Effect of Acupressure on Nausea, Vomiting, Anxiety and Pain among Post-Cesarean Section Women in Taiwan

穴位指壓對部腹產術後噁心、嘔吐、焦慮及疼痛之成效

陳惠敏(Huei-Mein Chen) ； 張鳳儀(Feng-Yi Chang) ； 許靖岱(Ching-Tai Hsu)

《The Kaohsiung Journal of Medical Sciences》 21卷8期 (2005/08) Pp. 341-350

摘要

本研究的目的在探討穴位指壓對剖腹產術後噁心、嘔吐、焦慮、疼痛及生理指標之成效。本研究採類實驗研究設計，採方便取樣方式於台南某地區教學醫院及分院以接受剖腹產先後順序收案，實驗組52名、對照組52名。其中實驗組在手術前晚、術後2-4小時及術後8-10小時給予刺激按壓手腕處內關穴各20分鐘；控制組給予平敘的手術之護理指導20分鐘，沒有穴位指壓的介入。測量工具包括手術病患噁心、嘔吐量表、焦慮視覺類比量表、情境－特質焦慮量表、疼痛視覺類比量表及生理指標測量。統計方法包括：百分比、平均值、標準差、t檢定、重複測量變異數分析。結果顯示：在術後2-4小時實驗組比對照組噁心、嘔吐及乾嘔發生率有顯著性之差異（53.9%及69.3%）（95%信賴區間0.11-1.65；P=0.040）在術後8-10小時實驗組比對照組噁心、嘔吐及乾嘔發生率有顯著性之差異（15.4%及36.2%）（95%信賴區間0.02-0.59；P=0.024）。穴位指壓亦能顯著降低術後焦慮感、疼痛感，在呼吸、脈搏、收縮壓、舒張壓之生理指標上亦較對照組有顯著改善之成效。建議臨床護理推廣穴位指壓，促進婦女在剖腹生產過程的身心舒適。

關鍵字

穴位指壓 ； 焦慮 ； 剖腹生產

並列摘要

The purpose of this study was to examine the effectiveness of acupressure for controlling post-cesarean section (CS) symptoms, such as nausea and vomiting, anxiety perception and pain perception. A total of 104 eligible participants were recruited by convenience sampling of operating schedules at two hospitals. Participants assigned to the experimental group received acupressure, and those assigned to the control group received only postoperative nursing instruction. The experimental group received three acupressure treatments before CS and within the first 24 hours after CS. The first treatment was performed the night before CS, the second was performed 2-4 hours after CS, and the third was performed 8-10 hours after CS. The measures included the Rhodes Index of Nausea and Vomiting, Visual Analog Scale for Anxiety, State-Trait Anxiety Inventory, Visual Analog Scale for Pain, and physiologic indices. Statistical methods included percentages, mean value with standard deviation, I test and repeated measure ANOVA. The use of acupressure reduced the incidence of nausea, vomiting or retching from 69.3% to 53.9%, compared with control group (95% confidence interval=1.65-0.11; p=0.040) 2-4 hours after CS and from 36.2% to 15.4% compared with control group (95% confidence interval=0.59-0.02; p=0.024) 8-10 hours after CS. Results indicated that the experimental group had significantly lower anxiety and pain perception of cesarean experiences than the control group. Significant differences were found in all physiologic indices between the two groups. In conclusion, the utilization of acupressure treatment to promote the comfort of women during cesarean delivery is strongly recommended.

並列關鍵字

acupressure ； anxiety ； cesarean section