The Effectiveness of Using Ice Cold Packs and Slow Deep Breathing on Pain During Puncture in Patients with Arterivenosus Fistula (Cimino)

Authors

  • Marthalena Siahaan Program Studi Ilmu Keperawatan, Fakultas Ilmu Kesehatan, Institut Kesehatan Sumatera Utara, Indonesia
  • Kalvin Ginting Program Studi Ilmu Keperawatan, Fakultas Ilmu Kesehatan, Institut Kesehatan Sumatera Utara, Indonesia
  • Sari Saraswati Purba Program Studi Ilmu Gizi, Fakultas Ilmu Kesehatan, Institut Kesehatan Sumatera Utara, Indonesia

DOI:

https://doi.org/10.51601/ijhp.v5i4.445

Abstract

Pain during arteriovenous fistula (Cimino) puncture in chronic kidney failure patients undergoing regular hemodialysis can cause discomfort, anxiety, depression, and low self-esteem. This study aims to determine the effectiveness of using ice cold pack therapy and slow deep breathing on pain during puncture in patients with arteriovenous fistula (Cimino). The research design used was a quasi-experimental research design with two groups pre-post test conducted at Efarina Etaham Berastagi Hospital. One group was given experimental treatment, namely ice cold pack therapy and slow deep breathing, while the other group as the control group was only given slow deep breathing treatment. Data analysis was carried out to see the relationship between the independent and dependent variables using the independent samples t-test at a significance level of α = 0.05. The independent samples t-test results obtained a p value> 0.05, namely 0.104, meaning that statistically there was no significant difference in the average pain scale between patients given ice cold pack therapy and slow deep breathing with patients only given slow deep breathing. Nurses are advised to continue to carry out slow deep breathing therapy and ice cold packs to overcome pain during puncture in patients with arteriovenous fistula (Cimino).

Downloads

Download data is not yet available.

References

[1] Imagine ANO, Hidayat NA. Arteriovenous shunt as the best hemodialysis access in Chronic Kidney Disease (CKD) patients: a literature review. J Indonesia Vasc Access. 2021;1(1):1–3.

[2] Indriani D. Self-esteem of hemodialysis patients with Cimino implants at Ir. Soerkarno Sukaharjo Regional General Hospital. J Health [Internet]. 2020;1–23. Available from: https://journals.ums.ac.id/index.php/JK

[3] Sugiharto F, Yusanti I, Sari WP, Yuliandani E, Kosasih CE, Trisyani Y, et al. A Systematic Review of the Potential of Cold Compresses Therapy: Strategy for Preventing Hematoma and Alleviating Pain in Post Cardiac Catheterization Patients. J Pain Res. 2025;18:161–75.

[4] Muhtadini R, Permana RH. Slow Deep Breathing in Patients Post Double Lumen Catheter Installation with Acute Pain Nursing Problems: A Case Report. J Nurs Care. 2024;7(1):71–6.

[5] Khusna AT, Nurjayanti I, Rismanto A. The Effect of Combination of Slow Deep Breathing and Cryotherapy on Pain Due to Arteriovenous Fistula Puncture in Hemodialysis Patients: Case Report. J Med Nusant. 2024;2(2):49–56.

[6] Wati RA,Wahyu A.The Effect of Classical Music Therapy on Av-Fistula Insertion Pain Intensity in Chronic Kidney Failure Patients Undergoing Hemodialysis at Murni Teguh Hospital, Ciledug.Indones Trust Nurs J. 2024;2(2):61–7.

[7] Enggar E, Gintoe HL. The Effect of Pregnancy Yoga on Reducing Physical Complaints in Pregnant Women in the Third Trimester. Voice of Midwifery. 2019;9(1):796–805.

[8] Rahayu BY, Rekawati E, Wanda D, Lestari AW. The effect of cold application on pain in children undergoing invasive procedures: A systematic review. Holistic J Health. 2025;18(11):1450–7.

[9] Anggar Jantik, LG, & Sulastri S. Implementation of Cold Compress Therapy Using Ice Packs to Reduce Perineal Pain in Postpartum Mothers: A Case Study. J Ners. 2024;9(1):502–507.

[10] Dais EG, Lusty J, Karwati E, Purwati NH. The effectiveness of cold compress in reducing pain before insertion of IV or blood draw in school-aged children. Ris Inf Health. 2025;14(1):58.

[11] Abstract DNL. Factors Associated with Pain Levels in Post-Elective Surgery Patients in the Surgical Inpatient Room of Dr. H. Abdul Moeloek Regional Hospital, Lampung Province in 2023. 2023.

[12] Siahaan M, Sembiring E. Effectiveness of Cold Pack and Deep Breathing Relaxation in Reducing Pain Intensity After Open Reduction Internal Fixation (ORIF) Surgery. J Peneliti Kesejahteraan Suara Forikes. 2023;14(8):33–5.

[13] Kristanto A, Arofiati F. Effectiveness of Cold Pack Use Compared to Deep Breathing Relaxation to Overcome Pain After Open Reduction Internal Fixation (ORIF). Indones J Nurs Pract. 2016;1(1):68–76.

[14] Ronika RD, Susilo CB, Istianah U, RN S, Ermawan B. The Use of Slow Deep Breathing Relaxation Techniques to Fulfill the Need for Comfort in Post-Appendectomy Patients (Case Study at Sleman Regional Hospital). IJOH Indones J Public Heal [Internet]. 2023;01(01):70–8.

[15] Bastami M, Azadi A, Mayel M. The use of ice packs for pain associated with arterial punctures. J Clin Diagnostic Res. 2015;9(8):JC07–9.

[16] Rahma N, Jundapri K, Susyanti D, Suharto S. Nursing Care for Chronic Kidney Failure Patients with Hemodialysis Through Cold Compress Action on Av Shunt. SENTRI J Ris Ilm. 2023;2(12):5163–71.

[17] Roji F. Inseri Av Fistual Pain Scale in Hemdodialysis Pateints Who Are Given Cold Compresses. Media Husada J Nurs Sci. 2022;3(2):175–84.

[18] PRATIWI A. Nursing Care for Patients with Acute Kidney Failure with Acute Pain Nursing Problems with Breathing Exercise Therapy in …. 2023; Available from: http://repository.unimugo.ac.id/id/eprint/3083

[19] Novitasari D, Aprilia E. Temperature Measurement in the Axilla. J Nursing Dirgahayu. 2023;5(1):40–8.

[20] Yusiana AM, Suprihatin.Effectiveness of Deep Breathing Therapy and Progressive Muscle Relaxation on Reducing Blood Pressure in Hypertension Patients. Effectiveness. 2018;(3):104–13.

Downloads

Published

2026-03-17

How to Cite

Siahaan, M., Ginting, K., & Saraswati Purba, S. (2026). The Effectiveness of Using Ice Cold Packs and Slow Deep Breathing on Pain During Puncture in Patients with Arterivenosus Fistula (Cimino). International Journal of Health and Pharmaceutical (IJHP), 5(4), 1036–1041. https://doi.org/10.51601/ijhp.v5i4.445