Banca de QUALIFICAÇÃO: LAURA LIMA SOUZA

Uma banca de QUALIFICAÇÃO de MESTRADO foi cadastrada pelo programa.
STUDENT : LAURA LIMA SOUZA
DATE: 03/09/2025
TIME: 16:30
LOCAL: Google Meet
TITLE:

Effect of Virtual Reality on pain and anxiety associated with arteriovenous fistula puncture: randomized crossover clinical trial.

 

KEY WORDS:

Keywords: Nursing, Virtual Reality, pain, anxiety, Arteriovenous Fistula.

PAGES: 22
BIG AREA: Ciências da Saúde
AREA: Enfermagem
SUMMARY:

Introduction: Arteriovenous fistula puncture, necessary for renal replacement therapy by
hemodialysis in patients with chronic kidney disease, is a routine, invasive, and often painful
procedure. Performed several times a week, it can trigger high levels of pain and anxiety,
compromising patients’ well-being and treatment adherence. Although pharmacological and
non-pharmacological strategies exist to manage these symptoms, they are not always effective or
accessible. In this context, virtual reality has emerged as a promising tool by providing immersion
in visual and auditory environments that promote cognitive distraction and sensory modulation,
potentially reducing the perception of pain and anxiety during invasive procedures.
Objective: To evaluate the effect of virtual reality on pain and anxiety in patients undergoing
arteriovenous fistula puncture for hemodialysis.
Method: A randomized controlled crossover clinical trial with a 2x2 design and single blinding,
conducted according to international guidelines for clinical studies. Thirty-four adult patients on
hemodialysis for less than six months, treated at a specialized private nephrology clinic, will be
recruited. Participants will be randomly assigned to two groups, defined by the order of
interventions (group AB and group BA). Each participant will undergo two interventions, control
and experimental, in alternating order, separated by a one-week washout period to avoid residual
effects. In the control intervention, patients will receive the institution’s usual pre-puncture
instructions. In the experimental intervention, virtual reality will be applied through goggles with
headphones connected to a mobile device. Participants will watch a five-minute immersive video
with natural scenes such as beaches, forests, and waterfalls, accompanied by ambient sounds,
starting before puncture and maintained until the procedure ends, promoting sensory immersion and
attention redirection. Dependent variables include pain levels, assessed by the Visual Analog Scale,
and anxiety, measured by the State-Trait Anxiety Inventory. Secondary outcomes include changes in
vital signs such as blood pressure, heart rate, respiratory rate, and oxygen saturation before and after
puncture. Data will be collected using a standardized instrument and analyzed with statistical
software, adopting a 5% significance level. The statistician responsible will be blinded to
participant allocation to minimize bias.
Expected Results: Virtual reality is expected to significantly reduce pain and anxiety during
arteriovenous fistula puncture, demonstrating potential as a low-cost, easily applicable resource in
nursing clinical practice with high humanitarian value.

 

COMMITTEE MEMBERS:
Externa ao Programa - 2262871 - ANA ELZA OLIVEIRA DE MENDONCA - nullInterna - 4665456 - DANIELE VIEIRA DANTAS
Presidente - 2553720 - KATIA REGINA BARROS RIBEIRO