The research was planned to measure pain, ecchymosis, hematoma and patient satisfaction with ice massage applied to the fistula before the arteriovenous fistula procedure in hemodialysis patients. Patients who agree to participate in the study will be given ice massage before the procedure and the relevant parameters will be measured.

Chronic renal failure is a condition that causes irreversible damage to kidney functions and prevents the excretion of metabolic wastes through urine. In the treatment of the disease; renal replacement therapies and kidney transplant options are available. The most commonly used treatment in end-stage renal failure patients is hemodialysis. Hemodialysis is performed through catheters and fistula channels. Patients receiving hemodialysis treatment through fistula are connected to the dialysis device. For this procedure, an injection occurs 2 or 3 times a week. It is a distressing situation for patients that needle insertion is painful during the procedure and that conditions such as ecchymosis and hematoma frequently occur afterwards. In this study, cold application was planned in a pre-test post-test design to evaluate pain, ecchymosis, hematoma and patient satisfaction. Volunteer participants who receive hemodialysis treatment through fistula will receive an ice massage for an average of 3-5 minutes on the fistula area where the needle will be inserted before the procedure.

Inclusion Criteria:

• Conscious and oriented
• Communicable,
• Those who are 18 years or older,
• Hemodialysis treatment is applied via arteriovenous fistula,
• There are no signs of infection such as redness, swelling, or open wound in the area where the procedure will be performed,
• Patient: International Normalized Ratio: 2-3, Activated Partial Thromboplastin Time: 27-45 sec. Prothrombin Time: 11-16 sec. Thrombocyte: 125-350 m3
• Can tolerate the application,
• 10 minutes before starting Hemodialysis treatment. vissual analog scale pain score was evaluated beforehand and vissual analog scale was ≥4.
• Patients who agree to participate in the study verbally and in writing will be included in the research.

Exclusion Criteria:

• Unconscious,
• Unable to communicate,
• Those who are under 18 years of age,
• Hemodialysis treatment is not applied via arteriovenous fistula,
• If there is any sign of infection such as redness, swelling, open wound in the area where cannulation will be performed,
• 10 minutes before starting hemodialysis treatment. vissual analog scale pain score was evaluated beforehand and vissual analog scale ≤ 4
• Using any painkillers before the procedure on the same day,
• Patient: International Normalized Ratio: 2-3, Activated Partial Thromboplastin Time: 27-45 sec. Prothrombin Time: 11-16 sec. Thrombocyte: above 125-350 m3, prone to bleeding,
• Patients who cannot tolerate the application or do not want to participate in the study voluntarily will not be included in the research.

Exclusion Criteria:

Patients who cannot tolerate ice massage during the procedure will not be included in the study.