<![CDATA[The study examined the relationship between anxiety levels and pain intensity during AV shunt cannulation among patients undergoing hemodialysis at RSUI Harapan Anda Tegal. A quantitative correlational study with a cross-sectional approach was conducted among 103 patients selected through purposive sampling. Anxiety was assessed using the Hamilton Anxiety Rating Scale (HARS), while pain intensity during AV shunt cannulation was measured using the Numeric Rating Scale (NRS), with the relationship between variables analyzed using the Spearman Rank test. The findings showed that 71 respondents (68.9%) experienced moderate anxiety, while 32 respondents (31.1%) experienced mild anxiety. Regarding pain intensity, 72 respondents (69.9%) reported moderate pain, 30 respondents (29.1%) reported mild pain, and 1 respondent (1.0%) reported severe pain during AV shunt cannulation. Spearman Rank analysis demonstrated a very strong, positive, and statistically significant relationship between anxiety level and AV shunt puncture pain intensity, with a correlation coefficient of Rho = 0.938 and p = 0.000. The positive correlation indicates that patients with higher anxiety levels tended to experience greater pain intensity during AV shunt cannulation. These findings highlight the importance of integrating psychological assessment with pain assessment in routine hemodialysis care. Early identification of anxiety and appropriate anxiety-management strategies may support individualized nursing interventions and improve patient comfort during repeated AV shunt cannulation.]]>
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