Effects of guided visualization and cryotherapy on hemodynamic symptoms of hemodialysis patients: A crossover, randomized controlled trial

Hemodialysis is a chronic and complex condition that significantly impacts human physiological systems, particularly hemodynamic symptoms, affecting the recovery process and patients' quality of life. This study aimed to compare the effects of guided visualization and cryotherapy on hemodynamic symptoms in hemodialysis patients. This crossover, randomized controlled trial involved two experimental groups (guided visualization and cryotherapy) and a control group. In 2022, 60 hemodialysis patients at Shariati Hospital in Fasa participated in the study. Pre-test and post-test measurements were conducted before and after the interventions. Each intervention was administered over three sessions, with each patient receiving different treatments at different stages (first, second, and third). A one-week washout period was implemented between stages to minimize potential carryover effects. Before the interventions, demographic information and hemodynamic symptoms (systolic and diastolic blood pressure and pulse rate) were recorded. The results indicated that guided visualization led to a significantly more significant reduction in diastolic blood pressure compared to cryotherapy and the control group (P<0.001). However, the trend of systolic blood pressure changes across the three intervention sequences—V->Cr->Co (P=0.022), Cr->Co->V (P=0.320), and Co->V->Cr (P=0.780)—did not show statistically significant differences. Additionally, the cryotherapy group demonstrated a greater reduction in pulse rate compared to the guided visualization and control groups. These findings suggest that non-pharmacological methods, such as guided visualization and cryotherapy, can help stabilize hemodynamic symptoms in hemodialysis patients.