Hmwe Nant Thin Thin, Subramanian Pathmawathi, Tan Li Ping, Chong Wan Kuan
Department of Nursing Science, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia.
Nephrology Division, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia.
Int J Nurs Stud. 2015 Feb;52(2):509-18. doi: 10.1016/j.ijnurstu.2014.11.002. Epub 2014 Nov 11.
Patients with end stage renal disease on hemodialysis are affected by physiological and psychological stressors, which contribute to poor quality of life and negative clinical outcomes. Depression, anxiety, and stress are highly prevalent in this population. Effective interventional strategies are required to manage these psychological symptoms. Acupressure has been believed to be one of the complementary therapies that could promote psychological wellbeing.
The aim of this study was to evaluate the effects of acupressure on depression, anxiety, stress, and general psychological distress in patients with hemodialysis.
Open-label randomized controlled trial.
Three hemodialysis centers.
A total of 108 patients with hemodialysis were randomly recruited into the acupressure group (n=54) and the control group (n=54).
The intervention was carried out from January to March 2014. The acupressure group received routine hemodialysis treatment plus 15 min acupressure applied three times a week for four weeks. The control group received only usual care with routine hemodialysis treatment. The outcome measurements were the Depression, Anxiety Stress Scales (DASS-21), and general psychological distress using the General Health Questionnaire (GHQ-28). Statistical analysis was performed using Wilcoxon signed-rank test to compare DASS scales and GHQ-28 scores before and after acupressure intervention.
The acupressure group had significantly lower DASS scores and GHQ scores compared to the control group, signifying improvements in depression, anxiety, stress and general psychological distress. The sub-score of the GHQ-28 for social dysfunction, however, were similar in both groups.
Findings from this study indicates that acupressure therapy delivered three times a week for four weeks was able to significantly reduce depression, anxiety, stress, and general psychological distress in patients with hemodialysis. This positive finding suggests that acupressure may have a role in promoting psychological wellbeing of patients. Promoting psychological wellness will improve patients' quality of life, and reduce negative outcomes associated with psychological illnesses and distress experienced by patients with hemodialysis.
接受血液透析的终末期肾病患者受到生理和心理应激源的影响，这导致生活质量低下和不良临床结局。抑郁、焦虑和压力在这一人群中非常普遍。需要有效的干预策略来管理这些心理症状。穴位按压被认为是能够促进心理健康的补充疗法之一。
本研究的目的是评估穴位按压对血液透析患者抑郁、焦虑、压力和一般心理困扰的影响。
开放标签随机对照试验。
三个血液透析中心。
共108名血液透析患者被随机招募到穴位按压组（n = 54）和对照组（n = 54）。
干预于2014年1月至3月进行。穴位按压组接受常规血液透析治疗，外加每周三次、每次15分钟的穴位按压，持续四周。对照组仅接受常规血液透析治疗的常规护理。结局测量指标为抑郁、焦虑压力量表（DASS - 2）和使用一般健康问卷（GHQ - 28）评估的一般心理困扰。采用Wilcoxon符号秩检验进行统计分析，以比较穴位按压干预前后的DASS量表和GHQ-28评分。
与对照组相比，穴位按压组的DASS评分和GHQ评分显著更低，表明抑郁、焦虑、压力和一般心理困扰有所改善。然而，两组在GHQ-28社会功能障碍子评分方面相似。
本研究结果表明，每周进行三次、持续四周的穴位按压疗法能够显著降低血液透析患者的抑郁、焦虑、压力和一般心理困扰。这一积极发现表明穴位按压可能在促进患者心理健康方面发挥作用。促进心理健康将改善患者的生活质量，并减少与血液透析患者心理疾病和困扰相关的负面结局。
