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Sim H, Park Y. Effects of Auricular Acupressure on Nurses' Perceived Stress, Sleep Quality, and Presenteeism: A Single-Blind, Randomized Controlled Trial. Holist Nurs Pract 2024:00004650-990000000-00027. [PMID: 39042725 DOI: 10.1097/hnp.0000000000000667] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/25/2024]
Abstract
The physical and psychological health management of nurses is very important not only for individual nurses but also for organizations and patients. However, nurses are exposed to high stress, sleep problems, and high presenteeism. Therefore, this study aimed to examine the effects of auricular acupressure (AA) on nurses' stress, sleep problems, and presenteeism. This randomized controlled trial encompassed 60 nurses divided into an experimental group (n = 30) and a control group (n = 30). Auricular acupressure using AA stickers with small magnets attached was performed in the experimental group, and a placebo AA using simple AA stickers (without the small magnets) was performed in the control group. The treatment lasted 7 weeks. To confirm the results, stress, sleep quality, and presenteeism were measured at pre- and posttest. There was a statistically significant difference in scores for sleep quality (t = -1.98, P = .047), health problems (z = -2.38, P = .017), and work impairment (t = -4.46, P < .001) between the experimental and control groups at posttest. Auricular acupressure increased sleep quality scores and decreased presenteeism. Auricular acupressure using AA stickers with small magnets attached was effective in improving sleep quality and reducing presenteeism in nurses.
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Affiliation(s)
- Hyunseo Sim
- Author Affiliations: College of Nursing, Graduate School, Dongguk University, Gyeongju, Gyeongsangbuk-do, Republic of Korea
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Wang G, Yi X, Fan H, Cheng H. Anxiety and sleep quality in patients receiving maintenance hemodialysis: multiple mediating roles of hope and family function. Sci Rep 2024; 14:15073. [PMID: 38956144 PMCID: PMC11219716 DOI: 10.1038/s41598-024-65901-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2024] [Accepted: 06/25/2024] [Indexed: 07/04/2024] Open
Abstract
The objective of this cross-sectional study was to examine the extent of sleep quality among individuals undergoing maintenance hemodialysis (MHD) and to scrutinize whether hope and family function serve as mediators in the association between anxiety and sleep quality in this cohort. A convenience sampling method was used to recruit 227 patients receiving maintenance hemodialysis from two tertiary hospitals in Wuhan. Participants completed several self-report questionnaires, including the Sociodemographic questionnaire, Hospital Anxiety and Depression Scale, Athens Insomnia Scale, Herth Hope Index, and Family APGAR Index. As per the findings of the chain mediation analysis, it was observed that the sleep quality scores were directly predicted by anxiety. Moreover, anxiety positively predicted sleep quality scores through hope and family function as mediators. The observed types of mediation were partial mediation. The total indirect effect value was 0.354, indicating the mediating effect of hope and family function, while the total effect value was 0.481, representing the overall effect of anxiety on sleep quality. The total effect size was 73.60% (0.354/0.481), indicating that the mediation accounted for a significant portion of the relationship. This study established the chain mediating effect of hope and family function between anxiety and sleep quality in patients receiving maintenance hemodialysis. The findings highlight the importance of addressing anxiety and promoting hope and family function to improve sleep quality in this population. The findings suggest that healthcare professionals should be attentive to the anxiety levels of these patients and implement targeted interventions to help alleviate anxiety, enhance hope, and improve family functioning, with the ultimate goal of improving sleep quality in this population.
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Affiliation(s)
- Guoqing Wang
- Hemodialysis Center, Renmin Hospital of Wuhan University, Wuhan, 430060, Hubei, China
| | - Xiang Yi
- Department of Organ Transplantation, Renmin Hospital of Wuhan University, Wuhan, 430060, Hubei, China
| | - Hui Fan
- Department of Respiratory and Critical Care Medicine, Renmin Hospital of Wuhan University, Wuhan, 430060, Hubei, China.
| | - Huiling Cheng
- Hemodialysis Center, Renmin Hospital of Wuhan University, Wuhan, 430060, Hubei, China.
