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Parker K, Raugust S, Vink B, Parmar K, Fradsham A, Armstrong M. The Feasibility and Effects of Self-Acupressure on Symptom Burden and Quality of Life in Hemodialysis Patients: A Pilot RCT. Can J Kidney Health Dis 2024; 11:20543581241267164. [PMID: 39114647 PMCID: PMC11304491 DOI: 10.1177/20543581241267164] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2023] [Accepted: 05/01/2024] [Indexed: 08/10/2024] Open
Abstract
Background 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. Objective 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. Design A pilot randomized controlled study. Setting Two outpatient community HD clinics between in Calgary, Alberta, Canada. Patients or Sample or Participants Patients on HD for at least 3 months and with at least one symptom score rated greater than moderate were eligible for the study. Methods 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]). Results 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). Limitations Small sample size and intervention duration are limitations of this pilot study. Conclusions 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.
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Affiliation(s)
- Kristen Parker
- Alberta Kidney Care–South, Alberta Health Services, Calgary, Canada
| | - Shauna Raugust
- Alberta Kidney Care–South, Alberta Health Services, Calgary, Canada
| | - Becky Vink
- Alberta Kidney Care–South, Alberta Health Services, Calgary, Canada
| | - Kuljit Parmar
- Alberta Kidney Care–South, Alberta Health Services, Calgary, Canada
| | - Allan Fradsham
- Canadian Institute of Traditional Chinese Medicine, Calgary, AB, Canada
| | - Marni Armstrong
- Medicine Strategic Clinical Network, Alberta Health Services, Calgary, Canada
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, AB, Canada
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Rukmindar D, Pekerti F, Sirvel R, Khasanah N, Dimara I, Mihardja H, Djaali W. The Role of Self-Care Acupressure in Maternal Health Problems to Support the Sustainable Development Goals Program in the Health Sector: A Narrative Review. Med Acupunct 2023; 35:170-179. [PMID: 37609550 PMCID: PMC10440639 DOI: 10.1089/acu.2023.0001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/24/2023] Open
Abstract
Objective This narrative review discusses several studies that demonstrated the effect of self-care acupressure, especially on maternal-health problems in antenatal, labor, and postpartum times, as well as the mechanism of acupressure, the points used, and treatment strategies to support the Sustainable Development Goals (SDGs) program in the health sector. Methods PubMed and Google Scholar were searched for randomized controlled trials and systematic reviews/meta-analyses from the date of their inception to February 2022. Results The 14 studies that were included showed the possibility that acupressure could have a positive impact on maternal health. This self-care can be the main alternative in overcoming the gap in solving health problems in the world. Conclusions Self-care acupressure at various acupoints has been shown to be feasible to reduce problems during antenatal, labor, and postpartum times. Additional research on the use of acupressure during pregnancy and cross-sectional collaboration to increase the awareness of acupressure techniques are needed.
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Affiliation(s)
- Dion Rukmindar
- Medical Acupuncture Specialist Program, Faculty of Medicine, Universitas Indonesia and Cipto Mangunkusumo Hospital, Jakarta, Indonesia
| | - Fransisca Pekerti
- Medical Acupuncture Specialist Program, Faculty of Medicine, Universitas Indonesia and Cipto Mangunkusumo Hospital, Jakarta, Indonesia
| | - Ray Sirvel
- Medical Acupuncture Specialist Program, Faculty of Medicine, Universitas Indonesia and Cipto Mangunkusumo Hospital, Jakarta, Indonesia
| | - Nur Khasanah
- Medical Acupuncture Specialist Program, Faculty of Medicine, Universitas Indonesia and Cipto Mangunkusumo Hospital, Jakarta, Indonesia
| | - Imelda Dimara
- Medical Acupuncture Specialist Program, Faculty of Medicine, Universitas Indonesia and Cipto Mangunkusumo Hospital, Jakarta, Indonesia
| | - Hasan Mihardja
- Medical Acupuncture Specialist Program, Faculty of Medicine, Universitas Indonesia and Cipto Mangunkusumo Hospital, Jakarta, Indonesia
| | - Wahyuningsih Djaali
- Medical Acupuncture Specialist Program, Faculty of Medicine, Universitas Indonesia and Cipto Mangunkusumo Hospital, Jakarta, Indonesia
- Universitas Negeri Jakarta, Jakarta, Indonesia
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Kubasch J, Ortiz M, Binting S, King R, Dietzel J, Nögel R, Hummelsberger J, Willich SN, Brinkhaus B, Teut M, Siewert J. Hydrotherapy and acupressure in restless legs syndrome: A randomized, controlled, 3-armed, explorative clinical trial. Medicine (Baltimore) 2023; 102:e34046. [PMID: 37390284 PMCID: PMC10313283 DOI: 10.1097/md.0000000000034046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/26/2023] [Accepted: 05/30/2023] [Indexed: 07/02/2023] Open
Abstract
BACKGROUND Restless legs syndrome (RLS) is a common neurological disease that has a significant impact on daily activities and quality of life, for which there is often no satisfactory therapy. Complementary medicine, such as acupressure and hydrotherapy, is used to treat patients with RLS; however, the clinical evidence is unclear. This study aims to investigate the effects and feasibility of self-administered hydrotherapy and acupressure in patients with RLS. METHODS This is a randomized, controlled, open-label, exploratory, clinical study with 3 parallel arms, comparing both self-applied hydrotherapy (according to the German non-medical naturopath Sebastian Kneipp) and acupressure in addition to routine care in comparison to routine care alone (waiting list control) in patients with RLS. Fifty-one patients with at least moderate restless-legs syndrome will be randomized. Patients in the hydrotherapy group will be trained in the self-application of cold knee/lower leg affusions twice daily for 6 weeks. The acupressure group will be trained in the self-application of 6-point-acupressure therapy once daily for 6 weeks. Both interventions take approximately 20 minutes daily. The 6-week mandatory study intervention phase, which is in addition to the patient preexisting routine care treatment, is followed by a 6-week follow-up phase with optional interventions. The waitlist group will not receive any study intervention in addition to their routine care before the end of week 12. Outcome parameters including RLS-severity, disease and health-related quality of life (RLS-QoL, SF-12), Hospital Anxiety and Depression Score in German version, general self-efficacy scale, and study intervention safety will be measured at baseline and after 6 and 12 weeks. The statistical analyses will be descriptive and exploratory. CONCLUSION In the case of clinically relevant therapeutic effects, feasibility, and therapeutic safety, the results will be the basis for planning a future confirmatory randomized trial and for helping to develop further RLS self-treatment concepts.
