The cannulation of arteriovenous fistula is a painful procedure in hemodialysis patients. Previous studies have shown the effectiveness of virtual reality in reducing pain during needle-related procedures

Patients undergoing hemodialysis experience anxiety and pain related to the insertion of hemodialysis needles, estimated 320 times in total per year. The pain experienced is mostly caused by needle insertion into a fistula. Pain control is one of the main nursing tasks. Pain relief leads to the acceptance of the procedure and ultimately enhances the patients' quality of life. The use of virtual reality to reduce pain and anxiety during the arteriovenous fistula cannulation procedure is based on the concept that the perception of pain can be controlled because an individual is able to process only a limited amount of information at once. As such, the use of virtual reality during painful procedures may serve as a distraction.

Inclusion Criteria:

• patients who are under- going conventional hemodialysis three times a week
• hemodialysis period of one month or more
• having a healthy AVF access with good function
• welling to participate in study

Exclusion Criteria:

• patients who have psychiatric diseases
• panic disorder, anxiety disorder
• dysfunctional fistula
• vertigo, issues with sight, hearing, or perception
• or use painkillers within three hours before hemodialysis