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Han Z, Tang H, Hou M, Gao L, Dong Z, Wang C, Lin Q, Yang W. Auricular Acupressure in Relieving PONV and Promoting Gastrointestinal Function Recovery in Females After Laparoscopic Sleeve Gastrectomy: A Prospective Randomized Controlled Trial. Obes Surg 2024; 34:2007-2016. [PMID: 38652438 DOI: 10.1007/s11695-024-07243-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2024] [Revised: 04/16/2024] [Accepted: 04/17/2024] [Indexed: 04/25/2024]
Abstract
BACKGROUND The role of current pharmacological treatment after laparoscopic sleeve gastrectomy (LSG) is limited. The incidence of postoperative nausea and vomiting (PONV) after LSG remains high. Auricular acupressure (AA) is believed to relieve PONV after laparoscopic surgeries, but its role in patients with obesity after LSG has yet to be confirmed. METHODS Ninety-five female patients who underwent LSG were randomized into two groups: AA combined with conventional anti-nausea medication (AA group, 47 patients) or conventional anti-nausea medication group (control group, 48 patients). Index of nausea and vomiting and retching (INVR) scores, postoperative anti-vomiting medication use, time of first anus exhausting, time of first fluid intake, and time of first to get out of bed were collected within 48 h after surgery. RESULTS Demographic data of patients in both groups were balanced and comparable. INVR score (F = 7.505, P = 0.007), vomiting score (F = 11.903, P = 0.001), and retching score (F = 12.098, P = 0.001) were significantly lower in the AA group than that in the control group within 48 h postoperatively. Use of metoclopramide was significantly less in the AA group than in the control group (4.7 [5.5]) vs. 8.8 [7.6], P = 0.004); time to first anus exhausting was significantly less in the AA group than in the control group (17.50 [6.00] vs. 20.42 [8.62], P = 0.020). CONCLUSIONS AA combined with conventional anti-vomiting agents can alleviate PONV in female patients after LSG, and AA can promote gastrointestinal exhaustion. TRIAL REGISTRATION The trial has been registered in the Chinese Clinical Trial Registry (ChiCTR) with the registration no. ChiCTR2100047381 on June 13, 2021.
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Affiliation(s)
- Zhonghui Han
- Department of Metabolic and Bariatric Surgery, The First Affiliated Hospital of Jinan University, No. 613, Huangpu Avenue West, Tianhe District, Guangzhou, Guangdong Province, China
- School of Nursing, Jinan University, No.601, Huangpu Avenue West, Guangzhou, Guangdong Province, China
| | - Hanlin Tang
- Department of Metabolic and Bariatric Surgery, The First Affiliated Hospital of Jinan University, No. 613, Huangpu Avenue West, Tianhe District, Guangzhou, Guangdong Province, China
- Department of Gastrointestinal Surgery, The First Affiliated Hospital of Jinan University, Guangzhou, Guangdong Province, China
| | - Min Hou
- Department of Metabolic and Bariatric Surgery, The First Affiliated Hospital of Jinan University, No. 613, Huangpu Avenue West, Tianhe District, Guangzhou, Guangdong Province, China
- School of Nursing, Jinan University, No.601, Huangpu Avenue West, Guangzhou, Guangdong Province, China
| | - Lilian Gao
- School of Nursing, Jinan University, No.601, Huangpu Avenue West, Guangzhou, Guangdong Province, China
| | - Zhiyong Dong
- Department of Metabolic and Bariatric Surgery, The First Affiliated Hospital of Jinan University, No. 613, Huangpu Avenue West, Tianhe District, Guangzhou, Guangdong Province, China
- Department of Gastrointestinal Surgery, The First Affiliated Hospital of Jinan University, Guangzhou, Guangdong Province, China
| | - Cunchuan Wang
- Department of Metabolic and Bariatric Surgery, The First Affiliated Hospital of Jinan University, No. 613, Huangpu Avenue West, Tianhe District, Guangzhou, Guangdong Province, China
- Department of Gastrointestinal Surgery, The First Affiliated Hospital of Jinan University, Guangzhou, Guangdong Province, China
| | - Qingran Lin
- School of Nursing, Jinan University, No.601, Huangpu Avenue West, Guangzhou, Guangdong Province, China.
- Department of Nursing, The First Affiliated Hospital of Jinan University, Guangzhou, Guangdong Province, China.
| | - Wah Yang
- Department of Metabolic and Bariatric Surgery, The First Affiliated Hospital of Jinan University, No. 613, Huangpu Avenue West, Tianhe District, Guangzhou, Guangdong Province, China.
- Department of Gastrointestinal Surgery, The First Affiliated Hospital of Jinan University, Guangzhou, Guangdong Province, China.