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Affiliation(s)
- Julia Kubasch
- Charité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Institute of Social Medicine, Epidemiology and Health Economics, Berlin, Germany
| | - Miriam Ortiz
- Charité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Institute of Social Medicine, Epidemiology and Health Economics, Berlin, Germany
| | - Sylvia Binting
- Charité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Institute of Social Medicine, Epidemiology and Health Economics, Berlin, Germany
| | - Ryan King
- Charité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Institute of Social Medicine, Epidemiology and Health Economics, Berlin, Germany
| | - Joanna Dietzel
- Charité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Institute of Social Medicine, Epidemiology and Health Economics, Berlin, Germany
| | - Rainer Nögel
- International Society for Chinese Medicine (SMS), Munich, Germany
| | | | - Stefan N. Willich
- Charité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Institute of Social Medicine, Epidemiology and Health Economics, Berlin, Germany
| | - Benno Brinkhaus
- Charité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Institute of Social Medicine, Epidemiology and Health Economics, Berlin, Germany
| | - Michael Teut
- Charité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Institute of Social Medicine, Epidemiology and Health Economics, Berlin, Germany
| | - Julia Siewert
- Charité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Institute of Social Medicine, Epidemiology and Health Economics, Berlin, Germany
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Chen SC, Cheung TW, Yu BYM, Chan MY, Yeung WF, Li L. Improving Sleep with Far-Infrared-Emitting Pajamas: A Pilot Randomized Controlled Trial. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:3870. [PMID: 36900881 PMCID: PMC10002002 DOI: 10.3390/ijerph20053870] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/12/2022] [Revised: 02/17/2023] [Accepted: 02/20/2023] [Indexed: 06/18/2023]
Abstract
Far infrared (FIR)-based clothing may alleviate sleep disturbance. This study aimed to explore the effects of FIR-emitting pajamas on sleep quality. This was a pilot randomized, sham-controlled trial. Forty subjects with poor sleep quality were randomized to FIR-emitting-pajamas and sham-pajamas groups in a 1:1 ratio. The primary outcome measure was the Pittsburgh Sleep Quality Index (PSQI). Other measures included the Insomnia Severity Index, and 7 day sleep diary, the Multidimensional Fatigue Inventory (MFI), the Hospital Anxiety and Depression Scale, the Epworth Sleepiness Scale, and the Satisfaction with Life Scale. Outcomes were measured at baseline and weeks 2, 4, and 6. Both groups showed within-group improvements in the PSQI score, but there was no significant difference between the two groups. However, FIR-emitting pajamas appeared to perform better than sham pajamas in reducing the MFI-physical score, with large effect sizes at three time points (dppc2 = 0.958, 0.841, 0.896); however, the differences were statistically insignificant. The intervention compliance was satisfactory. The effects of FIR-emitting pajamas on sleep quality were not superior to those in the control group. However, these pajamas may improve physical fatigue in adults with poor sleep quality, which warrants further exploration.
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Affiliation(s)
- Shu-Cheng Chen
- School of Nursing, The Hong Kong Polytechnic University, Hong Kong SAR 999077, China
| | - Tin-Wai Cheung
- School of Fashion and Textiles, The Hong Kong Polytechnic University, Hong Kong SAR 999077, China
| | - Branda Yee-Man Yu
- Department of Psychology, The University of Hong Kong, Hong Kong SAR 999077, China
| | - Mei-Yan Chan
- School of Nursing, The Hong Kong Polytechnic University, Hong Kong SAR 999077, China
| | - Wing-Fai Yeung
- School of Nursing, The Hong Kong Polytechnic University, Hong Kong SAR 999077, China
| | - Li Li
- School of Fashion and Textiles, The Hong Kong Polytechnic University, Hong Kong SAR 999077, China
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Sui Y, Kor PPK, Li M, Wang J. Effects of a Social Media-Based Mind-Body Intervention Embedded With Acupressure and Mindfulness for Stress Reduction Among Family Caregivers of Frail Older Adults: Pilot Randomized Controlled Trial. JMIR Form Res 2023; 7:e42861. [PMID: 36804167 PMCID: PMC9989915 DOI: 10.2196/42861] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2022] [Revised: 12/16/2022] [Accepted: 01/09/2023] [Indexed: 01/11/2023] Open
Abstract
BACKGROUND Family caregivers of frail older adults experience high levels of stress. Mind-body interventions (MBIs) focused on caregiver stress are often limited in teaching approaches, difficult to practice, and costly. A social media-based MBI embedded with mindfulness meditation (MM) and self-administered acupressure (SA) may be effective for family caregivers, offer greater usability, and lead to greater adherence. OBJECTIVE The aim of this study was to test the feasibility and preliminary effects of a social media-based MBI embedded with MM and SA on family caregivers of frail older adults and to investigate the preliminary effects of the intervention using a pilot randomized controlled trial. METHODS A 2-arm randomized controlled trial design was adopted. Family caregivers of frail older adults (n=64) were randomized into either the intervention group (n=32), receiving 8 weeks of social media-based MM and SA, or the control group (n=32), receiving brief education on caregiving for people with frailty. The primary outcome (caregiver stress) and secondary outcomes (caregiver burden, sleep quality, and mindfulness awareness and attention) were measured using a web-based survey at baseline (T0), immediately after the intervention (T1), and at the 3-month follow-up (T2). RESULTS The feasibility of the intervention was established with a high attendance rate (87.5%), high usability score (79), and low attrition rate (1.6%). The generalized estimating equation results showed that participants in the intervention group at T1 and T2 experienced a significant improvement in stress reduction (P=.02 and P=.04, respectively), sleep quality (P=.004 and P=.01, respectively), and mindful awareness and attention (P=.006 and P=.02, respectively) compared with the control group. There were no substantial improvements in caregiver burden at T1 and T2 (P=.59 and P=.47, respectively). A focus group session conducted after the intervention had 5 themes: impact on the family caregivers, difficulty in practicing the intervention, the strength of the program, the limitations of the program, and perception of the intervention. CONCLUSIONS The findings support the feasibility and preliminary effects of social media-based MBI embedded with acupressure and MM on reducing stress among family caregivers of frail older people and enhancing sleep quality and mindfulness levels. A future study with a larger and more diverse sample is proposed to evaluate the longer-term effects and generalizability of the intervention. TRIAL REGISTRATION Chinese Clinical Trial Registry ChiCTR2100049507; http://www.chictr.org.cn/showproj.aspx?proj=128031.
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Affiliation(s)
- Yufang Sui
- School of Nursing, The Hong Kong Polytechnic University, Hong Kong, Hong Kong
| | - Patrick Pui Kin Kor
- School of Nursing, The Hong Kong Polytechnic University, Hong Kong, Hong Kong
| | - Mengli Li
- School of Nursing, The Hong Kong Polytechnic University, Hong Kong, Hong Kong
| | - Jingjing Wang
- School of Nursing and Health, Zhengzhou University, Zhengzhou, China
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Verma K, Singh D, Srivastava A. The Impact of Complementary and Alternative Medicine on Insomnia: A Systematic Review. Cureus 2022; 14:e28425. [PMID: 36176875 PMCID: PMC9509538 DOI: 10.7759/cureus.28425] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/25/2022] [Indexed: 11/14/2022] Open
Abstract
Insomnia is characterized by difficulty in maintaining sleep and early morning awakenings. Although pharmacotherapies and psychological interventions remain essential for conventional treatment, motivational factors and interest in using complementary and alternative therapies for insomnia have developed over the last two decades. This review aims to comprehensively explore the effects of complementary and alternative medicine (CAM) on improving sleep quality to guide evidence-based clinical decision-making and inform future research. Several electronic databases such as MEDLINE, PubMed, Scopus, EMBASE, Clinical key, Cochrane, and Research gate were explored to search the relevant articles. For the systematic review, CAM studies were classified under "manual practices," "natural practices," and "mind-body practices." A total of 35 clinical trials were selected for inclusion in the systematic review, comprising adult samples. The systematic review revealed 11 RCTs with manual practice, 12 with mind-body practice, and 12 with natural medicine practice. The methodological quality of the RCTs was measured using the modified Jadad scale, a scientific quality index of ≥ 5/10 (on the augmented Jadad scale). Effect sizes (Cohen’s d) were calculated and reported in all placebo-controlled studies with the available data. Regardless of systematic reviews, and randomized controlled trials on CAM, acupuncture, acupressure, herbal medicine, yoga, and tai chi, for insomnia, most of the RCTs did not agree with the findings. Further RCT for insomnia should be developed by considering the current advanced studies in the field of CAM.
