ABSTRACT Introduction Needle phobia is a significant barrier to home HD adoption, affecting 20%–60% of adults andchildren. This comprehensive review explores the complexities of needle phobiain dialysis patients, examining its origins, mechanisms, and impact through patient experiences and coping strategies. The necessity of cannulation in home HD patients with an AV access can deter patients from adopting self‐care, yet mastering self‐cannulation can effectively help overcome needle phobia. Methods Factors contributing to needle phobia include genetic predisposition, traumatic experiences, andchronic pain. The physiological response involves a diphasic reaction, with initial sympathetic activation followed by a parasympathetic surge, potentially leading to vasovagal syncope. Results A holistic approach to managing needle‐related distress, addressing physiological pain, fear, and lack of control is proposed. This includes both pharmacological and non‐pharmacological methods, such as desensitization therapy, topical anesthetics, distraction techniques, and cognitive‐behavioral interventions. Conclusion Systematic screening for needle phobia, education and targeted interventions can empower patientsand improve outcomes. Only then can we foster a culture of compassion, empathy, and personalized support, thereby transforming dialysis care and improving patient experiences.
Bermúdez et al. (Sun,) studied this question.