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Ezzati M, Bagheri-Nesami M, Setareh J, Moosazadeh M, Espahbodi F, Esmaeili Ahangarkelai N. Comparing the Effects of Acupressure and Clonazepam Tablets on Sleep Quality of Hemodialysis Patients: A Randomized Controlled Trial. IRANIAN JOURNAL OF PSYCHIATRY 2023; 18:455-465. [PMID: 37881413 PMCID: PMC10593989 DOI: 10.18502/ijps.v18i4.13632] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/30/2022] [Revised: 03/31/2023] [Accepted: 05/02/2023] [Indexed: 10/27/2023]
Abstract
Objective: The current study aimed to compare the impact of acupressure and clonazepam tablets on the quality of sleep in hemodialysis patients in light of the rising prevalence of chronic kidney disease (CKD), the high prevalence of sleep disturbance in these patients, and the side effects of hypnotic drugs. Method : A total of 60 patients were selected for this randomized, controlled clinical trial and randomly assigned to two groups. For two weeks during the researcher's evening shift, one group received acupressure (six spots bilaterally for three minutes each day). The opposing group was administered clonazepam tablets (0.5 mg) for two weeks. The Pittsburgh Sleep Quality Index (PSQI), which measures sleep quality, was used to compare sleep in the two groups before and after the intervention. Results: There was no statistically significant difference between the two groups prior to the intervention (P = 0.75) in terms of the mean pre-intervention PSQI scores for the acupressure and clonazepam groups, which were 15.83 ± 1.51 and 16.17 ± 0.91, respectively. However, the average PSQI scores after the intervention in the clonazepam and acupressure groups were 13.25 ± 2.88 and 8.97 ± 4.29, respectively, indicating a statistically significant difference (P < 0.0001). Both the acupressure and the clonazepam groups showed improvements in their post-intervention sleep quality among the patients. However, when the percentage changed in the mean scores of the total score and all of the PSQI components were calculated for each group, it became clear that acupressure was more effective at enhancing sleep than clonazepam tablets. Conclusion: The findings of the present investigation demonstrate that acupressure has a greater impact on patients' sleep quality compared to clonazepam tablets. Depending on the circumstances, acupressure can be used as a simple, safe, and non-drug way to enhance hemodialysis patients' quality of sleep.
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Affiliation(s)
- Mansooreh Ezzati
- Student Research Committee, Mazandaran University of Medical Sciences, Sari, Iran
| | - Masoumeh Bagheri-Nesami
- Traditional and Complementary Medicine Research Center, Addiction Institute, Mazandaran University of Medical Sciences, Sari, Iran
- World Federation of Acupuncture-Moxibustion Societies (WFAS), Beijing, China
| | - Javad Setareh
- Psychiatry and Behavioral Sciences Research Center, Addiction Institute, Mazandaran University of Medical Sciences, Sari, Iran
| | - Mahmood Moosazadeh
- Gastrointestinal Cancer Research Center, Non-communicable Diseases Institute, Mazandaran University of Medical Sciences, Sari, Iran
| | - Fatemeh Espahbodi
- Department of Nephrology, School of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
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Tang X, Wang L, Ni S, Wu M, Hu S, Zhang L. Feasibility and effect of emotional freedom therapy on sleep quality in patients with end-stage renal disease receiving maintenance hemodialysis: A pilot study. Geriatr Nurs 2023; 51:112-120. [PMID: 36940505 DOI: 10.1016/j.gerinurse.2023.02.021] [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: 12/03/2022] [Revised: 02/25/2023] [Accepted: 02/28/2023] [Indexed: 03/22/2023]
Abstract
OBJECTIVE To explore the feasibility and efficacy of emotional freedom therapy (EFT) in improving sleep quality and managing negative emotions in end-stage renal disease patients on maintenance hemodialysis. METHODS Between May 2021 and February 2022, 66 maintenance hemodialysis patients with sleep problems were recruited and randomized into an intervention and control group. The intervention group underwent a 12-week intervention of EFT. Two groups' hospital anxiety depression scale (HADS) scores, Pittsburgh sleep quality index (PSQI), and interdialysis weight gain (IDWG) before and one week after the formal intervention were collected and compared. Feasibility analysis was performed using a feasibility questionnaire and in-depth interviews with patients. RESULTS Before the intervention, there was no statistical difference in the anxiety, depression, PSQI scores and IDWG between the two groups. After balancing the effects of gender and pre-intervention scores, two-way ANCOVA results showed that there were statistically significant differences between the two groups after the intervention in terms of anxiety, depression, sleep quality, sleep duration, daytime dysfunction and PSQI total score. However, interactions effect for IDWG was statistically significant. Simple effects analysis revealed a difference in post-intervention IDWG between the intervention and control groups for patients over 65 (p < 0.05). Most patients agreed or strongly agreed that the EFT was easy to schedule and they did not experience difficulties during learning the EFT process (respectively 75% and 71.88%). And 75% of the participants were willing to continue practicing EFT. Qualitative content analysis identified five prominent categories related to feasibility and acceptability: affirmation, benefits, communication, support and trust. CONCLUSION EFT can relieve anxiety and depression, enhance sleep quality, and improve the physical condition of patients with end-stage renal disease receiving maintenance hemodialysis. As well, the EFT intervention is practicable, acceptable, and perceived as being beneficial to the patient.
