Chronic Kidney DiseaseMIRROR-MUSICNCT07320859
Comparing Mirror and Music for Dialysis Needle Pain
A study testing Mirror Therapy (Visual Illusion Therapy) and Music Therapy in people with Chronic Kidney Disease and Pain, Procedural, run by Izmir Kavram Vocational School at 1 site in Turkey (Türkiye).
Trial summary
Inserting needles into the vascular access (fistula) is a major source of pain and anxiety for many hemodialysis patients. This study compared two simple, non-drug techniques to reduce this pain: listening to music and looking into a mirror during the needle insertion. Read more about this study
- Who is it for?
- Ages 18 to 85 years
- Conditions the study is for
- Chronic Kidney Disease, Pain, Procedural, Arteriovenous Fistula
- What is being tested?
- Mirror Therapy (Visual Illusion Therapy) and Music Therapy
- Type of treatment
- Medical device
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 75 participants
- Where
- 1 siteTurkey (Türkiye)
- Study dates
- 1 Dec 2025to 6 Dec 2025
- Phase
- Interventional
- Are there results?
- None posted in the registry
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages 18 to 85 years
- All sexes
- No healthy volunteers
- Adult, Older adult
Who may be able to join
- Being 18-85 years of age or older
- Receiving HD treatment 3 days a week
- Being able to read and write
- Having no hearing impairment
- Having Turkish as their native language
- Having received HD treatment for at least 6 months
- Having a VAS pain score >3
- Agreeing to listen to music
Who cannot join
- Having a psychological disorder
- Having communication problems
- Having cancer
- Not wanting to participate in the study
Trial locations and contacts
1 site in 1 country.
About this study
Official title: Mirror Therapy Versus Music Therapy for Pain During Arteriovenous Fistula Cannulation in Hemodialysis Patients: A Randomized Controlled Trial
Inserting needles into the vascular access (fistula) is a major source of pain and anxiety for many hemodialysis patients. This study compared two simple, non-drug techniques to reduce this pain: listening to music and looking into a mirror during the needle insertion.
A total of 75 adult patients receiving regular hemodialysis at Izmir Özel Can Dialysis Center were randomly divided into three groups: a music group, a mirror group, and a control group. Patients in the music group listened to calming, instrumental Turkish classical music (makam) via headphones during cannulation. Patients in the mirror group looked at the reflection of their healthy arm in a mirror. The control group received standard care without these interventions.
Read more
Pain intensity was measured immediately after needle insertion using a 10-cm Visual Analogue Scale (VAS), where 0 means "no pain" and 10 means "the worst imaginable pain." Pain scores were compared between the groups to determine which method was more effective.
The results of this study may provide nurses and patients with easy-to-use, evidence-based options to make hemodialysis needle procedures less painful and stressful.
Read the detailed description
Study Design: This was a prospective, three-arm, parallel-group, randomized controlled trial with a 1:1:1 allocation ratio.
Setting and Sample: The study was conducted at the Hemodialysis Unit of Izmir Özel Can Dialysis Center between December 1 and 30, 2025. The study population consisted of 150 patients. The sample size was calculated using G*Power 3.1.9.2 software. With a significance level (alpha) of 0.05, a power (1-beta) of 80%, and an effect size of 5%, a sample of 25 patients per group (total n=75) was determined to be sufficient for a three-group comparison.
Inclusion Criteria:
Age between 18 and 85 years.
Receiving hemodialysis treatment three times per week.
Literate (able to read and write).
No hearing impairment.
Native Turkish speaker.
On hemodialysis for at least 6 months.
Baseline pain score >3 on the Visual Analogue Scale (VAS).
Willing to listen to music.
Exclusion Criteria:
Presence of a psychological disorder.
Communication problems.
Diagnosis of cancer.
Unwillingness to participate in the study.
Randomization: Eligible patients were randomly assigned to one of three groups: the Music Intervention Group, the Mirror Intervention Group, or the Control Group.
Interventions:
Music Intervention Group: During the arteriovenous fistula (AVF) cannulation procedure, patients listened to pre-selected instrumental Turkish classical music (makam), specifically Nihavend and Muhayyerkürdi maqams, via an MP3 player and headphones. The volume was adjusted to a comfortable level.
Mirror Intervention Group: During cannulation, a standard mirror (40 cm in diameter) was positioned on a table stand. It was adjusted so that patients could see the reflection of their healthy (non-cannulated) arm. The distance between the fingertips of the reflected hand and the mirror surface was approximately 30 cm. Patients were instructed to focus only on the image of their healthy hand in the mirror. The cannulation was performed in two phases: immediately after looking at the healthy hand image (incongruent phase) and after 10 minutes of adaptation to the mirror image (adaptation phase).
Control Group: Patients received standard cannulation care without any additional intervention.