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Chen SC, Yu J, Wang HS, Wang DD, Sun Y, Cheng HL, Suen LKP, Yeung WF. Parent-administered pediatric Tuina for attention deficit/hyperactivity disorder symptoms in preschool children: A pilot randomized controlled trial embedded with a process evaluation. PHYTOMEDICINE : INTERNATIONAL JOURNAL OF PHYTOTHERAPY AND PHYTOPHARMACOLOGY 2022; 102:154191. [PMID: 35636174 DOI: 10.1016/j.phymed.2022.154191] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/05/2021] [Revised: 05/04/2022] [Accepted: 05/19/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND Beneficial effects of parent-administered pediatric tuina on ADHD in children have been reported in previous studies, but no rigorously designed randomized controlled trials (RCTs) have been conducted on it. OBJECTIVE To assess the feasibility and preliminary effects of parent-administered pediatric tuina for ADHD symptoms in preschoolers. METHODS This project was a two-arm, parallel, open-label, pilot RCT. Sixty-four participants were randomized into two groups at a 1:1 ratio. Parents in the parent-administered tuina group (n = 32) attended an online training program on pediatric tuina for ADHD and conduct this intervention on their children at home. Parents in the parent-child interaction group (n = 32) attended an online training about progressive muscle relaxation exercise and carried out parent-child interactive physical activities with their children at home. Both interventions were carried out every other day during a two-month intervention period, with each manipulation for at least 20 min. Feasibility outcomes included recruitment rate, consent rate, participants' adherence, retention rate, and adverse event. Outcomes were assessed at baseline, week 4, and week 8. The primary outcome measure was the Swanson, Nolan, and Pelham parent scale (SNAP); the secondary outcomes included preschool anxiety scale, children's sleep habits questionnaire, and parental stress scale. A mixed-method process evaluation embedded within the outcome evaluation was performed. RESULTS The recruitment rate was 12.8 per month. The consent rate was 98.5%. Good adherence was shown from the parent logbook. Four participants withdraw from the study. No severe adverse event was reported. For the SNAP total score, both groups showed improvement with moderate within-group effect size (Cohen's d > 0.5, all p < 0.001) and the between-group effect size was minimal (dppc2< 0.2, p > 0.05). Perceived improvements on children's appetite and sleep quality, and parent-child relationship was observed from the qualitative data. CONCLUSIONS The study design and the parent-administered pediatric tuina intervention were feasible. Parent-administered pediatric tuina provided beneficial effects on improving core hyperactivity/impulsivity symptoms in preschool children. Parents perceived improvements on children's appetite and sleep quality. Further large-scale are warranted.
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Affiliation(s)
- Shu-Cheng Chen
- School of Nursing, the Hong Kong Polytechnic University, 11 Yuk Choi Road, Hung Hom, Kowloon, HKSAR, China
| | - Juan Yu
- Yantai Aviation Medical Room, Shandong airlines, China
| | | | - Dong-Dong Wang
- Children's Massage Center, Shandong University of Traditional Chinese Medicine Affiliated Hospital, China
| | - Yan Sun
- Yantai Aviation Medical Room, Shandong airlines, China
| | - Hui-Lin Cheng
- School of Nursing, the Hong Kong Polytechnic University, 11 Yuk Choi Road, Hung Hom, Kowloon, HKSAR, China
| | | | - Wing-Fai Yeung
- School of Nursing, the Hong Kong Polytechnic University, 11 Yuk Choi Road, Hung Hom, Kowloon, HKSAR, China.
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Chen SC, Cheng HL, Han LF, Wu GT, Zhang RY, Suen LKP, Chen X, Yeung WF. Parent-administered pediatric tuina for the treatment of attention deficit hyperactivity disorder symptoms: Process evaluation of a pilot randomized controlled trial. Complement Ther Med 2022; 70:102854. [PMID: 35842070 DOI: 10.1016/j.ctim.2022.102854] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2021] [Revised: 07/07/2022] [Accepted: 07/11/2022] [Indexed: 11/03/2022] Open
Abstract
BACKGROUND A pilot randomized controlled trial (RCT) was conducted in mainland China to examine the feasibility, acceptability, and preliminary effects of parent-administered pediatric tuina on attention deficit hyperactivity disorder (ADHD) symptoms in preschool children. An embedded process evaluation was performed to explore barriers and facilitators in the implementation, identify additional questions, and refine the study design for a future fully powered study. METHODS The process evaluation comprises the following parts: (a) self-reported questionnaires on parents (n = 43), traditional Chinese medicine (TCM) practitioners (n = 2), outcome assessor (n = 1), and research assistant (n = 1); (b) parent logbook on parent-administered pediatric tuina (n = 32); and (c) focus group interview sessions (n = 15). Accomplishment of the self-report questionnaires was voluntary for all participants and compulsory for research personnel and TCM practitioners. The parent logbook on the intervention was filled out by all participants in the intervention group. Participants of focus group interviews were selected via purposive sampling, and data were analyzed with template analysis. Qualitative findings were summarized in tables, while the mean was calculated to reflect the quantitative findings. RESULTS Perceived benefits, acceptability of parents and children, and professional support from the research team facilitated the implementation of the intervention. Meanwhile, the TCM pattern identification using online mode may limit the accuracy and lead to parents doubting the precision of the TCM pattern. This limitation was regarded as a major barrier. Parents perceived improvements in terms of children's appetite, sleep quality, and parent-child relationship. Participants were generally satisfied with the settings of parent-administered pediatric tuina and showed satisfactory adherence to the implementation. CONCLUSIONS Implementation of parent-administered pediatric tuina intervention is feasible and acceptable. The intervention can be refined by improving the TCM pattern identification procedure and adjusting outcome settings in a fully powered study in the future.
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Affiliation(s)
- Shu-Cheng Chen
- School of Nursing, The Hong Kong Polytechnic University, HKSAR, China
| | - Hui-Lin Cheng
- School of Nursing, The Hong Kong Polytechnic University, HKSAR, China
| | - Le-Fei Han
- School of Global Health, Chinese Center for Tropical Diseases Research, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Guo-Tao Wu
- Faculty of Psychology, Southwest University, Chongqing, China
| | - Ru-Yi Zhang
- Department of Psychology, University of Victoria, Canada
| | | | - Xi Chen
- School of Nursing, The Hong Kong Polytechnic University, HKSAR, China
| | - Wing-Fai Yeung
- School of Nursing, The Hong Kong Polytechnic University, HKSAR, China.
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Yeung WF, Yu BYM, Chung KF, Zhang ZJ, Lao L, Ho FYY, Suen LKP, Ho LM. Self-administered acupressure for insomnia disorder: A randomized controlled trial. PHYTOMEDICINE : INTERNATIONAL JOURNAL OF PHYTOTHERAPY AND PHYTOPHARMACOLOGY 2022; 99:153993. [PMID: 35193046 DOI: 10.1016/j.phymed.2022.153993] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/15/2021] [Revised: 01/11/2022] [Accepted: 02/12/2022] [Indexed: 06/14/2023]
Abstract
BACKGROUND Insomnia is a significant health problem in the community. Self-administered acupressure (SAA) may be an alternative strategy to alleviate insomnia. PURPOSE This study is the first to investigate the effects of SAA delivered through a training course in alleviating insomnia disorder compared with sleep hygiene education (SHE). METHODS A randomized controlled trial was conducted on 200 participants with insomnia disorder. The eligible participants were randomized into the SAA or SHE group. Both groups attended the allocated training courses (two sessions, 2 h each) and then were followed up at weeks 4 and 8. The primary outcome was the severity of insomnia symptoms and related daytime impairment as measured by the Insomnia Severity Index (ISI). Other measures included a 7-day sleep diary and actigraphy, Hospital Anxiety and Depression Scale (HADS), and Short-Form Six-Dimension (SF6D). RESULTS The SAA group showed a significantly greater improvement in ISI score than the SHE group at week 4 (mean difference: -1.89 units, 95% CI: 0.85, 2.93; Cohen's d = 0.51, p < 0.001) and week 8 (mean difference: -2.89 units, 95% CI: 1.67, 4.11; d = 0.67, p < 0.001). In addition, the SAA group showed a greater reduction in the HADS anxiety score and HADS depression score and increase in SF6D at week 8. CONCLUSIONS SAA taught in a short training course is a feasible and effective approach to improve sleep and related daytime impairment and mood problems in individuals with insomnia disorder.