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Affiliation(s)
- Xin Tang
- Department of Nursing, Medical College of Hunan Normal University, Changsha 410013, PR China; Hemodialysis Center, Lukou District Hospital of Traditional Chinese Medicine, Zhuzhou, Hunan 412000, PR China
| | - Li Wang
- Department of Nursing, Medical College of Hunan Normal University, Changsha 410013, PR China
| | - Siyao Ni
- Department of Nursing, Medical College of Hunan Normal University, Changsha 410013, PR China
| | - Mengyu Wu
- Department of Nursing, Medical College of Hunan Normal University, Changsha 410013, PR China
| | - Shengnan Hu
- Department of Nursing, Medical College of Hunan Normal University, Changsha 410013, PR China
| | - Liuyi Zhang
- Department of Nursing, Medical College of Hunan Normal University, Changsha 410013, PR China.
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Wu Y, Yang L, Zhong Z, Wu X, He Z, Ma H, Cai C, Li Y, Wu X, Fu B, Chen X, Wang L, Zhao D, Meng X, Qi A, Yang A, Li L, Liu X, Zou C, Lin Q. Auricular Acupressure for Hemodialysis Patients with Insomnia: A Multicenter Double-Blind Randomized Sham-Controlled Trial. JOURNAL OF INTEGRATIVE AND COMPLEMENTARY MEDICINE 2022; 28:339-348. [PMID: 35426736 DOI: 10.1089/jicm.2021.0332] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Background and objectives: The effect of auricular acupressure (AA) for maintenance hemodialysis (MHD) patients with insomnia has been controversial. This study assessed the efficacy and safety of AA for MHD patients with chronic insomnia. Design, setting, participants, and measurements: This was a multicenter, double-blind (participant and assessor), randomized sham-controlled trial. A total of 133 subjects were randomized to receive AA on active points (AA group, n = 64) or on sham auricular acupressure (SAA) points (SAA group, n = 69) for 8 weeks and followed up for 12 weeks. AA was provided by assigned qualified nurses who were not involved in assessment. The primary outcome was the clinical response rate, which was defined as the percentage of participants who reached a reduction of Pittsburgh Sleep Quality Index (PSQI) global score ≥3 in each group. Secondary outcomes included changes in PSQI scores over time, PSQI scores and hypnotics use at each visit, and changes in the weekly dose of hypnotics for drug-dependent subjects. Results: At week 8, the AA group yielded a higher clinical response rate than the SAA group (AA: 55% vs. SAA: 36%, odds ratio: 1.5, 95% confidence interval: 1.0-2.2, p = 0.033). Both groups showed a reduction in PSQI global scores during treatment and follow-up, compared with the baseline, respectively. A significant change of PSQI global score was observed over time (F = 28.387, p < 0.001). PSQI global score of the AA group was relatively lower than that of the SAA group at each visit (p < 0.05 at week 16 and 20). For those depending on hypnotics, AA reduced their consumption of hypnotics. The intervention was safe, and its adherence was satisfactory. Conclusion: AA could serve as a complementary or alternative therapy for MHD patients with insomnia by improving their sleep quality and reducing their use of hypnotics. Clinical trial registration: Clinicaltrials.gov, Identifier: NCT03015766.
