The Feasibility and Effects of Self-Acupressure on Symptom Burden and Quality of Life in Hemodialysis Patients: A Pilot RCT.

IF 1.6 Q3 UROLOGY & NEPHROLOGY Canadian Journal of Kidney Health and Disease Pub Date : 2024-08-06 eCollection Date: 2024-01-01 DOI:10.1177/20543581241267164
Kristen Parker, Shauna Raugust, Becky Vink, Kuljit Parmar, Allan Fradsham, Marni Armstrong
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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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自我压迫对血液透析患者症状负担和生活质量的可行性及影响:试验性 RCT。
背景:长期血液透析(HD)患者的症状负担很重,解决症状问题已被患者确定为研究的重点。穴位按摩在控制血液透析患者的症状方面有一定的效果:本研究旨在探讨对中心内的 HD 患者实施自我管理的穴位按摩干预对症状负担和生活质量的可行性和影响:设计:试验性随机对照研究:患者或样本或参与者:患者或样本或参与者:接受 HD 治疗至少 3 个月且至少有一项症状评分超过中度的患者有资格参与研究:参与者被随机分为(1)自我穴位按摩+常规护理组或(2)单纯常规护理组。穴位按摩组的参与者将获得一个木制穴位按摩工具,并在为期 4 周的研究期间学习如何在 6 个穴位按摩部位进行自我按摩。可行性结果通过满意度调查和自然减员进行评估。其他结果包括通过有效问卷(EQ-5D-5L 和综合姑息治疗结果评分-肾脏 [IPOS-Renal])得出的生活质量和症状评分:32名参与者成功加入了研究;干预组的研究完成率为98%,4周方案的坚持率为82%,接受度很高。干预组参与者的生活质量得分有所提高(EQ-5D-5L 指数得分变化 = +0.053;EQ-5D-5L 视觉模拟量表得分变化 = +6.7)。干预组参与者的症状评分也有所改善(IPOS-Renal 总体变化 = -2.8):局限性:样本量小和干预持续时间长是这项试点研究的局限性:本研究的结果表明,自我按压在这一 HD 患者样本中是可接受和可行的。自我按压疗法可能有助于缓解 HD 患者的症状。这些试点结果可为更大规模、更明确的调查提供依据。
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来源期刊
CiteScore
3.00
自引率
5.90%
发文量
84
审稿时长
12 weeks
期刊介绍: Canadian Journal of Kidney Health and Disease, the official journal of the Canadian Society of Nephrology, is an open access, peer-reviewed online journal that encourages high quality submissions focused on clinical, translational and health services delivery research in the field of chronic kidney disease, dialysis, kidney transplantation and organ donation. Our mandate is to promote and advocate for kidney health as it impacts national and international communities. Basic science, translational studies and clinical studies will be peer reviewed and processed by an Editorial Board comprised of geographically diverse Canadian and international nephrologists, internists and allied health professionals; this Editorial Board is mandated to ensure highest quality publications.
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