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Affiliation(s)
- Wing Fai Yeung
- School of Nursing, the Hong Kong Polytechnic University, HKSAR, China; Research Centre for Chinese Medicine Innovation, the Hong Kong Polytechnic University, HKSAR, China.
| | | | - Ka-Fai Chung
- Department of Psychiatry, the University of Hong Kong, HKSAR, China
| | - Zhang-Jin Zhang
- School of Chinese Medicine, the University of Hong Kong, HKSAR, China
| | - Lixing Lao
- Virginia University of Integrative Medicine, USA
| | - Fiona Yan-Yee Ho
- Department of Psychology, the Chinese University of Hong Kong, HKSAR, China
| | | | - Lai-Ming Ho
- School of Public Health, the University of Hong Kong, HKSAR, China
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Ucun Y, Küçük L. The efficacy of complementary and traditional practice on psychiatric patients with depression symptoms: A meta- analysis study. Perspect Psychiatr Care 2022; 58:744-757. [PMID: 33969496 DOI: 10.1111/ppc.12844] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/11/2021] [Revised: 04/16/2021] [Accepted: 04/26/2021] [Indexed: 01/10/2023] Open
Abstract
PURPOSE This study examined the effect sizes of the complementary and traditional practices on the depressive symptom levels in psychiatric patients DESIGN AND METHODS: The "Health Evidence™ Quality Assessment Tool" and "Comprehensive Meta-Analysis 3" program was used. FINDINGS A total of 81 studies with 5934 patients were included. The effect size of the complementary and traditional methods applied to psychiatric patient on depressive symptoms was calculated as d = 0.718 (p = 0.000). According to Cohen, studies have moderate effect size. PRACTICE IMPLICATIONS Complementary and traditional practices were found to be significant and effective on depressive symptoms in psychiatric patients.
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Affiliation(s)
| | - Leyla Küçük
- Istanbul University-Cerrahpasa, Florence Nightingale Faculty of Nursing, Department of Mental Health and Psychiatric Nursing, Istanbul, Turkey
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Wang J, Chen Y, Zhai X, Chu Y, Liu X, Ma X. Visualizing Research Trends and Identifying Hotspots of Traditional Chinese Medicine (TCM) Nursing Technology for Insomnia: A 18-Years Bibliometric Analysis of Web of Science Core Collection. Front Neurol 2022; 13:816031. [PMID: 35432182 PMCID: PMC9009417 DOI: 10.3389/fneur.2022.816031] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2021] [Accepted: 02/04/2022] [Indexed: 12/11/2022] Open
Abstract
Objective To explore the research hotspot and frontier direction of TCM nursing of insomnia and provide reference for the follow-up study of the optimal scheme of TCM nursing of insomnia. Background Insomnia is a common sleep-wake disorder, affects 6–10% of adults and was associated with independent higher risks of cardiovascular disease and diabetes. TCM Nursing Techniques of insomnia has a long history and has shown a definite impact. However, it's still lack of analysis in the field of the most commonly used and effective techniques, as well as the co-morbidities associated with insomnia. Therefore, the database was searched and analyzed to find effective TCM Nursing Techniques for insomnia and related diseases related to insomnia. Method Randomized controlled trials on the intervention of TCM Nursing Techniques in insomnia were retrieved from Web of Science Core Collection and imported into CiteSpace 5.6.R5 visualization software. The works of literature were co-cited by keywords authors and institutions for visual analysis, and the co-morbidities associated with insomnia of TCM Nursing Techniques in literature was extracted manually. The symptoms of co-morbidities associated with insomnia were imported into Cytoscape 3.9.0 software and clustered by CytoHubba. Result As of October 20, 2021, the literature published in the last 20 years from Web of Science Core Collection was screened, and the publication period of the included literature was from 2004 to 2021. From 2016 to now, the total number of articles has been increasing. A total of 146 articles were included, and the highest production year was 2020. There is little cooperation between states, institutions, and authors. China (including Hong Kong and Taiwan) and Hong Kong Polytech University are leading countries and institutions in this area. MYUNGHAENG HUR is the most cited author, and J ALTERN COMPLEM MED is the most cited journal. According to cluster analysis and keyword frequency, auricular therapy, aromatherapy, and acupressure are the three most commonly used techniques. While the top five co-morbidities are fatigue, anxiety, depression, pain and hemodialysis. The three frontier topics and the main research directions are sleep quality, comorbid insomnia and clinical trial design. Conclusion We found that acupressure, aromatherapy, and auricular acupoint therapy are the most commonly used nursing methods of TCM to intervene in insomnia. However, these studies have limitations such as small sample size, lack of objectivity in evaluating sleep quality, and high heterogeneity of intervention measures, which are not conducive to forming TCM clinical nursing guidelines. Therefore, it is necessary to adopt objectified sleep quality evaluation methods, select suitable acupoints according to TCM theories, and design multi-center large-sample clinical trials based on the safety principle of randomized blind control. This study provides an in-depth perspective for insomnia research on TCM Nursing Techniques and includes information for follow-up research on TCM Nursing Techniques of insomnia.
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Affiliation(s)
- Junxin Wang
- School of Nursing, Beijing University of Chinese Medicine, Beijing, China
| | - Yufeng Chen
- School of Traditional Chinese Medicine, Beijing University of Chinese Medicine, Beijing, China
| | - Xing Zhai
- School of Management, Beijing University of Chinese Medicine, Beijing, China
| | - Yupeng Chu
- School of Management, Beijing University of Chinese Medicine, Beijing, China
| | - Xiangdi Liu
- School of Nursing, Beijing University of Chinese Medicine, Beijing, China
- *Correspondence: Xiangdi Liu
| | - Xueling Ma
- School of Nursing, Beijing University of Chinese Medicine, Beijing, China
- Xueling Ma
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12
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Liang Y, Lenon GB, Li M, Yang AWH. Feasibility of self-administered acupressure for allergic rhinitis: a pilot randomized controlled trial and lessons learnt for future studies. Acupunct Med 2021; 40:142-151. [PMID: 34763534 DOI: 10.1177/09645284211055757] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
OBJECTIVES Allergic rhinitis (AR) is an immunoglobulin (Ig)E-mediated inflammatory condition that is highly prevalent worldwide. The aim of this pilot trial was to evaluate the feasibility and safety of self-administered acupressure for AR. METHODS A randomized, single-blind, non-specific controlled clinical trial was conducted at Royal Melbourne Institute of Technology (RMIT) University, Melbourne, Australia. Fifteen AR patients were randomized into two groups: self-administered acupressure at five specific acupressure (SA) points or five non-specific acupressure (NSA) points (1 min/point, twice a day), and treated for 4 weeks with an 8-week follow-up period. The primary outcome was the change in 7-point scale symptom severity. Secondary outcomes included the rhinoconjunctivitis quality of life questionnaire and standardized activities (RQLQs), medication usage, adverse events and participants' opinions of the blinding method. The Statistical Package for the Social Science (SPSS) version 26 was used for data analyses. RESULTS Fourteen participants completed the study and no major adverse events were reported. No statistically significant differences between SA and NSA groups were identified in 7-point scale symptom severity scores, RQLQs or medication usage. However, participants in the SA group believed that SA was useful for AR and recommended it for self-care. The credibility of the blinding method was successful. No adverse effects were considered to be related to the intervention. CONCLUSION Acupressure is feasible and appears to be safe for self-administration by AR sufferers. Experience from this pilot study has guided minor amendments to the protocol. A large-scale randomized controlled trial is warranted to further investigate the efficacy and safety of self-administered acupressure for the management of AR.