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Affiliation(s)
- Yuchi Wu
- Hemodialysis Department, Second Affiliated Hospital of Guangzhou University of Chinese Medicine/Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, China.,Second Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Lihong Yang
- Second Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou, China.,Evidence-based Chinese Medicine and Clinical Research Service Group, Guangdong Provincial Academy of Chinese Medical Sciences/Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, China
| | - Zhicong Zhong
- Hemodialysis Department, Second Affiliated Hospital of Guangzhou University of Chinese Medicine/Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, China
| | - Xiuqing Wu
- Hemodialysis Department, Second Affiliated Hospital of Guangzhou University of Chinese Medicine/Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, China
| | - Zhiren He
- Second Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou, China.,Hemodialysis Department, Guangzhou Charity Hospital, Guangzhou, China
| | - Hongyan Ma
- Second Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou, China.,Hemodialysis Department, Guangzhou Charity Hospital, Guangzhou, China
| | - Cun Cai
- Second Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou, China.,Hemodialysis Department, Guangzhou HEMC (Higher Education Mega Center) Hospital, Guangzhou, China
| | - Yin Li
- Second Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou, China.,Hemodialysis Department, Guangzhou HEMC (Higher Education Mega Center) Hospital, Guangzhou, China
| | - Xufang Wu
- Hemodialysis Department, Guangzhou Hospital of Traditional Chinese Medicine, Guangzhou, China
| | - Bo Fu
- Hemodialysis Department, Shenzhen Hospital of Traditional Chinese Medicine, Shenzhen, China
| | - Xiaoling Chen
- Second Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou, China.,Hemodialysis Department, Wuyi Hospital of Traditional Chinese Medicine, Jiangmen, China
| | - Lixin Wang
- Second Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou, China.,Hemodialysis Department, Guangzhou Charity Hospital, Guangzhou, China
| | - Daixin Zhao
- Second Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou, China.,Hemodialysis Department, Guangzhou HEMC (Higher Education Mega Center) Hospital, Guangzhou, China
| | - Xiangxin Meng
- Hemodialysis Department, Guangzhou Hospital of Traditional Chinese Medicine, Guangzhou, China
| | - Airong Qi
- Hemodialysis Department, Shenzhen Hospital of Traditional Chinese Medicine, Shenzhen, China
| | - Aicheng Yang
- Hemodialysis Department, Wuyi Hospital of Traditional Chinese Medicine, Jiangmen, China
| | - Lingli Li
- Second Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Xusheng Liu
- Second Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Chuan Zou
- Second Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Qizhan Lin
- Hemodialysis Department, Second Affiliated Hospital of Guangzhou University of Chinese Medicine/Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, China
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HUNG HM, CHIANG HC, WANG HL. The Impact of Gender on the Effectiveness of an Auricular Acupressure Intervention Administered to Community-Dwelling Poor Sleepers: A Cluster Randomized Controlled Trial. J Nurs Res 2021; 29:e153. [PMID: 33756521 PMCID: PMC8126490 DOI: 10.1097/jnr.0000000000000427] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/26/2020] [Indexed: 11/27/2022] Open
Abstract
BACKGROUND Women report a higher incidence of sleep problems than men. Few studies addressing the effect of gender on the efficacy of administering auricular acupressure (AA) at shenmen points (heart meridian 7 [HT7]) on sleep quality have been published. PURPOSE The primary aim of this study was to investigate the effects of a 4-week AA intervention applied at the HT7 points on sleep quality, perceived physical health, and perceived mental health in community-dwelling individuals with poor self-reported sleep quality. Additional analyses were used to evaluate the gender-specific effects of this intervention. METHODS A cluster randomized controlled trial with repeated-measures design was used. One hundred seventy-nine eligible participants were randomly assigned to either the AA group (n = 88; 47 women, 41 men) or the sleep hygiene instruction (SHI) group (n = 91; 52 women, 39 men). The AA group self-administered acupressure at HT7 on both ears for a 4-week period, whereas the SHI group received an SHI information sheet. Outcome measures included the Pittsburgh Sleep Quality Index (PSQI) and the Short-Form Health Survey-12 Version 2, with data collected at baseline and at 2, 4, and 8 weeks posttest. RESULTS Linear mixed-model analysis revealed that the participants in the AA group experienced significantly greater reductions in mean PSQI global score and the three indices of sleep latency, subjective sleep quality, and daytime dysfunction than the SHI group at 2 and 4 weeks posttest. The improvements in subjective sleep quality and daytime dysfunction remained at 4 weeks posttest in the AA group, but not in the SHI group. The PSQI global score decreased significantly more in men than women in the AA group between baseline and 4 weeks posttest. CONCLUSIONS/IMPLICATIONS FOR PRACTICE Four weeks of self-administered acupressure at HT7 on both ears is an effective intervention for community-dwelling poor sleepers who are over 45 years old. Moreover, the improvements in subjective sleep quality and daytime dysfunction persist for up to 4 weeks after the end of the intervention. This self-administered acupressure intervention is more effective in men than in women in terms of improving sleep quality. Gender bias is known to influence research results and may lead to inappropriate generalizations. Thus, future studies that are performed to build basic scientific evidence should include considerations of the effects of gender in the study design.
