Effect of 4-7-8 Breathing on AV Fistula Needle Pain in Dialysis Patients

For many hemodialysis patients, needle insertion into the vascular access site (fistula) is a significant source of pain and anxiety. In this study, patients will be guided to perform breathing exercises using the 4-7-8 breathing technique during needle insertion to reduce this pain. A total of 80 adult patients undergoing regular hemodialysis at Izmir Atatürk Training and Research Hospital will be randomly assigned to two groups: an intervention group and a control group. Participants in the intervention group will be taught a standardized intervention program consisting solely of the 4-7-8 breathing technique, to be applied before and during AVF cannulation. The program will be implemented during every hemodialysis session (three times a week) for one week. The technique will be explained in person by a research nurse before the first session, and patients will be provided with a short instructional video demonstrating the technique step by step. The video will be sent to patients' smartphones to encourage them to practice at home. Participants in the control group, however, will continue with their current routine hemodialysis care and standard cannulation procedures (without any structured breathing exercises). 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.

Inclusion Criteria: * 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 Exclusion Criteria: * Having a psychological disorder * Having communication problems * Having cancer * Not wanting to participate in the study