tamilnadu. Non - purposive sampling technique was used to select the sample. After that, the samples were equally divided into experimental and control group. The samples consisted of 25 in experimental group and 25 in control group. The tool used for data collection was Semi structured interview schedule. It has 3 sections. Section – A consists of socio demographic variables. Section – B consists of clinical data. Section – C consists of Numerical Pain Assessment Scale to assess the pain response of subjects during arteriovenous fistula cannulation. The pilot study was conducted during February 23.02.2018 to 27.02.2018 in Kalyani Kidney Care Hospital, Erode. About 10 samples were selected using nonprobability convenience sampling technique. 5 samples were in experimental group and 5 were in control group. Confidentiality was assured to the subjects. The semi structured interview schedule was used among 10 patients. Cold application was administered to the patients in the experimental group. The reliability of the tool was r = 0.93 established by inter rater reliability. The instrument was found to be reliable to conduct the study. The purpose of the study were: 1. To find out the feasibility of conducting final study. 2. To test the tool. 3. To determine the method of statistical analysis. The Main study was conducted from 01.03.2018 to 30.03.2018 in Dr.K.M.Nallasamy Hoapital, Erode and VMCH hospital, Namakkal District. Nonprobability convenience sampling technique was used. The intervention was given only to experimental group. The data gathered were analyzed and interpreted in terms of objectives. Descriptive and inferential statistics were used in data analysis. The Result of the study revealed that, after cold application, the Mean pain score in the experimental group were 2.4 where as in control group the Mean pain score were 3.6. In the experimental group, Maximum pain score was 5, where in control group the maximum pain score was 9. MAJOR FINDINGS OF THE STUDY: 1.1. Findings related to socio demographic variables. • About 13(52%) subjects belong to the age group of 41 – 60 years. • Most of the subjects 19(76%) were males. • About 14(56%) subjects studied up to primary education. • Most of the 18(72%) subjects were unemployed. • Majority of the subjects 22(88%) were married. • Majority 24(96%) subjects were belonging to nuclear family. • Most of the 18(72%) subjects had sleep at night time between the duration of 4 – 6 hours. • Majority 20 (80%) of the subjects were non – vegetarian. • About 14(56%) of the subjects had no personal habits • Majority 21(84%) of the samples were watching television during dialysis procedure. 1.2. Findings related to clinical data. • Majority of subjects 24(96%) were known case of chronic renal failure. • Majority 21(84%) of the subjects having arteriovenous fistula in their left arm. • Nearly half of the subjects 14(56%) had brachio – cephalic site of arteriovenous fistula. • All of subjects 25(100%) attending duration of hemodialysis is 4 hours. • Majority 22(88%) of the subjects were attending dialysis twice in a week and 8 times per month. • Nearly half of the subjects 14(56%) had area cannulation. • All the subjects 25 (100%) had arteriovenous needle puncture in the size of 16 G (green). • Majority 19 (76%) of the subjects had no complications of arteriovenous fistula. 2. Effectiveness of cold application on arteriovenous fistula puncture pain. This study revealed that, in experimental group among 25 patients, 16 (64%) experienced mild pain, 5 (20%) experienced moderate pain, 4 (16%) experienced no pain and none of them experienced severe and worst pain during arteriovenous fistula puncture. But, in control group among 25 patients, 12 (48%) experienced mild pain, 8 (32%) experienced moderate pain, 3 (12%) experienced severe pain, 2 (8%) experienced no pain, and none of them experienced worst pain during arteriovenous fistula puncture. Followed by, in experimental group the Mean pain score is 2.4, Mean percentage is 9.230 and standard deviation is 1.46. In control group, the mean pain score is 3.6, Mean percentage is 13.846 and standard deviation is 2.37. The‘t’ value is 2.14 (p = 0.05, 48 df, t=1.96) which is statistically significant and this study showed that, the cold application is effective in reducing arteriovenous fistula puncture pain. 3. Assessment of post-test score of pain in experimental and control group with Socio demographic variables. Chi-square test was used to assess the post-test score of pain in experimental and control group with socio demographic variables. It was concluded that age, gender, educational status, occupational status, marital status, type of family, duration of sleep at night time, dietary pattern, personal habits recreational activities during dialysis procedure were non-significant at 0% level. 4. Association between post test pain score in the experimental group with selected clinical data: Chi-square test was used to assess the post-test score of pain in experimental and control group with selected clinical data. It was concluded that Co-morbid conditions, period of hemodialysis in months, presence of arteriovenous fistula in an arm, site of arteriovenous fistula, duration of present arteriovenous fistula site use, frequency of attending dialysis in a week, number of dialysis per month, patients weight in kilograms, techniques of arteriovenous cannulation, size of arteriovenous cannula used were non-significant at P≤0.05 level. In the light of the above study the following recommendations are put forth: • A similar study can be conducted for a large sample to draw more conclusive generalization. • A comparative study can be conducted with two different age groups. • A study can be conducted by using cold application as a pain relief measure before intravenous cannula insertion. • A similar study can be conducted by using cold application as a pain relief measure for stomach cramps for peritoneal dialysis patients. CONCLUSION: The present study showed that samples in the control group had pain upto severe pain during post test, but after the cold application there was a significant reduction upto moderate pain in experimental group. The pain scores remains same and even some clients’ pain level got increased among control group. This implies that cold application is effective on arteriovenous fistula puncture pain among hemodialysis patients. And this effect was demonstrated through Numerical pain assessments scale.
| Item Type: | Thesis (Masters) |
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| Additional Information: | Reg.No.301610701 |
| Uncontrolled Keywords: | cold application, arteriovenous fistula puncture pain, hemodialysis patients, Erode, Namakkal District. |
| Subjects: | NURSING > Medical Surgical Nursing |
| Depositing User: | Subramani R |
| Date Deposited: | 28 Sep 2019 01:01 |
| Last Modified: | 28 Sep 2019 01:01 |
| URI: | http://repository-tnmgrmu.ac.in/id/eprint/11582 |
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