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Affiliation(s)
- Hsuan-Man HUNG
- PhD, RN, Associate Professor, Department of Nursing, Fooyin University, Kaohsiung City, Taiwan, ROC
| | - Hsiao-Ching CHIANG
- MSN, RN, Lecturer, Department of Nursing, Tajen University, Yanpu City, Taiwan, ROC
| | - Hui-Ling WANG
- PhD, RN, Assistant Professor, Department of Nursing, Fooyin University, Kaohsiung City, Taiwan, ROC
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Wang X, Lin H, Jiang X, Ma M, Shi D, Fan C, Shao Y, Wu S, Yu L, Li D, He J, Chen Y. Effect of Electroacupuncture and Counseling on Sub-Threshold Depression: A Study Protocol for a Multicenter Randomized Controlled Trial. Front Psychiatry 2020; 11:346. [PMID: 32411031 PMCID: PMC7198880 DOI: 10.3389/fpsyt.2020.00346] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/25/2020] [Accepted: 04/06/2020] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND Sub-threshold depression is common and could impair function, as well as increase the risk of developing major depression. Despite evidence of efficacy for electroacupuncture (EA) and counseling in the treatment of sub-threshold depression, the sample size is insufficient and the level of evidence remains low. This study aims to evaluate the effectiveness of sub-threshold depression treatments by comparing the treatment effects among EA, counseling, and combination therapy, as well as to further study their mechanism. METHODS This study is a multicenter, randomized, single blind clinical trial that will be conducted in settings at four clinical centers in China. The randomized controlled trial (RCT) will examine the effectiveness of EA intervention, compared with counseling and combination therapy. A total of 138 sub-threshold depression patients (18 to 55 years of age with Beck Depression Inventory (BDI-II) score ≥ 14 points and Hamilton Depression Scale (HAMD-17) score: 7 points ≤ HAMD total score <17 points) will be recruited. The participants will be randomly assigned to receive the above treatments. The interventions will be delivered over a 6-week period (EA: 3 times a week for 6 weeks; 30 min a session. Counseling: once a week for 6 weeks; 50-60 min a session). The primary outcome measure will be the HAMD-17; BDI-II. The secondary outcome measures will be: Self-rating Depression Scale (SDS), Self-rating Anxiety Scale (SAS), and Pittsburgh Sleep Quality Index (PSQI). The assessments will occur at baseline, 2, 4, and 6 weeks and a follow-up period. Recruitment will commence in March 2020 and is anticipated to occur over a 2-year period. DISCUSSION This study intends to conduct a multicenter randomized controlled trial to compare the effectiveness among EA, counseling and the combined therapy in the treatment of patients with sub-threshold depression, and to further study the mechanisms of effect. CHINESE CLINICAL TRIAL REGISTRY REGISTRATION www.chictr.org.cn/, identifier ChiCTR1900028530.
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Affiliation(s)
- Xiaotong Wang
- South China Research Center for Acupuncture and Moxibustion, Clinical Medical College of Acupuncture, Moxibustion and Rehabilitation, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Haixiong Lin
- The First School of Clinical Medicine, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Xiumin Jiang
- South China Research Center for Acupuncture and Moxibustion, Clinical Medical College of Acupuncture, Moxibustion and Rehabilitation, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Minna Ma
- Student Mental Health Counseling Center, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Dandan Shi
- Student Mental Health Counseling Center, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Chun Fan
- South China Research Center for Acupuncture and Moxibustion, Clinical Medical College of Acupuncture, Moxibustion and Rehabilitation, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Yin Shao
- South China Research Center for Acupuncture and Moxibustion, Clinical Medical College of Acupuncture, Moxibustion and Rehabilitation, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Shengwei Wu
- Department of Traditional Chinese Medicine, Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, China
| | - Lin Yu
- Department of Traditional Chinese Medicine, Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, China
| | - Danian Li
- Rehabilitation Center, Counseling Department, The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Jun He
- South China Research Center for Acupuncture and Moxibustion, Clinical Medical College of Acupuncture, Moxibustion and Rehabilitation, Guangzhou University of Chinese Medicine, Guangzhou, China.,Rehabilitation Center, Counseling Department, The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Yongjun Chen
- South China Research Center for Acupuncture and Moxibustion, Clinical Medical College of Acupuncture, Moxibustion and Rehabilitation, Guangzhou University of Chinese Medicine, Guangzhou, China.,Guangdong-Hong Kong-Macao Greater Bay Area Center for Brain Science and Brain-Inspired Intelligence, Guangdong Province Key Laboratory of Psychiatric Disorders, Guangzhou, China
