EFEKTIVITAS KOMPRES DINGIN (ICE BAG) MENURUNKAN INTENSITAS NYERI INSERSI AV-FISTULA PADA PASIEN GAGAL GINJAL KRONIK YANG MENJALANI HEMODIALISA

Abstract

Background: Patients with chronic kidney disease (CKD) who have an arteriovenous fistula (AVF) undergo about 300 cannulations a year, which causes repeated acute pain. Cold compresses (ice bags) have been reported to reduce cannulation pain; however, the protocols used vary and evidence on brief (3-minute) application repeated across consecutive hemodialysis sessions remains limited. Objective: To determine the effectiveness of cold compresses (ice bags) in reducing the intensity of AV-fistula insertion pain in CKD patients receiving haemodialysis. Methods: A quasi-experimental one-group pretest-posttest approach was used in this quantitative investigation. Twenty respondents were selected by purposive sampling with the following inclusion criteria: routine haemodialysis patients with AVF access, mild to moderate cannulation pain (NRS score 1–6), fully conscious, and willing to participate. Cold compresses were administered for three minutes before needle insertion in four consecutive haemodialysis sessions. The Numeric Rating Scale (NRS) was used to gauge pain. JASP 0.95.4 software was used for analysis, utilizing the Wilcoxon Signed-Rank test because the data were not normally distributed (Shapiro-Wilk p<0.001). Results: The average pain score dropped by 2.40 points, from 4.65 (SD=0.875; moderate) to 2.25 (SD=0.444; mild); Z=3.920; p<0.001. Conclusion: Cold compresses (ice bags) effectively reduce the intensity of AV-fistula insertion pain and may be considered for inclusion in the Standard Operating Procedure (SOP) for non-pharmacological pain management in haemodialysis units.