Abstract
Background: Children undergoing treatment with hemodialysis are exposed frequently to pain and anxiety which are caused by the insertion of large-gauge needles into an arteriovenous fistula. Non pharmacological pain management methods such as virtual reality and guided visualization are used to manage pain and pain related anxiety. Aim: to evaluate the effect of virtual reality compared to guided visualization on arteriovenous fistula cannulation pain and pain anxiety among hemodialysis children. Setting: the study was carried out at the Tanta Main University Hospital, Pediatric Medical Department, Dialysis Unit, Tanta City, Egypt. Sample: a convenience sampling of thirty children undergoing hemodialysis with arteriovenous fistula were included from the previously mentioned setting. Tools: there were three tools used: Tool I: Structured interview schedule, consisting of three components: sociodemographic characteristics of the children, data about the caregiver of the child and data related to the disease and fistula. Tool II: Wong–Baker faces pain rating scale for children. Tool III: Pain Anxiety Symptom Scale Short Form which was developed by McCracken (2002). Results: 53.33% and 33.33% of the studied children had moderate and severe pain anxiety symptoms pre-intervention respectively while 73.33%and 46.67%of them had mild pain anxiety symptoms during application of virtual reality and guided visualization respectively. Conclusion: visual reality was the preferred method which given the greater relief of pain and pain anxiety than guided visualization. Recommendations: visual reality should be used and disseminated to other hemodialysis centers as a strategy to reduce pain and pain anxiety among those children undergoing hemodialysis.