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9
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Ghavami H, Shamsi SA, Abdollahpoor B, Radfar M, Khalkhali HR. Impact of hot stone massage therapy on sleep quality in patients on maintenance hemodialysis: A randomized controlled trial. JOURNAL OF RESEARCH IN MEDICAL SCIENCES 2019; 24:71. [PMID: 31523257 PMCID: PMC6734672 DOI: 10.4103/jrms.jrms_734_18] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/21/2018] [Revised: 02/26/2019] [Accepted: 06/03/2019] [Indexed: 11/04/2022]
Abstract
Background: Many patients on maintenance hemodialysis experience sleep disorders. This problem is related to depression, anxiety, hospitalizations, chronic medical conditions, decreased quality of life, and increasing mortality rate in patients on maintenance hemodialysis. The objective of this research is to determine the impact of massage therapy by hot stone on quality of sleep in patients on maintenance hemodialysis. Materials and Methods: This was a randomized controlled trial conducted on 60 patients on maintenance hemodialysis. They were assigned via random allocation process into two groups of study: intervention group (n = 30), or control group (n = 30). Patients in the experimental group received massage therapy by hot basalt stone for 12 séances. During the massage therapy, each of five basalt stones were placed at the sites of the fifth, fourth, third, second, and first chakra. Control group received their treatment as usual without any massage therapy. Using Pittsburgh Sleep Quality Index (PSQI), the global score and its components were computed in both groups of study, two times (before the intervention and 1 month after the intervention). Results: Although there were not any baseline differences between the two groups of study for the mean of global PSQI score (P = 0.92) before the study, the mean of global PSQI score in the intervention group, after the intervention decreased to 5.7 ± 3.06, but in the control group sleep quality increased to 10.7 ± 3.6. The difference between the mean of global score of PSQI among two groups of study after the massage therapy was statistically significant (P < 0.001). Conclusion: Applying massage therapy by hot stone in hemodialysis patients may contribute in enhancing their quality of sleep.
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Affiliation(s)
- Haleh Ghavami
- Department of Medical/Surgical Nursing, Nursing and Midwifery Faculty of Urmia University of Medical Sciences, Urmia, Iran
| | - Shams Aldin Shamsi
- Department of Medical/Surgical Nursing, Nursing and Midwifery Faculty of Urmia University of Medical Sciences, Urmia, Iran
| | - Behnam Abdollahpoor
- Department of Medical/Surgical Nursing, Nursing and Midwifery Faculty of Urmia University of Medical Sciences, Urmia, Iran
| | - Moloud Radfar
- Department of Medical/Surgical Nursing, Nursing and Midwifery Faculty of Urmia University of Medical Sciences, Urmia, Iran
| | - Hamid Reza Khalkhali
- Department of Biostatistics and Epidemiology, Patient Safety Research Center, Urmia University of Medical Sciences, Urmia, Iran
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Natale P, Ruospo M, Saglimbene VM, Palmer SC, Strippoli GFM. Interventions for improving sleep quality in people with chronic kidney disease. Cochrane Database Syst Rev 2019; 5:CD012625. [PMID: 31129916 PMCID: PMC6535156 DOI: 10.1002/14651858.cd012625.pub2] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
BACKGROUND Sleep disorders are commonly experienced by people with chronic kidney disease (CKD). Several approaches for improving sleep quality are used in clinical practice including relaxation techniques, exercise, acupressure, and medication. OBJECTIVES To assess the effectiveness and associated adverse events of interventions designed to improve sleep quality among adults and children with CKD including people with end-stage kidney disease (ESKD) treated with dialysis or kidney transplantation. SEARCH METHODS We searched the Cochrane Kidney and Transplant Register of Studies up to 8 October 2018 with the Information Specialist using search terms relevant to this review. Studies in the Register are identified through searches of CENTRAL, MEDLINE, and EMBASE, conference proceedings, the International Clinical Trials Register (ICTRP) Search Portal and ClinicalTrials.gov. SELECTION CRITERIA We included randomised controlled trials (RCTs) or quasi-randomised RCTs of any intervention in which investigators reported effects on sleep quality. Two authors independently screened titles and abstracts of identified records. DATA COLLECTION AND ANALYSIS Two review authors independently extracted data and assessed the risk of bias for included studies. The primary outcomes were sleep quality, sleep onset latency, sleep duration, sleep interruption, and sleep efficiency. Risks of bias