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Affiliation(s)
- Yaqun Liang
- School of Health and Biomedical Sciences, RMIT University, Bundoora, VIC, Australia
| | - George Binh Lenon
- School of Health and Biomedical Sciences, RMIT University, Bundoora, VIC, Australia
| | - Mingdi Li
- School of Health and Biomedical Sciences, RMIT University, Bundoora, VIC, Australia
| | - Angela Wei Hong Yang
- School of Health and Biomedical Sciences, RMIT University, Bundoora, VIC, Australia
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13
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Ho FYY, Choi WT, Yeung WF, Lam HK, Lau WY, Chung KF. The efficacy of integrated cognitive behavioral therapy (CBT) and acupressure versus CBT for insomnia: a three-arm pilot randomized controlled trial. Sleep Med 2021; 87:158-167. [PMID: 34619500 DOI: 10.1016/j.sleep.2021.08.024] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2021] [Revised: 08/09/2021] [Accepted: 08/24/2021] [Indexed: 11/15/2022]
Abstract
OBJECTIVES This pilot study aimed to examine the efficacy of integrated cognitive behavioral therapy (CBT) and acupressure in treating insomnia and its daytime impairments in a Chinese adult population. METHODS 40 eligible participants with insomnia were randomly assigned to either the integrated CBT and acupressure (CBTAcup) group (n = 14), the CBT group (n = 13), or the waitlist control (WL) group (n = 13). Participants in the CBTAcup group attended a 2-hour integrated CBT and self-administered acupressure group treatment once per week for six consecutive weeks, while participants in the CBT group attended six weekly 2-hour CBT for insomnia. Sleep, mood, daytime impairments, quality of life, and treatment credibility and adherence were assessed at baseline, immediate post-treatment (Week 7), and 4-week post-treatment (Week 11). RESULTS Linear mixed-effects models showed that both the CBTAcup and CBT groups had significantly lower insomnia severity (d = -1.74 and d = -2.61), dysfunctional beliefs related to sleep (d = -2.17 and -2.76), and mental fatigue (d = -1.43 and -1.60) compared with the WL group at Week 7. The CBTAcup group provided additional benefits in reducing total fatigue (d = -1.43) and physical fatigue (d = -1.45). Treatment credibility was found to be improved in the CBTAcup group from baseline to Week 7. CONCLUSIONS Integrated CBT and acupressure demonstrated comparable efficacy to pure CBT in treating insomnia symptoms, with additional advantages to improve fatigue symptoms and acceptability in the Chinese population. Further methodologically rigorous studies on a larger scale and longer follow-up are warranted to confirm these findings.
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Affiliation(s)
- Fiona Yan-Yee Ho
- Department of Psychology, The Chinese University of Hong Kong, Shatin, Hong Kong.
| | - Wing-Ting Choi
- Department of Clinical Psychology, Pamela Youde Nethersole Eastern Hospital, Chai Wan, Hong Kong
| | - Wing-Fai Yeung
- School of Nursing, The Hong Kong Polytechnic University, Hunghom, Hong Kong
| | - Hiu-Kwan Lam
- Department of Psychology, The Chinese University of Hong Kong, Shatin, Hong Kong
| | - Wing-Yin Lau
- Department of Psychology, The Chinese University of Hong Kong, Shatin, Hong Kong
| | - Ka-Fai Chung
- Department of Psychiatry, The University of Hong Kong, Pokfulam, Hong Kong
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14
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Staines AC, Broomfield N, Pass L, Orchard F, Bridges J. Do non-pharmacological sleep interventions affect anxiety symptoms? A meta-analysis. J Sleep Res 2021; 31:e13451. [PMID: 34331373 DOI: 10.1111/jsr.13451] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2021] [Revised: 07/09/2021] [Accepted: 07/16/2021] [Indexed: 12/13/2022]
Abstract
Research indicates a bidirectional relationship between sleep and anxiety, with findings suggesting anxiety can precede poor sleep and vice versa. Evidence suggests sleep-related thought processes associated with anxiety are involved in the maintenance of insomnia. Previous meta-analyses provide some evidence to suggest cognitive behavioural therapy for insomnia moderately improves anxiety, yet little research has investigated the effect of other sleep interventions on anxiety symptoms. The aim of this meta-analysis was to review whether non-pharmacological sleep interventions have an impact on anxiety symptoms immediately post-intervention. A systematic search of electronic databases was conducted to identify all randomized control trials (RCTs) investigating non-pharmacological sleep interventions that included anxiety symptoms as an outcome. Forty-three RCTs (n = 5945) met full inclusion criteria and were included in a random-effects meta-analysis model. The combined effect size of non-pharmacological sleep interventions on anxiety symptoms was moderate (Hedges' g = -0.38), indicating a reduction in symptoms. Subgroup analyses found a moderate effect for those with additional physical health difficulties (g = -0.46), a moderate effect for those with additional mental health difficulties (g = -0.47) and a moderate effect for those with elevated levels of anxiety at baseline (g = -0.43). A secondary meta-analysis found a large effect of non-pharmacological sleep interventions on sleep-related thought processes (g = -0.92). These findings indicate non-pharmacological sleep interventions are effective in reducing anxiety and sleep-related thought processes, and these effects may be larger in patients with anxiety. This has clinical implications for considering sleep interventions in the treatment of anxiety.
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Affiliation(s)
- Alex Catherine Staines
- Department of Clinical Psychology, Norwich Medical School, University of East Anglia, Norwich, UK
| | - Niall Broomfield
- Department of Clinical Psychology, Norwich Medical School, University of East Anglia, Norwich, UK
| | - Laura Pass
- Department of Clinical Psychology, Norwich Medical School, University of East Anglia, Norwich, UK
| | - Faith Orchard
- School of Psychology, University of Sussex, Brighton, UK
| | - Jessica Bridges
- Department of Clinical Psychology, Norwich Medical School, University of East Anglia, Norwich, UK
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15
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Chen H, So TH, Cho WCS, Qin Z, Ma CH, Li SG, Yang Z, Jiang F, Wu J, Zhang ZJ, Kong FM, Lao L. The Adjunctive Effect of Acupuncture for Advanced Cancer Patients in a Collaborative Model of Palliative Care: Study Protocol for a 3-Arm Randomized Trial. Integr Cancer Ther 2021; 20:15347354211012749. [PMID: 33957783 PMCID: PMC8113363 DOI: 10.1177/15347354211012749] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
Background: Cancer is the second leading cause of death before the age of 70. Improved cancer survival has put increasing demands on cancer care. Palliative care is the specialized multi-disciplinary care providing relief from the pain, symptoms, and stress of serious illness. The study aims to evaluate the adjunctive effect of acupuncture for advanced cancer patients in a collaborative model of palliative care. Methods/Design: This is a single-blinded, randomized, sham-controlled trial. One hundred twenty advanced cancer patients undergoing palliative care will be randomized in a ratio of 2:1:1 to manual acupuncture plus standard care group (ASC), sham acupuncture plus standard care group (SSC), and standard care group (SC). Patients in ASC and SSC will receive 9 sessions of acupuncture or sham acupuncture for 3 weeks, and will be followed up for 2 months. The primary measure is the change from baseline score of the Edmonton Symptom Assessment System at 3 weeks. The secondary measures include the Brief Fatigue Inventory, Hospital Anxiety and Depression Scale, Insomnia Severity Index, Numeric Rating Scale, and European Organization for Research and Treatment of Cancer Quality of Life 15 items Questionnaire for Palliative Care. Discussion: The finding of this trial will provide high-quality evidence on the adjunctive effect of acupuncture to standard care on advanced cancer patients undergoing palliative care. Trial Registration: Clinicaltrials.gov, NCT04398875 (https://www.clinicaltrials.gov/ct2/show/NCT04398875), Registered on 21 May 2020.
