Music-Assisted Acupressure for Pain During AVF Cannulation in Hemodialysis Patients (MUSIC-ACUP)

June 15, 2026 updated by: Gülsüm Gülşen

Effect of Music-Assisted Acupressure on Pain During Arteriovenous Fistula Cannulation in Hemodialysis Patients: A Randomized Controlled Trial

This randomized controlled trial was conducted to evaluate the effect of music-assisted acupressure on pain experienced during arteriovenous fistula (AVF) cannulation in hemodialysis patients. The study was carried out with 72 patients receiving hemodialysis treatment three times per week via AVF in a state hospital in Gaziantep, Türkiye.

Participants were randomly assigned to one of four groups: music-assisted acupressure, acupressure alone, music alone, and control group (routine care). The acupressure intervention was applied to the Hegu (LI4) point for approximately 3 minutes prior to needle insertion, while the music intervention consisted of listening to instrumental Classical Turkish Music in the Acemaşiran mode through headphones starting 5 minutes before cannulation and continuing until the end of the procedure.

Pain intensity during AVF cannulation was measured using the Visual Analog Scale (VAS) during three consecutive dialysis sessions. The primary outcome was pain severity during needle insertion. The study aimed to determine whether combining music therapy and acupressure would provide greater pain relief compared to single interventions or routine care.

Findings suggest that music-assisted acupressure may be an effective non-pharmacological nursing intervention for reducing procedural pain in hemodialysis patients.

Study Overview

Status

Completed

Conditions

Intervention / Treatment

Detailed Description

This study was designed as a randomized controlled trial to investigate the effect of music-assisted acupressure on procedural pain during arteriovenous fistula (AVF) cannulation in patients undergoing hemodialysis. The study was conducted between March and November 2024 in the hemodialysis unit of a state hospital in Gaziantep, Türkiye.

A total of 72 eligible patients receiving hemodialysis treatment via AVF were included. Patients were randomly assigned into four equal groups (n=18 per group): music-assisted acupressure, acupressure, music, and control. Randomization was performed using a simple lottery method. All AVF cannulation procedures were performed by the same experienced dialysis nurse to ensure procedural consistency.

The acupressure intervention was applied to the Hegu (LI4) point on the hand contralateral to the AVF site. Finger pressure was applied perpendicularly for approximately 3 minutes prior to needle insertion. The music intervention consisted of listening to instrumental Classical Turkish Music in the Acemaşiran mode through headphones, beginning 5 minutes before cannulation and continuing until the end of the procedure.

Participants in the combined intervention group received both acupressure and music simultaneously using the same protocols described above. The control group received routine hemodialysis care without additional intervention.

Pain intensity during AVF cannulation was assessed using the Visual Analog Scale (VAS, 0-10) immediately after each procedure. Measurements were repeated over three consecutive hemodialysis sessions. Sociodemographic and clinical data were also collected using a structured patient information form.

The primary outcome of the study was pain intensity during AVF cannulation. Data were analyzed using non-parametric statistical tests due to non-normal distribution, including Kruskal-Wallis, Friedman, and Brunner-Langer models for repeated measures. Statistical significance was set at p < 0.05.

Study Type

Interventional

Enrollment (Actual)

72

Phase

  • Not Applicable

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Locations

  • Turkey (Türkiye)
    • Şahinbey
      • Gaziantep, Şahinbey, Turkey (Türkiye), 27470
        • Gaziantep Şehir Hastanesi

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

  • Adult
  • Older Adult

Accepts Healthy Volunteers

No

Description

Inclusion Criteria:

  • Age ≥ 18 years
  • Receiving hemodialysis treatment three times per week
  • Presence of an arteriovenous fistula (AVF) for vascular access
  • Ability to communicate in Turkish
  • No use of analgesic medication prior to AVF cannulation
  • No pain or pathology in the upper extremities that could affect intervention application or pain assessment
  • Willingness to participate in the study and provide informed consent

Exclusion Criteria:

