Assessment of Pain and Anxiety During Arteriovenous Fistula Cannulation Among Hemodialysis Patients: A Cross-Sectional Study in Saudi Arabia

Figures & data

Table 1 Distribution of Study Participants According to Their Sociodemographic Characteristics (n=117)

Sociodemographic Characteristics	No.	%
Age
18–28	10	8.5
29–39	24	20.5
40–50	26	22.2
51–61	30	25.6
62 and above	27	23.1
Gender
Male	63	53.8
Female	54	46.2
Marital status
Single	26	22.2
Married	54	46.2
Divorced	16	13.7
Widowed	21	17.9
Nationality
Saudi	112	95.7
Non-Saudi	5	4.3
Educational level
Illiterate	26	22.2
Read and write	14	12.0
Primary	12	10.3
Intermediate	14	12.0
Secondary	33	28.2
Bachelor	15	12.8
Post-graduate	3	2.6
Working status
Employed	21	17.9
Non-employed	96	82.1
Commute distance between home and hospital
Less than 30 minutes	80	68.4
30–60 minutes	29	24.8
More than 60 minutes	8	6.8
Frequency of pain during previous cannulation
Always	57	48.7
Often	60	51.3

Table 2 Distribution of the Study Participants According to Their Responded Anxiety (n=117)

	Hospital Anxiety Scale*	No.	%
1.	I feel tense “wound up”
	From time to time	31	26.5
	Sometimes	16	13.7
	Most of the time	17	14.5
	Never	53	45.3
2.	Frightened feeling “butterflies in my chest”
	Not always	46	39.3
	Sometimes	52	44.4
	Most of the time	10	8.5
	All the time	9	7.7
3.	Frightened feeling some things awful may happen
	Never	34	29.1
	A little but does not worry me	35	29.9
	Yes, but not too bad	31	26.5
	Sure, and badly	17	14.5
4.	Feel restless as I have to be on the move
	Never	21	17.9
	Not too much	62	53.0
	Too much	19	16.2
	Sure, all the time	15	12.8
5.	Worrying thoughts go through my mind
	Most of the time	11	9.4
	Sometimes	25	21.4
	From time to time but not too much	38	32.5
	Time to time	43	36.8
6.	I feel sudden feelings of panic
	Never	35	29.9
	From time to time	56	47.9
	Usually	16	13.7
	Most of the time	10	8.5
7.	I can sit easily and feel relaxed
	Sure	41	35.0
	Usually	37	31.6
	Not too much	33	28.2
	Not really	6	5.1

Notes: *The Hospital Anxiety Scale, reprinted with permission from: Zigmond AS, Snaith RP. The Hospital Anxiety and Depression Scale. Acta Psychiatr Scand. 1983;67(6):361–370. doi:10.1111/j.1600-0447.1983.tb09716.x. © John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.¹³

Figure 1 Distribution of the study participants according to their level of anxiety (n=117).

Table 3 Distribution of the Study Participants According to Hospital Depression

	Hospital Depression Scale*	No. (n=117)	%
1.	I feel as if I am slowed down
	From time to time	20	17.1
	Sometimes	50	42.7
	All the time	11	9.4
	Never	36	30.8
2.	I still enjoy the things I used to enjoy
	Sure, most of the time	32	27.4
	Not too much	53	45.3
	Just a little	25	21.4
	Hardly done	7	6.0
3.	I have lost interest in my appearance
	I care too much	29	24.8
	Most of the time I do not	37	31.6
	Sometimes not	28	23.9
	Sure	23	19.7
4.	I can laugh and see the funny side of things
	As I can	57	48.7
	From time to time	34	29.1
	Not all the time	24	20.5
	Never	2	1.7
5.	I desire the interest of things
	I did too much	47	40.2
	Less than usual	41	35.0
	Significantly less than usual	23	19.7
	Hardly done	6	5.1
6.	I feel cheerful
	Most of the time	33	28.2
	From time to time	40	34.2
	Not too much	27	23.1
	Not usually	17	14.5
7.	I can enjoy a good book or radio or TV programme
	Never	42	35.9
	From time to time	28	23.9
	Sometimes	34	29.1
	Most of the time	13	11.1

Notes: *The Hospital Depression Scale, reprinted with permission from: Zigmond AS, Snaith RP. The Hospital Anxiety and Depression Scale. Acta Psychiatr Scand. 1983;67(6):361–370. doi:10.1111/j.1600-0447.1983.tb09716.x. © John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.¹³

Figure 2 Distribution of the study participants according to their level of depression (n=117).

Figure 3 Distribution of the study participants according to their level of pain intensity during AVF cannulation (n=117).

Table 4 Simple Correlation Analysis Between Pain Intensity with Anxiety and Depression Level Among Study Participants Regarding AVF Canulation (n=117)

	Level of Pain Intensity
Level of Anxiety and Depression	None (n=11)		Mild (n=36)		Moderate (n=38)		Severe (n=32)		χ^2	MC p
	No.	%	No.	%	No.	%	No.	%
Level of anxiety
Normal (0–7)	10	90.9	18	50.0	12	31.6	11	34.4	34.529*	<0.001*
Mild (8–10)	1	9.1	15	41.7	18	47.4	4	12.5
Moderate (11–14)	0	0.0	2	5.6	8	21.1	11	34.4
Severe (15–21)	0	0.0	1	2.8	0	0.0	6	18.8
r (p)	0.436* (<0.001*)
Level of depression
Normal (0–7)	10	90.9	18	50.0	12	31.6	12	37.5	16.838*	0.030*
Mild (8–10)	1	9.1	10	27.8	14	36.8	9	28.1
Moderate (11–14)	0	0.0	8	22.2	11	28.9	7	21.9
Severe (15–21)	0	0.0	0	0.0	1	2.6	4	12.5
r (p)	0.436* (<0.001*)

Note: *Statistically significant at p≤0.05.

Abbreviations: χ², Chi square test; MC, Monte Carlo; r, Pearson coefficient.

Figure 4 Simple correlation analysis between pain intensity with anxiety level among studied HD patients regarding AVF cannulation (n=117).

Zigmond AS, Snaith RP. The hospital anxiety and depression scale. Acta Psychiatr Scand. 1983;67(6):361–370. doi:10.1111/j.1600-0447.1983.tb09716.x

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