IRCT20151228025732N81 IRCT 2024-01-17 Semnan University of Medical Sciences The effect of valsalva maneuver and distraction on pain intensity during vascular needle insertion in hemodialysis patients The effect of valsalva maneuver and distraction on pain intensity during vascular needle insertion in hemodialysis patients 2024-01-20 anticipated 30 Complete https://irct.ir/trial/73783 interventional Randomization: Randomized, Blinding: Single blinded, Placebo: Not used, Assignment: Parallel, Purpose: Health service research, Randomization description: Block randomization; Individual; Random Number Tables. Randomized permutation blocks (block 3). Using Sealed Envelope software to generate random number tables, Blinding description: The participating person and the person who performs the statistical analysis do not know about the intervention modes. N/A Pain intensity. Intervention 1: Intervention group: In this group (Valsalva maneuver), according to the protocol, the patient blew into a disposable plastic tube connected to a mercury sphygmomanometer (Easy Life, TXJ-10B model, China). and keeps the mercury column up to 20 mm Hg for at least 15 seconds. after the intervention, the arterial needle is inserted into the vessels near the fistula site and after one minute after being fixed, the pain intensity is measured. Intervention 2: Intervention group: In this group (thought deviation), according to the protocol, one minute before the intervention, the patient holds a soft pressure ball in his opposite hand and presses it by opening and closing his hand and starts counting, and it continues for one minute after entering the arterial needle. Intervention 3: Control group: No treatment is done and only routine treatment is done. It is only for comparison with the intervention group. Undecided - It is not yet known if there will be a plan to make this available Justification or reason for indecision in sharing IPD is No more information.