應用耳穴貼壓改善產婦睡眠之成效

Effects of Auricular Acupressure on Improving the Sleep Quality of Puerperae

劉千滋(Chien-Tzu Liu) ； 賴榮年(Jung-Nien Lai) ； 戈依莉(Yi-Li Ko)

《護理雜誌》 63卷2期 (2016/04) Pp. 39-48

https://doi.org/10.6224/JN.63.2.39

摘要

背景　產婦普遍睡眠品質不佳，過去有研究運用耳穴按壓於護理人員、大學生及原住民老年婦女等健康群體，發現可有效改善睡眠品質，但尚未見探討耳穴按壓對於失眠產婦之成效的相關研究，故引發進行研究之動機。目的　探討耳穴貼壓措施介入對產婦睡眠品質之成效。方法　本研究採前瞻性類實驗性設計，共收案有睡眠品質不佳產婦共60人，實驗組（30人）施予神門穴、心穴、腎穴之耳穴貼壓，控制組（30人）則接受一般常規照顧。運用中文版匹茲堡睡眠量表（Chinese versionof the Pittsburgh Sleep Quality Index）於介入措施前及介入後第21天後，追蹤兩組產婦睡眠品質之改變，以廣義估計方程（generalized estimating equation）統計法比較耳穴貼壓介入後睡眠品質之改善成效。結果　耳穴貼壓於介入後第21天，實驗組之睡眠品質比控制組有顯著改善。於總分、主觀睡眠品質、睡眠時數及睡眠困擾等變項，實驗組改善程度均顯著大於控制組（p ＜ .05）。結論／實務應用　本研究發現，運用耳穴按壓三週，能有效改善產婦失眠的問題，且此非藥物性與非侵入之措施，可增加產婦睡眠之品質。

關鍵字

產婦 ； 睡眠品質 ； 耳穴貼壓

並列摘要

Background: Puerperae exhibit generally poor sleep quality. Previous studies have shown auricular acupressure aseffective in improving the sleep problems of nurses, college students, and elderly indigenous Taiwanese women. However, no study has yet examined the effectiveness of auricular acupressure in improving the sleep quality of postpartumwomen. Purpose: To explore the efficacy of auricular acupressure (AA) on puerperae who were affected by sleep disturbance. Methods: A prospective quasi-experimental design was used and 60 puerperae with insomnia who scored at least 5on the Chinese version of the Pittsburgh Sleep Quality Index (CPSQI) were recruited at one postpartum centre (a ＂doing-the-month＂ care centre) in northern Taiwan. The experimental group (n = 30) received pasted auricular magneticbeads and acupressure on the Shenmen, Xin, and Shen points. The control group (n = 30) received general nursing directionsabout insomnia only. All participants were assessed using the CPSQI prior to the intervention and on the 21stpost-intervention day. The intervention effects were analysed using the Generalized Estimating Equation (GEE).Results: After three weeks of the AA intervention, the mean global CPSQI score had decreased significantly morein the experimental group than in the control group (p ＜ .05). Furthermore, experimental-group participants reportedbetter sleep quality (p ＜ .05), longer total sleep time (p ＜. 001) and lower sleep disturbance (p ＜ .05) than their control-group peers. Conclusions / Implications for Practice: The present pilot study found complementary AA to be an effective interventionfor treating puerperae with insomnia. This non-pharmacological and nonintrusive intervention for improvingsleep disturbance in puerperae promotes the quality of sleep.

並列關鍵字

postpartum women ； sleep quality ； auricular acupressure

參考文獻

王秀禾、葉美玲、鍾聿琳、楊千慧（2008）．應用耳穴貼壓改善睡眠之成效．實證護理，4（3），243–250。[Wang, H. H., Yeh, M. L. Chung, U. L., & Yang, C. H. (2008). Improving sleep quality: The efficacy of auricular acupressure. Journal of Evidence-Based Nursing, 4(3), 243–250.] doi:10.6225/JEBN.4.3.243

張瑋玲、柯淑華、張彩秀、洪麗珍（2010）．耳穴貼壓對護理人員睡眠品質改善之成效．護理暨健康照護研究，6（4），261–270。[Chang, W. L., Ko, S. H., Chang, T. H., & Hung, L. C. (2010). Effect of auricular acupressure on improving sleep quality in nurses. Journal of Nursing and Healthcare Research, 6(4), 261–270.] doi:10.6225/JNHR.6.4.261

蔡名秀、黃久美、郭維茗、吳慧美、李美鶯（2010）．孕婦身體活動、睡眠品質與非計畫性剖腹產．護理暨健康照護研究，6（1），13–23。[Tsai, M. S., Huang, C. M., Kuo, W. M., Wu, H. M., & Lee, M. Y. (2010). Physical activity, sleep quality, and unplanned cesarean section in pregnant women. Journal of Nursing and Healthcare Research, 6(1), 13–23.] doi:10.6225/JNHR.6.1.13

樊君儀、黃秀霖、陳嬿如、胡麗霞、蔡淑合、洪世欣 （2015）．應用耳穴按壓改善癌症病人之睡眠困擾．護理暨健康照護研究，11（1），3–12。[Fan, C. I., Huang, H. L., Chen, Y. R., Hu, L. S., Tasi, S. H., & Hung, S. H. (2015). The efficacy of using an auricular acupressure program to improve sleep disturbance in cancer patients. Journal of Nursing and Healthcare Research, 11(1), 3–12.] doi:10.6225/JNHR.11.1.3

闕可欣（2009）．社區原住民老年婦女睡眠障礙與耳穴貼壓介入成效之研究（未發表的博士論文）．高雄市：高雄醫學大學護理研究所。[Chueh, K. H. (2009). Sleep disturbance and effects of auricular acupressure among aboriginal older women (Unpublished doctoral dissertation). Kaohsiung Medical University, Taiwan, ROC.