Purpose
Contrast therapy, which includes alternately applying cold and heat therapy, is an effective intervention to increase muscle elasticity and reduce musculoskeletal edema and pain. This study aimed to confirm the effects of contrast therapy by using flexible Thermoelectric Devices (TEDs) — that not only maintain a constant temperature but can also change the temperature in a short time — on lower extremity edema, pain, muscle fatigue, and stress among nursing home workers.
Methods
This randomized controlled pre-post experimental study used a flexible thermoelectric element to administer contrast therapy in nursing home workers to compare its impact on lower extremity swelling, pain, muscle fatigue, and stress. As an intervention method, 4 minutes of heat therapy and 1 minute of cold therapy were repeated for a total of 30 minutes.
Results
The experimental group displayed a significant difference of -2.53 points, and the control group displayed a significant difference of -0.94 points (t=2.65, p<.050) as a result of an analysis comparing the two groups’ pain levels before and after the experimental treatment. The experimental group also displayed a statistically significant reduction in the degree of lower extremity edema (t=3.91, p=.001). Furthermore, the experimental group’s lower extremity stress index decreased significantly (t=2.87, p=.049).
Conclusion
The findings of this study indicated that contrast therapy by using flexible TEDs alleviated stress, leg pain, and swelling in nursing home workers and could be used as an intervention to alleviate musculoskeletal problems in healthcare workers.

Purpose
This study investigates the effects of thermomechanical stimulation intervention during arteriovenous fistula puncture on hemodialysis patients’ pain, anxiety, and stress. Methods: We used a nonequivalent groups pretest-posttest experimental design. In this study, 44 patients on regular hemodialysis (22 each in experimental and control groups) at a general hospital in South Korea were enrolled from December 2020 to January 2021.Subsequently, thermomechanical stimulation intervention using the Buzzy device was applied to the experimental group during arteriovenous fistula puncture. The outcome measures were the patients’ pain, anxiety, and stress.
Results
After the intervention, the experimental group recorded significantly lower arteriovenous fistula puncture pain compared to the control group (t=2.90, p=.006). However, no significant differences in anxiety and stress were noted before and after the intervention between the groups.
Conclusion
The study indicates that thermomechanical stimulation intervention can be utilized as an easy and effective intervention method to reduce the puncture pain experienced by patients on hemodialysis during arteriovenous fistula puncture.

Citations

• Effects of an intervention combining warm therapy with a digital distraction app on pain, stress, and satisfaction during intravenous catheterization in South Korea: a randomized controlled trial
  Jae-Kyeum Lee, Ki-Yong Kim, Yean-Hee Jeong, Yu-Jin Lee, Min-Ho Lee, Myung-Haeng Hur
  Journal of Korean Biological Nursing Science.2025; 27(2): 191.     CrossRef
• Effects of a thermoelectric element tourniquet on venipuncture pain and stress relief in Korea: a randomized controlled trial
  Tae Jung Lee, Jihoo Her, Myung-Haeng Hur
  Journal of Korean Biological Nursing Science.2025; 27(2): 179.     CrossRef
• Thermoelectric tourniquet–assisted thermotherapy and cryotherapy for pain, regional blood flow, and satisfaction with intravenous injections among hospitalized patients in Korea: a randomized controlled trial
  Seon-Mi Lee, Myung-Haeng Hur
  Journal of Korean Biological Nursing Science.2024; 26(4): 323.     CrossRef
• Effect of aromatherapy on quality of life in maintenance hemodialysis patients: a systematic review and meta-analysis
  Cong Zhang, Hang Mu, Yong-Fang Yang, Yong Zhang, Wen-Jun Gou
  Renal Failure.2023;[Epub]     CrossRef
• Juan Bi Tang, a traditional Chinese medicine, for alleviating pain related to arteriovenous fistula in maintenance hemodialysis patients: An interventional pilot study with brief review
  Yung-Tang Hsu, Yung-Hsiang Chen, Chung-Ming Fu, Wen-Chin Lee, Ming-Yen Tsai
  Medicine.2023; 102(45): e35974.     CrossRef

