Ask an answerable question (PICO)：
According to National Health Insurance Administration， there are 89,497 patients with chronic renal failure (uremia) who require regular dialysis treatment. Sadigova, et al.(2020) stated that 154 patients pain (63.1%) experienced pain during Arteriovenous fistula (AVF). Although the fear of pain can lead to psychological stress, anxiety, and affects the quality of life, stopping dialysis may be life-threatening. The most common analgesic methods currently are oral analgesics or anti-anxiety agents for physical and psychological discomfort relief. This, however, adds to the additional impact on renal function, triggers physical dependence, and hypotension during hemodialysis. This dilemma opens a discussion on how to apply music intervention to reduce Arteriovenous fistula puncture-related pain for hemodialysis patients.
The Method and Analysis of Literature Review：
The key words set were: Participants: (Hemodialysis、Renal Dialysis、Hemodialysis patient), Intervention: (Music Therapy、Music intervention), and Outcome: (needle-related procedural pain、Arteriovenous fistula puncture-related pain、fistula puncture-related pain、pain Management), and the systematic review (SR) or randomized controlled trial (RCT) searched were published within 5 years. Bollean logic was used to search the database in PubMed, Cochrane Library, and CEPS. A total of 12 studies were gathered. After studying them, one systematic review study was selected, for critical appraisal of the validity, relevance, and applicability of the research evidence.
Critical Appraisal：
Oxford center for EBM in 2011 was used to analyse the level of evidence for the studies and appraised by CASP (Critical Appraisal Skills Program). Three broad issues considered were validity, importance, and practice. The study aimed to investigate the effects of music therapy for pain when cannulating hemodialysis access for hemodialysis patients. The result of SR reported that music can be effective for pain related to inserting a needle into a fistula for hemodialysis patients (SMD: −0.90, 95%CIs: −1.25 to −0.55, P < .001).
Results, Conclusions and Recommendations：
Based on the critical appraisal results of these one evidence-based approach, we can conclude that music interventions could significantly relieve pain for patients undergoing hemodialysis. We suggest a non-pharmacological intervention in clinical settings to alleviate Arteriovenous fistula puncture-related pain among patients undergoing hemodialysis. Based on the current best evidence and taking the patients’ expectations and needs into consideration, appropriate music therapy should be considered to reduce the pain during puncture, improve comfort, reduce hemodialysis rejection, and improve the overall quality of care for hemodialysis patients.