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Affiliation(s)
| | - Tsz Him So
- The University of Hong Kong, Hong Kong, China
| | | | - Zongshi Qin
- The University of Hong Kong, Hong Kong, China
| | - Chun Ho Ma
- The University of Hong Kong Clinical Centre for Teaching and Research in Chinese Medicine (Aberdeen), Hong Kong, China
| | - Shi Guang Li
- Shen Zhen Hospital of Traditional Chinese Medicine, Shenzhen, China
| | - Zhenjiang Yang
- Shen Zhen Hospital of Traditional Chinese Medicine, Shenzhen, China
| | - Fei Jiang
- University of California, San Francisco, CA, USA
| | - Junmei Wu
- The University of Hong Kong, Hong Kong, China
| | | | | | - Lixing Lao
- The University of Hong Kong, Hong Kong, China.,Virginia University of Integrative Medicine, Fairfax, VA, USA
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16
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Chen SC, Yu J, Suen LKP, Sun Y, Pang YZ, Wang DD, Zhao WX, Yeung WF. Pediatric tuina for the treatment of attention deficit hyperactivity disorder (ADHD) symptoms in preschool children: study protocol for a pilot randomized controlled trial. Pilot Feasibility Stud 2020; 6:169. [PMID: 33292826 PMCID: PMC7643336 DOI: 10.1186/s40814-020-00704-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2020] [Accepted: 10/15/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Medication and behavior therapy are the conventional treatments for attention deficit hyperactivity disorder (ADHD), but they have limitations for preschool children. Evidence suggests that pediatric tuina, which is a modality of traditional Chinese medicine, might have beneficial effects on this condition. OBJECTIVE To assess the feasibility of conducting an RCT in terms of recruitment, use, and acceptability of the parent-administered pediatric tuina for ADHD symptoms in preschoolers. METHODS It is a single-center, two-arm, parallel, open-label, pilot randomized controlled trial (RCT). Sixty children with pre-specified ADHD symptoms (hyperactivity, anxiety, and sleep disturbance) together with one of their parents will be recruited and randomized into two groups at a 1:1 ratio. Parents in the parent-administered tuina group (intervention group, n = 30) will attend an online training program to learn pediatric tuina skills for ADHD symptoms and conduct this treatment on their children at home. Parents in the parent-child interaction group (comparison group, n = 30) will attend an online training about progressive muscle relaxation exercise and do this exercise with their children at home. Additional teaching materials will be provided to the participants in both groups. Both interventions should be carried out every other day during a 2-month treatment period, with each time around 20 min. Assessment will be performed at baseline, week 4, and week 8. The primary outcome measure is the Swanson, Nolan, and Pelham parent scale; the secondary outcomes include preschool anxiety scale, children's sleep habits questionnaire, and parental stress scale. A process evaluation embedded within the outcome evaluation will be performed. Differences in the scale scores and test parameters between groups will be examined using a linear mixed-effects model. Qualitative data will be analyzed using thematic content analysis, facilitated by QSR NVivo. DISCUSSION This study will provide evidence on the acceptability and feasibility of pediatric tuina for ADHD in preschool children. The process evaluation will help to better understand the facilitators and barriers of the intervention functioning. TRIAL REGISTRATION The study was registered at ClinicalTrials.gov (Identifier: NCT04237259 ) on 14 February 2020. Protocol version: 2; date, 23 June 2020.
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Affiliation(s)
- Shu-Cheng Chen
- School of Nursing, The Hong Kong Polytechnic University, 11 Yuk Choi Road, Hung Hom, Kowloon, Hong Kong SAR, China
| | - Juan Yu
- Pediatric Tuina Health Care Clinic, Shandong University of Traditional Chinese Medicine Affiliated Hospital, Jinan, China
| | - Lorna Kwai-Ping Suen
- School of Nursing, The Hong Kong Polytechnic University, 11 Yuk Choi Road, Hung Hom, Kowloon, Hong Kong SAR, China
| | - Yan Sun
- Pediatric Tuina Health Care Clinic, Shandong University of Traditional Chinese Medicine Affiliated Hospital, Jinan, China
| | - Ya-Zheng Pang
- School of Acupuncture, Moxibustion and Tuina, Shandong University of Traditional Chinese Medicine, Jinan, China
| | - Dong-Dong Wang
- College of Traditional Chinese Medicine, Shandong University of Traditional Chinese Medicine, Jinan, China
| | - Wen-Xia Zhao
- Beijing Luhe Hospital, Capital Medical University, Beijing, China
| | - Wing-Fai Yeung
- School of Nursing, The Hong Kong Polytechnic University, 11 Yuk Choi Road, Hung Hom, Kowloon, Hong Kong SAR, China.
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17
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Cheung DST, Yeung WF, Chau PH, Lam TC, Yang M, Lai K, Ip CY, Lao L, Lin CC. Patient-centred, self-administered acupressure for Chinese advanced cancer patients experiencing fatigue and co-occurring symptoms: A pilot randomised controlled trial. Eur J Cancer Care (Engl) 2020; 31:e13314. [PMID: 32896014 DOI: 10.1111/ecc.13314] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2019] [Revised: 06/18/2020] [Accepted: 08/07/2020] [Indexed: 12/17/2022]
Abstract
OBJECTIVES To evaluate the feasibility and potential effects of patient-centred self-administered acupressure for alleviating fatigue and co-occurring symptoms among Chinese advanced cancer patients receiving treatment. METHODS Thirty advanced cancer patients who screened positive for moderate/severe fatigue with symptoms of insomnia and/or pain were recruited from a hospital in Hong Kong. They were randomly assigned (1:1) to receive a 4-week patient-centred self-administered acupressure intervention or health education. Fatigue (primary outcome) and secondary outcomes (sleep quality, pain, fatigue-sleep disturbance-pain symptom cluster severity, anxiety, depression and quality of life) were measured by questionnaires and actigraphy. RESULTS Twenty-four participants (80%) completed the study. Adherence to self-administered acupressure practice was satisfactory, with all retained participants attending all sessions and 90.9% practising acupressure daily. All completers rated the class as very enjoyable or quite enjoyable. Fatigue, pain, symptom cluster severity, anxiety, depression and quality of life appeared to improve from baseline to post-intervention in the intervention group. Among these outcomes, only the between-group difference in anxiety post-intervention was significant. The group × time interaction effect was nonsignificant for all outcomes. CONCLUSIONS Patient-centred self-administered acupressure appears to be feasible and acceptable among advanced cancer patients. A fully powered trial is warranted to confirm the intervention effect.