Data Collection Tools:
Patient Information Form: Collected socio-demographic characteristics, dialysis duration, and details about pain (location, intensity, type, timing, cause, and coping methods).
Visual Analogue Scale (VAS): A 10-cm horizontal line used to measure pain intensity, where the left end (0 cm) represents "no pain" and the right end (10 cm) represents "the worst pain imaginable." Patients marked their current pain level on the line, and the distance from the left end was measured in centimeters to obtain a numerical score (0-10).
Procedure: After providing informed consent, all participants completed baseline assessments (Patient Information Form, VAS). The interventions were applied during subsequent cannulation sessions as described. Procedural pain was assessed using the VAS immediately after cannulation.
- Being tested
- Mirror Therapy (Visual Illusion Therapy), Music Therapy
- Keywords
- Mirror Therapy, Music Therapy, Non-pharmacological Pain Management, Hemodialysis, Vascular Access, Cannulation Pain
- Medical subject headings
- Renal Insufficiency, Chronic, Pain, Procedural, Arteriovenous Fistula
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
Mirror Therapy (Visual Illusion Therapy)Device
A non-pharmacological, behavioral intervention. A standard mirror (40 cm diameter) is positioned to allow the patient to view the reflection of their non-cannulated, healthy arm during arteriovenous fistula cannulation. The patient focuses on this visual illusion for an adaptation period (10 minutes) before the needle insertion. The intervention is based on the principles of graded motor imagery and aims to reduce procedural pain by modulating cortical representation and attention.
Music TherapyOther
A non-pharmacological, complementary therapy. Patients listen to pre-recorded, instrumental Turkish classical music (specifically Nihavend and Muhayyerkürdi maqams) via headphones during the cannulation procedure. The music is selected for its calming properties and starts before needle insertion. The intervention aims to reduce pain and anxiety through auditory distraction, emotional modulation, and relaxation.
| Study group | Role | What they receive |
|---|---|---|
| Mirror group | Experimental | During arteriovenous fistula cannulation, patients viewed the reflection of their healthy arm in a 40-cm mirror placed approximately 30 cm away. They focused on this image for 10 minutes before cannulation (adaptation phase), and the procedure was performed while they continued to look at the mirror. The visual illusion aimed to modulate pain perception. Receives: Device: Mirror Therapy (Visual Illusion Therapy) |
| Music group | Experimental | During arteriovenous fistula cannulation, patients listened to pre-selected, calming instrumental Turkish classical music (Nihavend and Muhayyerkürdi maqams) via headphones and an MP3 player at a comfortable volume. The music started before cannulation and continued throughout the procedure. Receives: Other: Music Therapy |
| Control group | No intervention | Patients received routine, standard cannulation care as per the hemodialysis unit protocol, without any additional non-pharmacological intervention such as mirror or music therapy. |
What is being measured
The primary outcome is the main question the study is designed to answer.
Procedural pain intensity during arteriovenous fistula cannulation
Pain intensity experienced by the patient immediately following the needle insertion for hemodialysis. This primary outcome is measured during the second and third hemodialysis sessions following randomization (the first session post-randomization served as a runin with no intervention). Pain is measured using a 10-cm Visual Analogue Scale (VAS). Scores range from 0 to 10, where 0 cm represents 'no pain' and 10 cm represents 'the worst pain imaginable,' and higher scores indicate worse pain (greater pain intensity). The patient marks their pain level on the line, and the score is recorded in centimeters.
Measured: Procedure (during cannulation)
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted6 Jan 2026
- Study start1 Dec 2025
- Primary completion1 Dec 2025
- Study completion6 Dec 2025
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Publications (1)Papers the sponsor has linked to this study.
- Other trials for Chronic Kidney DiseaseStudies of the same condition, open and under way.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Interventional
- Phase
- Phase N/A
- Primary purpose
- Supportive care
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Model description
- Participants were randomly assigned in a 1:1:1 ratio to one of three parallel groups for the duration of the study.
- Masking
- None (open label)
- Enrolment
- 75 participants (actual)
Sponsor and investigators
- Lead sponsor
- Izmir Kavram Vocational School
- Sponsor type
- University, hospital or other
- Collaborators
- Izmir Bakircay University
- Responsible party
- Principal investigator, Izmir Kavram, Izmir Kavram Vocational School
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT07320859
- Sponsor's protocol ID
- 22.10.2025/2544
- Acronym
- MIRROR-MUSIC
- Status last verified
- Jan 2026
- First submitted
- 15 Dec 2025
- Last updated
- 8 Jan 2026
- Results posted
- No
- Data monitoring committee
- No
- FDA-regulated drug
- No
- FDA-regulated device
- No
- Individual data sharing
- No: The datasets generated during this study are not publicly available due to the small sample size and the potential risk of compromising individual privacy, even after de-identification. However, anonymized data may be made available from the corresponding author upon reasonable request and with permission from the institutional ethics committee.