PURPOSE
This systematic review and meta-analysis provided scientific evidence for oral cryotherapy as a nursing intervention for the prevention of Oral Mucositis (OM) associated with Hematopoietic Stem Cell Transplantation (HSCT).
METHODS
The literature search was carried out in July and October 2017. The MEDLINE, EMBASE, Cochrane Library, CINAHL, and KoreaMed electronic databases were searched using the MeSH keywords “mucositis” and “cryotherapy.” The Cochrane's Risk of Bias tool was used to assess the internal validity of the Randomized Controlled Trials (RCTs). The selected studies were included in the meta-analysis using Review Manager 5.3.
RESULTS
Among seven RCTs with 264 patients, oral cryotherapy significantly decreased the incidence of OM (Relative Risk [RR]=0.46, 95% Confidence Interval [CI]=0.31~0.66), including severe OM (grade 2~4: RR=0.33, 95% CI=0.21~0.52; grade 3~4: RR=0.34, 95% CI, 0.22~0.53), and also reduced the OM severity score (Standardized Mean Difference [SMD]=−0.92, 95% CI=−1.25~−0.58). In addition, the need of intravenous narcotics therapy (RR=0.19, 95% CI=0.07~0.51) and the total parenteral nutrition (RR=0.54, 95% CI=0.35~0.84) were reduced. These results were associated with a significantly reduced length of hospitalization (Weighted Mean Difference [WMD]=−1.22, 95% CI=−2.37~−0.07).
CONCLUSION
Oral cryotherapy is effective and well-tolerated nursing intervention to alleviate OM among patients receiving myeloablative therapy before HSCT. Nurses caring for patients treated with myeloablative therapy should place high priority to prevent OM based on this evidence.

Citations

• Radyoterapiye Bağlı Oral Mukozit ve Yönetiminde Kanıta Dayalı Uygulamalar
  Ülkü Saygılı Düzova
  Black Sea Journal of Health Science.2025; 8(2): 79.     CrossRef
• Nutritional interventions for the prevention and treatment of cancer therapy-induced oral mucositis: an umbrella review of systematic reviews and meta-analysis
  Reza Amiri Khosroshahi, Sepide Talebi, Sheida Zeraattalab-Motlagh, Hossein Imani, Amirabbas Rashidi, Nikolaj Travica, Hamed Mohammadi
  Nutrition Reviews.2023; 81(9): 1200.     CrossRef
• Cryotherapy for oral mucositis in cancer: review of systematic reviews and meta-analysis
  Reza Amiri Khosroshahi, Sepide Talebi, Nikolaj Travica, Hamed Mohammadi
  BMJ Supportive & Palliative Care.2023; 13(e3): e570.     CrossRef
• Oral cryotherapy for management of chemotherapy‐induced oral mucositis in haematopoietic cell transplantation: a systematic review
  Faizah Jabr Alsulami, Sadr ul Shaheed
  BMC Cancer.2022;[Epub]     CrossRef
• Effectiveness of low level laser therapy versus cryotherapy in cancer patients with oral mucositis: Systematic review and network meta-analysis
  Chih-Chin Lai, Shiau-Yee Chen, Yu-Kang Tu, Yu-Wei Ding, Jiu-Jenq Lin
  Critical Reviews in Oncology/Hematology.2021; 160: 103276.     CrossRef
• Kemoterapi ve Radyoterapi Alan Hastalarda Oral Mukozit: Bir Gözden Geçirme
  Seher ÇAKMAK, Nesrin NURAL
  Dokuz Eylül Üniversitesi Hemşirelik Fakültesi Elektronik Dergisi.2020; 13(3): 185.     CrossRef
• Experiences of Unrelated Hematopoietic Stem-cell Donors and Experts of Relevant Institutions
  Soyoung Yu, Miok Kim, Tai-Gyu Kim, Su-Hee Beom
  Korean Journal of Adult Nursing.2019; 31(5): 522.     CrossRef

PURPOSE
The aim of this study was to develop evidence-based nursing practice guidelines for cold application in adult care.
METHODS
The study procedure was based on the Scottish Intercollegiate Guidelines Network and Korean Hospital Nurses Association's guideline development methods. The evidence review procedures included targeted searches from databases including the Cochrane Library, PubMed, CINAHL, Embase, KoreaMed, KERIS and NDSL. The initial search yielded 6,426 articles published from 2006 to 2016. Based on the screening process, 147 articles were selected and systematically reviewed. From evidence summaries of 20 clinical questions, recommendations were formulated and graded. Draft recommendation were evaluated through external review.
RESULTS
The guidelines consisted of 10 domains and 27 recommendations. The content validity index of the recommendations was above .80. Major recommendations include 1) applying external cooling to reduce acute pain, edema, and hemorrhage, 2) selecting cooling instruments based on the purpose, patient's condition, and preference, 3) preparing and maintaining cooling instruments at an adequate temperature, and 4) intermittent cold application for appropriate durations with sufficient recovery time.
CONCLUSION
These guidelines can be utilized in both clinical and community settings to help narrow the gaps between nursing practices.