were assessed using the Cochrane tool. Evidence certainty was assessed using the GRADE approach. We calculated treatment estimates as risk ratios (RR) for dichotomous outcomes or mean difference (MD) or standardised MD (SMD) for continuous outcomes to account for heterogeneity in measures of sleep quality. MAIN RESULTS Sixty-seven studies involving 3427 participants met the eligibility criteria. Thirty-six studies involving 2239 participants were included in meta-analyses. Follow-up for clinical outcomes ranged between 0.3 and 52.8 weeks (median 5 weeks). Interventions included relaxation techniques, exercise, acupressure, cognitive-behavioural therapy (CBT), educational interventions, benzodiazepine treatment, dopaminergic agonists, telephone support, melatonin, reflexology, light therapy, different forms of peritoneal dialysis, music, aromatherapy, and massage. Incomplete reporting of key methodological details resulted in uncertain risk of bias in many studies.In very low certainty evidence relaxation techniques had uncertain effects on sleep quality and duration, health-related quality of life (HRQoL), depression, anxiety, and fatigue. Studies were not designed to evaluate the effects of relaxation on sleep latency or hospitalisation. Exercise had uncertain effects on sleep quality (SMD -1.10, 95% CI -2.26 to 0.05; I2 = 90%; 5 studies, 165 participants; very low certainty evidence). Exercise probably decreased depression (MD -9.05, 95% CI -13.72 to -4.39; I2 = 0%; 2 studies, 46 participants; moderate certainty evidence) and fatigue (SMD -0.68, 95% CI -1.07 to -0.29; I2 = 0%; 2 studies, 107 participants; moderate certainty evidence). Compared with no acupressure, acupressure had uncertain effects on sleep quality (Pittsburgh Sleep Quality Index (PSQI) scale 0 - 21) (MD -1.27, 95% CI -2.13 to -0.40; I2 = 89%; 6 studies, 367 participants: very low certainty evidence). Acupressure probably slightly improved sleep latency (scale 0 - 3) (MD -0.59, 95% CI -0.92 to -0.27; I2 = 0%; 3 studies, 173 participants; moderate certainty evidence) and sleep time (scale 0 - 3) (MD -0.60, 95% CI -1.12 to -0.09; I2 = 68%; 3 studies, 173 participants; moderate certainty evidence), although effects on sleep disturbance were uncertain as the evidence certainty was very low (scale 0 - 3) (MD -0.49, 95% CI -1.16 to 0.19; I2 = 97%). In moderate certainty evidence, acupressure probably decrease fatigue (MD -1.07, 95% CI -1.67 to -0.48; I2 = 0%; 2 studies, 137 participants). Acupressure had uncertain effects on depression (MD -3.65, 95% CI -7.63 to 0.33; I2 = 27%; 2 studies, 137 participants; very low certainty evidence) while studies were not designed to evaluate the effect of acupressure on HRQoL, anxiety, or hospitalisation. It was uncertain whether acupressure compared with sham acupressure improved sleep quality (PSQI scale 0 to 21) because the certainty of the evidence was very low (MD -2.25, 95% CI -6.33 to 1.82; I2 = 96%; 2 studies, 129 participants), but total sleep time may have been improved (SMD -0.34, 95% CI -0.73 to 0.04; I2 = 0%; 2 studies, 107 participants; low certainty evidence). 2 =2 =There were no studies designed to directly examine and/or correlate efficacy of any interventions aimed at improving sleep that may have been attempted for the spectrum of sleep disordered breathing. No studies reported treatment effects for children. Adverse effects of therapies were very uncertain. AUTHORS' CONCLUSIONS The evidence base for improving sleep quality and related outcomes for adults and children with CKD is sparse. Relaxation techniques and exercise had uncertain effects on sleep outcomes. Acupressure may improve sleep latency and duration, although these findings are based on few studies. The effects of acupressure were not confirmed in studies in which sham acupressure was used as the control. Given the very low certainly evidence, future research will very likely change the evidence base. Based on the importance of symptom management to patients, caregivers and clinicians, future studies of sleep interventions among people with CKD should be a priority.
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Affiliation(s)
- Patrizia Natale
- DiaverumMedical Scientific OfficeLundSweden
- University of BariDepartment of Emergency and Organ TransplantationBariItaly
| | | | - Valeria M Saglimbene
- DiaverumMedical Scientific OfficeLundSweden
- The University of SydneySydney School of Public HealthSydneyAustralia
| | - Suetonia C Palmer
- University of Otago ChristchurchDepartment of Medicine2 Riccarton AvePO Box 4345ChristchurchNew Zealand8140
| | - Giovanni FM Strippoli
- DiaverumMedical Scientific OfficeLundSweden
- University of BariDepartment of Emergency and Organ TransplantationBariItaly
- The University of SydneySydney School of Public HealthSydneyAustralia
- Diaverum AcademyBariItaly
- The Children's Hospital at WestmeadCochrane Kidney and Transplant, Centre for Kidney ResearchWestmeadNSWAustralia2145
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