Publications
Tuzun Ozdemir S, Kilic Akca N. Mirror Versus Music for Fistula Cannulation Pain in Hemodialysis: A Randomized Trial. Pain Manag Nurs. 2026 Jun 12:S1524-9042(26)00191-8. doi: 10.1016/j.pmn.2026.05.019. Online ahead of print.
PubMed 42285853
Study at a glance
From the registry record, last updated by the sponsor on 8 Jan 2026. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Mirror Therapy Versus Music Therapy for Pain During Arteriovenous Fistula Cannulation in Hemodialysis Patients: A Randomized Controlled Trial
- ClinicalTrials.gov ID
- NCT07320859
- Acronym / sponsor ID
- MIRROR-MUSIC / 22.10.2025/2544
- Keywords
- Mirror Therapy, Music Therapy, Non-pharmacological Pain Management, Hemodialysis, Vascular Access, Cannulation Pain
- Study type
- Interventional
- Recruitment status
- Completed
- Enrolment
- 75 participants (actual)
- Lead sponsor
- Izmir Kavram Vocational SchoolUniversity, hospital or other
- Collaborators
- Izmir Bakircay University
- Study start
- 1 Dec 2025 (actual)
- Primary completion
- 1 Dec 2025 (actual)
- Study completion
- 6 Dec 2025 (actual)
- First posted
- 6 Jan 2026 (actual)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
Inserting needles into the vascular access (fistula) is a major source of pain and anxiety for many hemodialysis patients. This study compared two simple, non-drug techniques to reduce this pain: listening to music and looking into a mirror during the needle insertion.
A total of 75 adult patients receiving regular hemodialysis at Izmir Özel Can Dialysis Center were randomly divided into three groups: a music group, a mirror group, and a control group. Patients in the music group listened to calming, instrumental Turkish classical music (makam) via headphones during cannulation. Patients in the mirror group looked at the reflection of their healthy arm in a mirror. The control group received standard care without these interventions.
Pain intensity was measured immediately after needle insertion using a 10-cm Visual Analogue Scale (VAS), where 0 means "no pain" and 10 means "the worst imaginable pain." Pain scores were compared between the groups to determine which method was more effective.
The results of this study may provide nurses and patients with easy-to-use, evidence-based options to make hemodialysis needle procedures less painful and stressful.
Detailed description
Study Design: This was a prospective, three-arm, parallel-group, randomized controlled trial with a 1:1:1 allocation ratio.
Setting and Sample: The study was conducted at the Hemodialysis Unit of Izmir Özel Can Dialysis Center between December 1 and 30, 2025. The study population consisted of 150 patients. The sample size was calculated using G*Power 3.1.9.2 software. With a significance level (alpha) of 0.05, a power (1-beta) of 80%, and an effect size of 5%, a sample of 25 patients per group (total n=75) was determined to be sufficient for a three-group comparison.
Inclusion Criteria:
Age between 18 and 85 years.
Receiving hemodialysis treatment three times per week.
Literate (able to read and write).
No hearing impairment.
Native Turkish speaker.
On hemodialysis for at least 6 months.
Baseline pain score >3 on the Visual Analogue Scale (VAS).
Willing to listen to music.
Exclusion Criteria:
Presence of a psychological disorder.
Communication problems.
Diagnosis of cancer.
Unwillingness to participate in the study.
Randomization: Eligible patients were randomly assigned to one of three groups: the Music Intervention Group, the Mirror Intervention Group, or the Control Group.
Interventions:
Music Intervention Group: During the arteriovenous fistula (AVF) cannulation procedure, patients listened to pre-selected instrumental Turkish classical music (makam), specifically Nihavend and Muhayyerkürdi maqams, via an MP3 player and headphones. The volume was adjusted to a comfortable level.
Mirror Intervention Group: During cannulation, a standard mirror (40 cm in diameter) was positioned on a table stand. It was adjusted so that patients could see the reflection of their healthy (non-cannulated) arm. The distance between the fingertips of the reflected hand and the mirror surface was approximately 30 cm. Patients were instructed to focus only on the image of their healthy hand in the mirror. The cannulation was performed in two phases: immediately after looking at the healthy hand image (incongruent phase) and after 10 minutes of adaptation to the mirror image (adaptation phase).
Control Group: Patients received standard cannulation care without any additional intervention.
Data Collection Tools:
Patient Information Form: Collected socio-demographic characteristics, dialysis duration, and details about pain (location, intensity, type, timing, cause, and coping methods).