Citations

• Effects of a thermoelectric element tourniquet on venipuncture pain and stress relief in Korea: a randomized controlled trial
  Tae Jung Lee, Jihoo Her, Myung-Haeng Hur
  Journal of Korean Biological Nursing Science.2025; 27(2): 179.     CrossRef
• Thermoelectric tourniquet–assisted thermotherapy and cryotherapy for pain, regional blood flow, and satisfaction with intravenous injections among hospitalized patients in Korea: a randomized controlled trial
  Seon-Mi Lee, Myung-Haeng Hur
  Journal of Korean Biological Nursing Science.2024; 26(4): 323.     CrossRef
• Cryoanalgesia for Reducing Unconscious Patients’ Pain During Arterial Puncture
  Sara Elsayed Hegazy, Hend Elsayed Mansour, Alexandra Hare, Nahed Attia Kandeel
  Critical Care Nursing Quarterly.2024; 47(4): 370.     CrossRef
• Effectiveness and methods of cryotherapy in reducing swelling after total knee arthroplasty: A systematic review on randomized controlled trials
  Yoonyoung Lee, Yong Soon Shin, Hyun Jung Kim, Jiwon An
  Nursing Open.2023; 10(9): 5989.     CrossRef
• The effect of cold application on episiotomy pain: A systematic review and meta‐analysis
  Ayça Şolt Kırca, Sevda Korkut Öksüz, Naci Murat
  Journal of Clinical Nursing.2022; 31(5-6): 559.     CrossRef
• Effects of a Thermoelectric Element Band on Venipuncture-associated Pain and Anxiety: A Randomized Controlled Trial
  Myung-Haeng Hur, Hee-Soo Choi
  Asian Nursing Research.2021; 15(5): 337.     CrossRef
• The effects of cryotherapy on perineal pain after childbirth: A systematic review and meta-analysis
  Hyun-Jung Kim, Ji-Won An, Yoonyoung Lee, Yong-Soon Shin
  Midwifery.2020; 89: 102788.     CrossRef
• Effects of Localized Heating on Pain, Skin Perfusion, and Wound Healing After Lumbar Decompression
  Jeoung Hee Kim, Yong Soon Shin
  Journal of Neuroscience Nursing.2020; 52(5): 251.     CrossRef
• Critical Review I to Standardize the Textbooks of Fundamentals of Nursing: Vital Sign Assessment, Body Temperature Regulation, Oxygenation
  YunHee Shin, Seung Kyo Chaung, Hyun-Ju Kim
  Journal of Korean Academy of Fundamentals of Nursing.2019; 26(4): 282.     CrossRef

The purpose of this study is to determine the effect of oral cryotherapy on oral mucositis in the patients who receiving high-dose ARA-C plus Mitoxantrone chemotherapy regimen. There were total of ten patients who received the chemotherapy regimen for 13 months ; 5 patients for the experimental group, while the others for the control group. The tool used for assess degree of oral mucositis was the Oral Assessment Guide(OAG) which was developed by Elier, Burger, Peterson in 1988. []The experimental group received oral cryotherapy range from 30minutes before the Mitroxantrone IV infusing to 30minutes after the high-dose ARA-C IV infusing. The control group was not treated by oral cryotherapy. The effect of this treatment was analyzed with the OAG score. The collected data were analysed with, mean, Mann-Whitney U test and Chi-square test according to characteristics of variables. The results were as follows : 1. There were no statistical difference in general characteristics(age, sex, cycle of the chemotherapy, smoking, alcohol) between the two groups, so the homogeneity of two groups was established. There were no differences in the OAG Scores between the two groups statistically. 2. The subjects of this study suffered the neutropenia from 5.6 days to 24.6 days after starting chemotherapy. During the neutropenia period the average OAG scores in the experimental group were lower than that of the control group(experimental group was 9.17+/-1.91, control group was 9.33+/-1.10). 3. The mean OAG of experimental group for 21 days was 204.72+/-20.61, while the mean of control group for 21 days was 206.23+/-15.97. There were, however, no differences between the experimental and the control groups statistically. The subjects of the experimental group expressed more comfortable oral condition than those of the past cycle and they would like to try oral cryotherapy again for the next chemotherapy. The subjects of this study suffered the neutropenia from 5.6 days to 24.6 days after starting chemotherapy. During the neutropenia period the average OAG scores in the experimental group were lower than that of the control group(experimental group was 9.17, control group was 9.33). 5 subjects of the study group complained of numbness, 3 subjects complained of slight headache, and 2 subjects expressed teeth and abdominal discomfort. However, these signs occurred temporarily and were resolved rapidly after cessation of the cryotherapy. It was I recommended that replication with larger sample.