The Effect of Acupressure with Massage on Fatigue and Depression in Patients with End-Stage Renal Disease

穴位指壓合併按摩對末期腎疾病患者的疲憊感和憂鬱之成效

卓宜靜(Yi-Ching Cho) ； 蔡秀鸞(Shiow-Luan Tsay)

《The Journal of Nursing Research》 12卷1期 (2004/03) Pp. 51-59

摘要

疲憊感和憂鬱是末期腎疾病患者最常見的症狀。本研究的目的在檢視穴位指壓合併按摩對末期腎臟疾病接受血液透析患者對疲憊感和憂鬱的成效。本研究為實驗型前測和後測設計，62 位血液透析患者參與研究。研究對象為南部一所區域醫院及醫學中心的洗腎中心患者。參與研究之患者以隨機分配至實驗組及控制組。實驗組患者接受每星期三次，每次12 分鐘的穴位指壓，3 分鐘按摩，為期共四週；控制組則接受一般透析照護。研究工具包括：Piper 疲憊感量表和貝氏憂鬱量表。資料以描述性統計分析、卡方檢定、配對t 檢定及共變異數分析 (ANCOVA) 進行分析與檢定。結果顯示研究對象有中等程度的疲憊感受，有63.8%的患者有憂鬱情緒。ANCOVA 結果顯示接受穴位指壓患者的疲憊感 (F(1,54) = 9.05, p = .004）和憂鬱(F(1,54) = 4.20，p = .045）比未接受者有顯著的改善。研究結果提供護理人員照護末期腎疾病患者之模式。

關鍵字

穴位指壓 ； 按摩 ； 疲憊感 ； 憂鬱 ； 末期腎疾病

並列摘要

Fatigue and depressive mood are the most significant symptoms experienced by patients with end-stage renal disease. The purpose of this study was to examine the effectiveness of acupressure with massage in fatigue and depression in patients with end-stage renal disease (ESRD) receiving hemodialysis treatment. The study applied an experimental pretest and posttest design. Sixty-two hemodialysis patients participated in the study. Data were collected from two hemodialysis clinics in major hospitals in southern Taiwan. Following consent to the study, subjects were randomly assigned to an acupressure group or a control group. Patients in the acupressure group received acupoint massage for 12 minutes per day, three days per week, for four weeks. Subjects in the control group only received routine unit care. The measures included the Revised Piper Fatigue Scale, and Beck’s Depression Inventory. Descriptive statistics, 2 tests, t-test and analyses of covariance were used for data analysis. The results indicate that subjects experienced a moderate level of fatigue. Nearly 65% of hemodialysis patients had a depressed mood. ANCOVA results indicated that fatigue (F(1,54) = 9.05, p = .004) and depression (F(1,54) = 4.20, p = .045) among patients in the acupressure group showed significantly greater improvement than patients in the control group. The findings of this study provide an interventional model for nurses taking care of ESRD patients.

並列關鍵字

acupressure ； massage ； fatigue ； depression ； end-stage renal disease

參考文獻

Aghanwa, H. S.,Morakinyo, O.(1997).Psychiatric complications of hemodialysis at a kidney center in Nigeria.Journal of Psychosomatic Research.42(5),445-452.

Beck, A.(1996).Beck Depression Inventory II (BDI II).San Antonio, TX:The Psychological Corporation.

Brunier, G. M.,Graydon, J.(1993).The influence of physical activity on fatigue in patients with ESRD on hemodialysis.ANNA Journal.20(4),457-461.

Buckwalter, K. C.,Babich, K. S.(1990).Psychologic and physiologic aspects of depression.Nursing Clinics of North America.25(4),945-953.

Cardenas, D. D.,Kuter, N. G.(1982).The problem of fatigue in dialysis patients.Nephron.30,336-340.