{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,13]],"date-time":"2026-08-13T19:37:31Z","timestamp":1786649851847,"version":"build-2736575974"},"reference-count":47,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"1","license":[{"start":{"date-parts":[[2025,12,1]],"date-time":"2025-12-01T00:00:00Z","timestamp":1764547200000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"abstract":"<jats:sec>\n                    <jats:title>BACKGROUND:<\/jats:title>\n                    <jats:p>Pain from needle insertion during hemodialysis is a common challenge that requires effective pain management to ensure patient comfort. This study aimed to compare the effects of Hugo point acupressure and vapocoolant spray on pain intensity during needle insertion in hemodialysis patients with arteriovenous fistulas.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHOD AND MATERIALS:<\/jats:title>\n                    <jats:p>A randomized controlled trial (RCT) was conducted in Iraq. A simple random sampling of adult patients with hemodialysis was assigned in the current study from the previously mentioned setting. Ninety-six patients were classified into three groups (34 control, 35 Hugo point acupressure, and 27 vapocoolant spray). The Hugo point acupressure group performed an acupressure before 2 minutes and during needle insertion, while the vapocoolant spray group received a brief spray application before the procedure. The study data were collected using the Structured Information Form, VAS for Pain, and Pain intensity was measured immediately after needle insertion using the visual analog scale (VAS) in all groups. Data were analyzed using SPSS version 27.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS:<\/jats:title>\n                    <jats:p>\n                      The primary outcome of the study showed that theapocoolant spray group experienced a significantly greater reduction in pain compared to the Hugo point acupressure group (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.000). As for the secondary outcomes, pain intensity was not significantly influenced by sociodemographic factors and clinical characteristics (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u2265 0.05).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSION:<\/jats:title>\n                    <jats:p>Vapocoolant spray can be used as an effective and safe method to reduce pain during needle insertion in hemodialysis patients, showing greater pain reduction compared to Hugo point acupressure.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.4103\/jehp.jehp_437_25","type":"journal-article","created":{"date-parts":[[2025,12,29]],"date-time":"2025-12-29T08:00:48Z","timestamp":1766995248000},"update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":0,"title":["Comparison between Hugo point acupressure and vapocoolant spray on pain intensity during needle insertion into arteriovenous fistula in hemodialysis patients: A randomized controlled trial"],"prefix":"10.4103","volume":"14","author":[{"given":"Hassan R.","family":"Al-Waeli","sequence":"first","affiliation":[{"name":"Department of Adult Nursing, College of Nursing, University of Baghdad, Baghdad, Iraq"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wafaa A. 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