Effect of Deep Breathing Relaxation and Lemongrass Aromatherapy on Pain During Needle Insertion and Anxiety in Hemodialysis Patients

Hemodialysis patients experience recurrent pain and anxiety during arteriovenous fistula cannulation, which can negatively affect treatment adherence and quality of life. Non-pharmacological interventions such as deep breathing relaxation and aromatherapy have shown potential in reducing procedure-related pain and anxiety. Lemongrass (Cymbopogon citratus) essential oil contains citral and other compounds with reported anxiolytic and analgesic properties. However, the combined effect of deep breathing relaxation with lemongrass aromatherapy has not been well studied in this population. This study will recruit hemodialysis patients who require arteriovenous fistula cannulation. The intervention group will receive deep breathing relaxation instruction combined with lemongrass aromatherapy inhalation before needle insertion. The control group will receive standard care. The primary outcomes are pain intensity measured by the Visual Analogue Scale (VAS) and anxiety measured by the State-Trait Anxiety Inventory (STAI). Secondary outcomes include physiological parameters (heart rate, blood pressure) and patient satisfaction. Data will be collected during three consecutive hemodialysis sessions to assess consistency of effects.