Visual Analogue Scale (VAS): A 10-cm horizontal line used to measure pain intensity, where the left end (0 cm) represents "no pain" and the right end (10 cm) represents "the worst pain imaginable." Patients marked their current pain level on the line, and the distance from the left end was measured in centimeters to obtain a numerical score (0-10).
Procedure: After providing informed consent, all participants completed baseline assessments (Patient Information Form, VAS). The interventions were applied during subsequent cannulation sessions as described. Procedural pain was assessed using the VAS immediately after cannulation.
Study design
- Primary purpose
- Supportive care
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- None (open label)
- Number of arms
- 3
- Model description
- Participants were randomly assigned in a 1:1:1 ratio to one of three parallel groups for the duration of the study.
| Arm | Type | Receives |
|---|---|---|
| Mirror group | Experimental | Device: Mirror Therapy (Visual Illusion Therapy)During arteriovenous fistula cannulation, patients viewed the reflection of their healthy arm in a 40-cm mirror placed approximately 30 cm away. They focused on this image for 10 minutes before cannulation (adaptation phase), and the procedure was performed while they continued to look at the mirror. The visual illusion aimed to modulate pain perception. |
| Music group | Experimental | Other: Music TherapyDuring arteriovenous fistula cannulation, patients listened to pre-selected, calming instrumental Turkish classical music (Nihavend and Muhayyerkürdi maqams) via headphones and an MP3 player at a comfortable volume. The music started before cannulation and continued throughout the procedure. |
| Control group | No intervention | –Patients received routine, standard cannulation care as per the hemodialysis unit protocol, without any additional non-pharmacological intervention such as mirror or music therapy. |
Who may qualify
- Ages
- 18 to 85 years
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult, Older adult
Key inclusion criteria (8 listed)
- Being 18-85 years of age or older
Key exclusion criteria (4 listed)
- Having a psychological disorder
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| Mirror Therapy (Visual Illusion Therapy)A non-pharmacological, behavioral intervention. A standard mirror (40 cm diameter) is positioned to allow the patient to view the reflection of their non-cannulated, healthy arm during arteriovenous fistula cannulation. The patient focuses on this visual illusion for an adaptation period (10 minutes) before the needle insertion. The intervention is based on the principles of graded motor imagery and aims to reduce procedural pain by modulating cortical representation and attention. | Device | Mirror group |
| Music TherapyA non-pharmacological, complementary therapy. Patients listen to pre-recorded, instrumental Turkish classical music (specifically Nihavend and Muhayyerkürdi maqams) via headphones during the cannulation procedure. The music is selected for its calming properties and starts before needle insertion. The intervention aims to reduce pain and anxiety through auditory distraction, emotional modulation, and relaxation. | Other | Music group |
Primary outcome
Procedural pain intensity during arteriovenous fistula cannulation
Time frame: Procedure (during cannulation)
Pain intensity experienced by the patient immediately following the needle insertion for hemodialysis. This primary outcome is measured during the second and third hemodialysis sessions following randomization (the first session post-randomization served as a runin with no intervention). Pain is measured using a 10-cm Visual Analogue Scale (VAS). Scores range from 0 to 10, where 0 cm represents 'no pain' and 10 cm represents 'the worst pain imaginable,' and higher scores indicate worse pain (greater pain intensity). The patient marks their pain level on the line, and the score is recorded in centimeters.
Results and safety
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 8 Jan 2026.
- Derived from this study: PubMed 42285853Tuzun Ozdemir S, Kilic Akca N. Mirror Versus Music for Fistula Cannulation Pain in Hemodialysis: A Randomized Trial. Pain Manag Nurs. 2026 Jun 12:S1524-9042(26)00191-8. doi: 10.1016/j.pmn.2026.05.019. Online ahead of print.
- Individual participant dataSharing planned: No. The datasets generated during this study are not publicly available due to the small sample size and the potential risk of compromising individual privacy, even after de-identification. However, anonymized data may be made available from the corresponding author upon reasonable request and with permission from the institutional ethics committee.
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.
The record lists no contact. Use the official record to reach the sponsor.
1 site in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A study testing Mirror Therapy (Visual Illusion Therapy) and Music Therapy in people with Chronic Kidney Disease and Pain, Procedural, run by Izmir Kavram Vocational School at 1 site in Turkey (Türkiye).
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 8 inclusion and 4 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: finished, as of the sponsor's last update on 8 Jan 2026. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 1 site in Turkey (Türkiye). Whether a site is taking part right now should be confirmed with that site. See every site.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
Are results available for this study?
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
How can a doctor refer a patient or contact the research team?
The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Procedural pain intensity during arteriovenous fistula cannulation (time frame: Procedure (during cannulation)). It is what the study was designed to measure, not a finding.
Where can I read the original study information?
On the ClinicalTrials.gov record for NCT07320859, which also lists 1 linked publication.
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 8 Jan 2026.