  • Diagnosis of neuropathy
  • History of upper extremity surgery or soft tissue injury
  • Presence of bleeding disorders or coagulation disorders
  • Diagnosis of heart failure
  • Presence of a pacemaker
  • Inability to comply with study procedures or complete data collection
  • Any condition that could interfere with pain perception or the application of acupressure or music intervention

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Treatment
  • Allocation: Randomized
  • Interventional Model: Factorial Assignment
  • Masking: None (Open Label)

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Other: Music-Assisted Acupressure Group
Listening to instrumental Classical Turkish Music (Acemaşiran mode) via headphones starting 5 minutes before AVF cannulation and continuing throughout the procedure.
Other: Music-Assisted Acupressure
Combined application of acupressure at the Hegu (LI4) point for approximately 3 minutes together with simultaneous listening to instrumental Classical Turkish Music in the Acemaşiran mode starting 5 minutes before and continuing during AVF cannulation.
Other: Acupressure
Manual acupressure applied to the Hegu (LI4) point on the hand contralateral to the AVF site for approximately 3 minutes prior to AVF cannulation.
Other: Acupressure
Manual acupressure applied to the Hegu (LI4) point on the hand contralateral to the AVF site for approximately 3 minutes prior to AVF cannulation. Finger pressure was applied perpendicularly at a tolerable intensity to reduce procedural pain.
Other: Music Group
Participants listened to instrumental Classical Turkish Music in the Acemaşiran mode through headphones starting 5 minutes before AVF cannulation and continuing until the end of the procedure.
Other: Music Therapy
Listening to instrumental Classical Turkish Music in the Acemaşiran mode via headphones starting 5 minutes before arteriovenous fistula (AVF) cannulation and continuing until the end of the procedure. The aim is to reduce procedural pain by distraction and emotional regulation.
Other: Standard Care
Routine hemodialysis care without additional music or acupressure intervention during AVF cannulation.
Other: Standard Care
Routine hemodialysis care without any additional intervention during arteriovenous fistula (AVF) cannulation. Pain assessment was performed after the procedure using the Visual Analog Scale (VAS).

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Pain Intensity During AVF Cannulation (VAS Score)
Time Frame: During each hemodialysis session over 3 consecutive sessions (March-November 2024)
Pain intensity experienced during arteriovenous fistula (AVF) cannulation was assessed using the Visual Analog Scale (VAS), ranging from 0 (no pain) to 10 (worst imaginable pain). Measurements were obtained immediately after each cannulation procedure across three consecutive hemodialysis sessions.
During each hemodialysis session over 3 consecutive sessions (March-November 2024)

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Change in Pain Scores Over Time
Time Frame: Baseline and across 3 consecutive hemodialysis sessions
Changes in pain intensity across repeated AVF cannulation procedures were evaluated to assess the consistency and trend of intervention effects over time among study groups.
Baseline and across 3 consecutive hemodialysis sessions

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Gülsüm Gülşen

Publications and helpful links

The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.

Helpful Links

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Actual)

February 1, 2024

Primary Completion (Actual)

November 30, 2024

Study Completion (Actual)

November 30, 2024

Study Registration Dates

First Submitted

June 15, 2026

First Submitted That Met QC Criteria

June 15, 2026

First Posted (Actual)

June 18, 2026

Study Record Updates

Last Update Posted (Actual)

June 18, 2026

Last Update Submitted That Met QC Criteria

June 15, 2026

Last Verified

June 1, 2026

More Information

Terms related to this study

Keywords

Additional Relevant MeSH Terms

Other Study ID Numbers

  • GAÜN-SBF-PHD-001

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

NO

IPD Plan Description

Individual participant data (IPD) will not be publicly shared. The dataset includes sensitive clinical information from patients undergoing hemodialysis, and ethical approval and informed consent were obtained under the condition that data would be used only for scientific analysis within the research team. Due to privacy and confidentiality considerations, and in accordance with institutional data protection policies, individual-level data will not be made available for external sharing. Aggregated results are reported in the publication.

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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