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Affiliation(s)
- Denise Shuk Ting Cheung
- School of Nursing, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China
| | - Wing Fai Yeung
- School of Nursing, The Hong Kong Polytechnic University, Hong Kong, China
| | - Pui Hing Chau
- School of Nursing, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China
| | - Tai Chung Lam
- Department of Clinical Oncology, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China
| | - Mingxiao Yang
- School of Chinese Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China
| | - Kithelia Lai
- Department of Clinical Oncology, Queen Mary Hospital, Hong Kong, China
| | - Chun Yat Ip
- Department of Clinical Oncology, Queen Mary Hospital, Hong Kong, China
| | - Lixing Lao
- School of Chinese Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China.,Virginia University of Integrative Medicine, Virginia, United States
| | - Chia-Chin Lin
- School of Nursing, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China.,Alice Ho Miu Ling Nethersole Charity Foundation Professor in Nursing, Hong Kong, China.,School of Nursing, College of Nursing, Taipei Medical University, Taiwan
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18
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Effectiveness of Self-administered Acupressure for Family Caregivers of Advanced Cancer Patients With Insomnia: A Randomized Controlled Trial. Cancer Nurs 2020; 45:E1-E9. [PMID: 32740328 DOI: 10.1097/ncc.0000000000000870] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Sleep disturbances are common among family caregivers (FCs) of patients with advanced cancer. Self-administered acupressure can combat insomnia, but no study has been conducted to evaluate its efficacy in caregivers of patients with advanced cancer. OBJECTIVE The aim of this study is to investigate whether self-administered acupressure improves sleep quality for FCs of patients with advanced cancer. METHODS Family caregivers of patients with advanced cancer who reported sleep disturbance (Pittsburgh Sleep Quality Index scores >5 in recent months) were recruited. The experimental group self-administered acupressure at the Baihui (GV20), Fengchi (GB20), Neiguan (PC6), and Shenmen (HT7) points over a 12-week period, whereas the comparison group received sleep hygiene education. Sleep quality was assessed subjectively at 4, 8, and 12 weeks after the intervention using the Pittsburgh Sleep Quality Index and objectively using actigraphy measurements. Improvements in sleep quality were analyzed using a generalized estimating equation. RESULTS Compared with the control group, the experimental group demonstrated significantly lower sleep latency (Wald χ2 = 11.49, P = .001) and significantly better sleep efficiency (Wald χ2 = 5.24, P = .02) according to actigraphy measurements, but Pittsburgh Sleep Quality Index scores did not differ significantly between the groups. CONCLUSIONS Self-administered acupressure did not demonstrate favorable effects on subjective sleep quality, but did reduce sleep latency and improve sleep efficiency, according to actigraphy measurements. Self-administered acupressure may help relaxation and sedation and promote sleep in FCs. IMPLICATIONS FOR PRACTICE Healthcare providers may consider advising FCs to apply this self-administered acupressure to improve their sleep latency and sleep efficiency.
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Baglioni C, Bostanova Z, Bacaro V, Benz F, Hertenstein E, Spiegelhalder K, Rücker G, Frase L, Riemann D, Feige B. A Systematic Review and Network Meta-Analysis of Randomized Controlled Trials Evaluating the Evidence Base of Melatonin, Light Exposure, Exercise, and Complementary and Alternative Medicine for Patients with Insomnia Disorder. J Clin Med 2020; 9:E1949. [PMID: 32580450 PMCID: PMC7356922 DOI: 10.3390/jcm9061949] [Citation(s) in RCA: 34] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2020] [Revised: 06/09/2020] [Accepted: 06/11/2020] [Indexed: 12/15/2022] Open
Abstract
Insomnia is a prevalent disorder and it leads to relevant impairment in health-related quality of life. Recent clinical guidelines pointed out that Cognitive-Behavior Therapy for Insomnia (CBT-I) should be considered as first-line intervention. Nevertheless, many other interventions are commonly used by patients or have been proposed as effective for insomnia. These include melatonin, light exposure, exercise, and complementary and alternative medicine. Evaluation of comparable effectiveness of these interventions with first-line intervention for insomnia is however still lacking. We conducted a systematic review and network meta-analysis on the effects of these interventions. PubMed, PsycInfo, PsycArticles, MEDLINE, and CINAHL were systematically searched and 40 studies were included in the systematic review, while 36 were entered into the meta-analysis. Eight network meta-analyses were conducted. Findings support effectiveness of melatonin in improving sleep-onset difficulties and of meditative movement therapies for self-report sleep efficiency and severity of the insomnia disorder. Some support was observed for exercise, hypnotherapy, and transcranial magnetic resonance, but the number of studies for these interventions is still too small. None of the considered interventions received superior evidence to CBT-I, which should be more widely disseminated in primary care.
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Affiliation(s)
- Chiara Baglioni
- Department of Psychiatry and Psychotherapy, Medical Center, Faculty of Medicine, University of Freiburg, 79104 Freiburg, Germany; (Z.B.); (F.B.); (K.S.); (L.F.); (D.R.); (B.F.)
- Department of Human Sciences, Guglielmo Marconi University, 00193 Rome, Italy;
| | - Zarina Bostanova
- Department of Psychiatry and Psychotherapy, Medical Center, Faculty of Medicine, University of Freiburg, 79104 Freiburg, Germany; (Z.B.); (F.B.); (K.S.); (L.F.); (D.R.); (B.F.)
| | - Valeria Bacaro
- Department of Human Sciences, Guglielmo Marconi University, 00193 Rome, Italy;
| | - Fee Benz
- Department of Psychiatry and Psychotherapy, Medical Center, Faculty of Medicine, University of Freiburg, 79104 Freiburg, Germany; (Z.B.); (F.B.); (K.S.); (L.F.); (D.R.); (B.F.)
| | - Elisabeth Hertenstein
- University Hospital of Psychiatry and Psychotherapy, University of Bern, 3012 Bern, Switzerland;
| | - Kai Spiegelhalder
- Department of Psychiatry and Psychotherapy, Medical Center, Faculty of Medicine, University of Freiburg, 79104 Freiburg, Germany; (Z.B.); (F.B.); (K.S.); (L.F.); (D.R.); (B.F.)
| | - Gerta Rücker
- Institute of Medical Biometry and Statistics, Medical Center, Faculty of Medicine, University of Freiburg, 79104 Freiburg, Germany;
| | - Lukas Frase
- Department of Psychiatry and Psychotherapy, Medical Center, Faculty of Medicine, University of Freiburg, 79104 Freiburg, Germany; (Z.B.); (F.B.); (K.S.); (L.F.); (D.R.); (B.F.)
| | - Dieter Riemann
- Department of Psychiatry and Psychotherapy, Medical Center, Faculty of Medicine, University of Freiburg, 79104 Freiburg, Germany; (Z.B.); (F.B.); (K.S.); (L.F.); (D.R.); (B.F.)
| | - Bernd Feige
- Department of Psychiatry and Psychotherapy, Medical Center, Faculty of Medicine, University of Freiburg, 79104 Freiburg, Germany; (Z.B.); (F.B.); (K.S.); (L.F.); (D.R.); (B.F.)
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20
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Cheung DST, Tiwari A, Yeung WF, Yu DSF, So MKP, Chau PH, Wang XM, Lum TYS, Yuk Fung HYK, Ng BYM, Zhang ZJ, Lao L. Self-Administered Acupressure for Caregivers of Older Family Members: A Randomized Controlled Trial. J Am Geriatr Soc 2020; 68:1193-1201. [PMID: 32096884 DOI: 10.1111/jgs.16357] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2019] [Revised: 01/07/2020] [Accepted: 01/12/2020] [Indexed: 02/01/2023]
Abstract
OBJECTIVE To test whether self-administered acupressure reduces stress and stress-related symptoms in caregivers of older family members. DESIGN In this randomized, assessor-blind, controlled trial, 207 participants were randomized (1:1) to an acupressure intervention or a wait-list control group. SETTING Community centers in Hong Kong, China. PARTICIPANTS Primary caregivers of an older family member who screened positive for caregiver stress with symptoms of fatigue, insomnia, or depression. INTERVENTION The 8-week intervention comprised four training sessions on self-administered acupressure, two follow-up sessions for learning reinforcement, and daily self-practice of self-administered acupressure. MEASUREMENTS The primary outcome was caregiver stress (Caregiver Burden Inventory). Secondary outcomes included fatigue (Piper Fatigue Scale), insomnia (Pittsburgh Sleep Quality Index), depression (Patient Health Questionnaire), and health-related quality of life (QoL) (12-item Short-Form Health Survey version 2). An intention-to-treat analysis was adopted. RESULTS Of 207 participants, 201 completed the study. Caregiver stress in the intervention group was significantly lower than that in the control group after 8 weeks (difference = -8.12; 95% confidence interval [CI] = -13.20 to -3.04; P = .002) and at 12-week follow-up (difference = -8.52; 95% CI = -13.91 to -3.12; P = .002). The intervention group, relative to the control group, also had significantly improved secondary outcomes of fatigue (difference = -0.84; 95% CI = -1.59 to -0.08; P = .031), insomnia (difference = -1.34; 95% CI = -2.40 to -0.27; P = .014), depression (difference = -1.76; 95% CI = -3.30 to -0.23; P = .025), and physical health-related QoL (difference = 3.08; 95% CI = 0.28-5.88; P = .032) after 8 weeks. CONCLUSION Self-administered acupressure intervention significantly relieves self-reported caregiver stress and co-occurring symptoms in those caring for older family members. Further studies are needed to measure the symptoms objectively and to examine the clinical importance of the observed improvement in caregiver stress. J Am Geriatr Soc 68:1193-1201, 2020.
