Parker Kristen, Raugust Shauna, Vink Becky, Parmar Kuljit, Fradsham Allan, Armstrong Marni
Alberta Kidney Care-South, Alberta Health Services, Calgary, Canada.
Canadian Institute of Traditional Chinese Medicine, Calgary, AB, Canada.
Can J Kidney Health Dis. 2024 Aug 6;11:20543581241267164. doi: 10.1177/20543581241267164. eCollection 2024.
Symptom burden among long-term hemodialysis (HD) patients is high, and addressing symptoms has been identified as a key research priority by patients. Acupressure has shown some effectiveness in management of symptoms in patients with HD.
The purpose of this study was to explore the feasibility and the effect of implementing a self-administered acupressure intervention on symptom burden and quality of life for in-center HD patients.
A pilot randomized controlled study.
Two outpatient community HD clinics between in Calgary, Alberta, Canada.
Patients on HD for at least 3 months and with at least one symptom score rated greater than moderate were eligible for the study.
Participants were randomized into either the (1) self-acupressure + usual care or (2) usual care alone group. Participants in the acupressure group were given a wooden acupressure tool and taught how to self-administer protocol on 6 acupressure sites for the 4-weeek study duration. Feasibility outcomes were assessed through satisfaction surveys and attrition. Other outcomes included quality of life and symptom scores by validated questionnaires (EQ-5D-5L and Integrated Palliative Outcome Score-Renal [IPOS-Renal]).
Thirty-two participants were successfully enrolled in the study; acceptability was high with study completion at 98% in the intervention group and 82% adherence rate to the 4-week protocol. Participants in the intervention group reported an improved change score in quality of life (EQ-5D-5L Index Score change = +0.053; EQ-5D-5L visual analog scale score change = +6.7). Participants in the intervention group also reported improved symptom scores (IPOS-Renal overall change = -2.8).
Small sample size and intervention duration are limitations of this pilot study.
The results from this study suggest that self-acupressure was acceptable and feasible in this sample of HD patients. Self-acupressure may have a role for supporting the management of symptoms in HD patients. These pilot results can be used to inform larger more definitive investigations.
长期血液透析（HD）患者的症状负担较重，患者已将解决症状问题确定为一项关键研究重点。指压疗法在HD患者症状管理方面已显示出一定疗效。
本研究旨在探讨对中心HD患者实施自我指压干预对症状负担和生活质量的可行性及效果。
一项试点随机对照研究。
加拿大艾伯塔省卡尔加里市的两家门诊社区HD诊所。
接受HD治疗至少3个月且至少有一项症状评分大于中度的患者符合本研究条件。
参与者被随机分为两组：（1）自我指压+常规护理组或（2）单纯常规护理组。指压组参与者被给予一个木制指压工具，并在为期4周的研究期间接受如何在6个指压穴位进行自我指压操作的指导。通过满意度调查和损耗情况评估可行性结果。其他结果包括通过经过验证的问卷（EQ-5D-5L和综合姑息治疗结果评分-肾脏版[IPOS-Renal]）得出的生活质量和症状评分。
32名参与者成功纳入本研究；干预组的研究完成率为98%，对4周方案的依从率为82%，可接受性较高。干预组参与者报告生活质量改善变化评分（EQ-5D-5L指数评分变化=+0.053；EQ-5D-5L视觉模拟量表评分变化=+6.7）。干预组参与者还报告症状评分有所改善（IPOS-Renal总体变化=-2.8）。
样本量小和干预持续时间短是本试点研究的局限性。
本研究结果表明，自我指压在该HD患者样本中是可接受且可行的。自我指压可能在支持HD患者症状管理方面发挥作用。这些试点结果可用于为规模更大、更具确定性的研究提供参考。