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Affiliation(s)
- Denise Shuk Ting Cheung
- School of Nursing, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China
| | - Agnes Tiwari
- School of Nursing, Hong Kong Sanatorium and Hospital, Hong Kong, China
| | - Wing-Fai Yeung
- School of Nursing, The Hong Kong Polytechnic University, Hong Kong, China
| | - Doris Sau Fung Yu
- School of Nursing, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China
| | - Mike Ka Pui So
- Department of Information Systems, Business Statistics and Operations Management, Hong Kong University of Science and Technology, Hong Kong, China
| | - Pui Hing Chau
- School of Nursing, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China
| | - Xiao-Min Wang
- Department of Anaesthesiology, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China
| | - Terry Yat Sang Lum
- Department of Social Work and Social Administration, The University of Hong Kong, Hong Kong, China
| | | | | | - Zhang-Jin Zhang
- School of Chinese Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China
| | - Lixing Lao
- School of Chinese Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China.,Virginia University of Integrative Medicine, Fairfax, Virginia
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21
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Wong CHL, Wu IXY, Balneaves LG, Lo RSK, Witt CM, Wu JCY, Leung TH, Chung VCH. Prioritizing Chinese Medicine Clinical Research Questions in Cancer Palliative Care: International Delphi Survey. J Pain Symptom Manage 2019; 58:1002-1014.e7. [PMID: 31404640 DOI: 10.1016/j.jpainsymman.2019.08.002] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/24/2019] [Revised: 07/31/2019] [Accepted: 08/02/2019] [Indexed: 01/09/2023]
Abstract
CONTEXT Chinese medicine modalities, including acupuncture and Chinese herbal medicine (CHM), have been used as palliative interventions among cancer patients. More research should be conducted to confirm their effectiveness. OBJECTIVES The objective of this study was to prioritize Chinese medicine clinical research questions for cancer palliative care. METHODS Twelve international experts, including physicians, Chinese medicine practitioners, nurses, and clinical research methodologists (n = 3 from each category), from Asia, North America, Australia, and Europe participated in a two-round Delphi survey for prioritizing 29 research questions identified from existing systematic reviews. The experts were asked to 1) rate clinical importance of answering the questions on a nine-point Likert scale; 2) provide qualitative comments on their ratings; and 3) suggest outcome measurement approaches. RESULTS Eight research priorities reached positive consensus after the two-round Delphi survey. Six of the priorities focused on acupuncture and related therapies, of which median ratings on importance ranged from 7.0 to 8.0 (interquartile range: 1.00 to 2.50), and the percentage agreement ranged from 75.0% to 91.7%. The remaining two priorities related to CHM, with median ratings ranged from 7.0 to 8.0 (interquartile range: 1.00 to 1.50) and percentage agreement ranged from 75.0% to 83.3%. Neither positive nor negative consensus was established among the remaining 21 questions. CONCLUSION The findings will inform rational allocation of scarce research funding for evaluating the effectiveness of Chinese medicine for cancer palliative care, especially on acupuncture and related therapies. Further research on herb safety and herb-drug interaction should be performed before conducting international trials on CHM.
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Affiliation(s)
- Charlene H L Wong
- Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Shatin, Hong Kong; Hong Kong Institute of Integrative Medicine, The Chinese University of Hong Kong, Shatin, Hong Kong
| | - Irene X Y Wu
- Xiang-Ya School of Public Health, Central South University, Changsha, China
| | - Lynda G Balneaves
- College of Nursing, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Canada
| | - Raymond S K Lo
- Hospice and Palliative Care, New Territories East Cluster, Hospital Authority, Kowloon, Hong Kong
| | - Claudia M Witt
- Institute for Complementary and Integrative Medicine, University Hospital Zurich and University Zurich, Zurich, Switzerland
| | - Justin C Y Wu
- Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Shatin, Hong Kong; Hong Kong Institute of Integrative Medicine, The Chinese University of Hong Kong, Shatin, Hong Kong
| | - Ting Hung Leung
- School of Chinese Medicine, The Chinese University of Hong Kong, Shatin, Hong Kong
| | - Vincent C H Chung
- School of Chinese Medicine, The Chinese University of Hong Kong, Shatin, Hong Kong; Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Shatin, Hong Kong.
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22
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Treatment Satisfaction with Persian Medicine in Patients with Insomnia. ARCHIVES OF NEUROSCIENCE 2019. [DOI: 10.5812/ans.86837] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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23
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Yeung WF, Lai AYK, Ho FYY, Suen LKP, Chung KF, Ho JYS, Ho LM, Yu BYM, Chan LYT, Lam TH. Effects of Zero-time Exercise on inactive adults with insomnia disorder: a pilot randomized controlled trial. Sleep Med 2018; 52:118-127. [DOI: 10.1016/j.sleep.2018.07.025] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/18/2018] [Revised: 07/03/2018] [Accepted: 07/05/2018] [Indexed: 10/28/2022]
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24
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Abstract
BACKGROUND Insomnia is a public sleep disorder defined as a deficiency of sleep quantity or quality. Acupressure is a low-cost treatment that has potential as an insomnia therapy. METHODS Four databases will be searched from inception to date. The researchers will screen clinical randomized trials of acupressure and auricular acupuncture for insomnia. The screening of the study, data extraction will be carried out independently by 2 researchers. The specific process will refer to the Cochrane Handbook for Systematic Review. RESULTS The results of the study will be published in a scientific journal after peer-review. We integrate the latest study about acupressure for insomnia. CONCLUSION This systematic review will provide evidence for assessing the improvement of acupressure for insomnia. ETHICS AND DISSEMINATION The systematic review will be published in a peer-reviewed journal. The review will also be disseminated electronically and in print.PROSPERO registration: CRD42018104155.
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Affiliation(s)
- Dong-Jie Wu
- Graduate School, Zhejiang Chinese Medical University, Hangzhou, Zhejiang
- School of Chinese Medicine, Hong Kong Baptist University, Hong Kong
| | - Hai-Cheng Dong
- Department of Tradition Chinese Medicine, Children's Hospital, Zhejiang University School of Medicine, Hangzhou
| | - Tsz-Nga Tang
- Graduate School, Zhejiang Chinese Medical University, Hangzhou, Zhejiang
| | - Shi-Feng Zhu
- Tongde Hospital of Zhejiang Province, Hangzhou, Zhejiang, China
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25
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Riemann D. Sleep research and sleep medicine: A flourishing field. J Sleep Res 2018. [PMID: 29516611 DOI: 10.1111/jsr.12685] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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