CE: Incorporating Acupressure into Nursing Practice.

Rooted in traditional Chinese medicine, the use of acupressure to alleviate symptoms, support the healing process, promote relaxation, and improve overall health has grown considerably in the West. The effects of acupressure--like those of acupuncture, with which it shares a theoretical framework--cannot always be explained in terms of Western anatomical and physiologic concepts, but this noninvasive practice involves minimal risk, can be easily integrated into nursing practice, and has been shown to be effective in treating nausea as well as low back, neck, labor, and menstrual pain. The author discusses potential clinical indications for the use of acupressure, describes the technique, explains how to evaluate patient outcomes, and suggests how future research into this integrative intervention might be improved.

Ensino e aprendizagem sobre Medicina Tradicional Chinesa e técnicas de acupressão como possibilidade de cuidado em saúde / Actions and education strategies in health made by nurses through Traditional Chinese Medicine

Como meio de disponibilizar à população novas opções de cuidado, com baixo custo, elevada efetividade, nas quais os próprios sujeitos foram/são co-responsáveis por sua saúde, contribuindo também na saúde da família e comunidade, buscou-se com esta pesquisa agregar às ações de educação em saúde, desenvolvidas pelo enfermeiro, a Medicina Tradicional Chinesa, apresentada pelo Ministério da Saúde na Política Nacional de Práticas Integrativas e Complementares. Para tanto esta investigação possuiu a questão norteadora: Quais benefícios o enfermeiro pode trazer aos sujeitos quando utiliza como estratégia de educação em saúde a Medicina Tradicional Chinesa, disposta na Política Nacional de Práticas Integrativas e Complementares? Definiu-se como objetivo geral: Desenvolver estratégias de educação em saúde, utilizando a Medicina Tradicional Chinesa, como inovação ao serviço. E como objetivos específicos: (1) Proporcionar através da realização de encontros, o conhecimento e aprendizagem da Medicina Tradicional Chinesa em relação a técnicas de acupressão, e (2) Identificar o conhecimento sobre Medicina Tradicional Chinesa antes e após as ações educativas. Para isso, realizou-se uma Pesquisa Convergente Assistencial em uma Estratégia Saúde da Família, na zona urbana de um município do Noroeste do Rio Grande do Sul, onde em um grupo, com doze sujeitos participantes da pesquisa, foram realizadas atividades de educação em saúde, momento em que os sujeitos foram convidados a conhecer e a utilizar práticas relacionadas a Medicina Tradicional Chinesa como nova opção de (auto)cuidado. Importante lembrar que neste método associaram-se pesquisa e assistência, as quais ocorreram ao mesmo tempo. Para a coleta de informações foram utilizadas a entrevista semi-estruturada e a observação participante, e para interpretação e análise, que ocorreram simultaneamente com a coleta, foram seguidas as fases apresentadas pelo método. Os resultados deram origem à três categorias: conceituando saúde na percepção dos sujeitos, conhecimento dos sujeitos sobre Medicina Tradicional Chinesa e Medicina Tradicional Chinesa/acupressão: benefícios e estratégias de educação em saúde. Com a realização do estudo, ficou evidente que a acupressão pode ser implantada em serviços de saúde, e demonstra-se benéfica tanto ao sujeito, que agrega novos conhecimentos, como aos profissional que passa a conhecer melhor seu publico e oferecer-lhe condições de saúde de maneiras alternativas.(AU)

As a means of providing the new care options population, with low cost, high effectiveness, in which the subjects themselves were/are co-responsible for their health, contributing also to the health of family and community, we sought to add to this search health education activities implemented by nurses, traditional Chinese medicine, presented by the Health Ministry in the National Integrative and Complementary Practices Politic. Therefore this research has owned the guiding question: "What benefits nurses can bring to the subjects when used as a health education strategy to traditional Chinese medicine, prepared by the National Politics on Integrative and Complementary Practices? Was defined as general objective: To develop health education strategies, using Traditional Chinese Medicine, such as innovation service. And the following objectives: (1) Provide by conducting meetings, knowledge and learning of Traditional Chinese Medicine for acupressure techniques, and (2) identify the knowledge about Traditional Chinese Medicine before and after the educational activities. For this, there was a Convergent Care Research in a Family Health Strategy, the urban area of a city in the Rio Grande do Sul Northwest, where in a group, health education activities were held, at which the subjects were invited to visit and use practices related to Traditional Chinese Medicine as a new option (self) care. Important to remember that this method were associated with research and care, which occurred at the same time. For the collection of information was used to semi-structured interviews and participant observation, and interpretation and analysis, which occurred simultaneously with the collection, we have followed the steps as defined by the method. The results led to three categories: conceptualizing health in the perception of the subjects, knowledge of the subjects on Traditional Chinese Medicine and Traditional Chinese Medicine / Acupressure: benefits and health education strategies. With the completion of the study revealed that acupressure can be deployed in health services, and proves to be beneficial both to the subject, which adds new knowledge, as the professional who gets to know better your public and offer you health conditions alternative ways.(AU)

O uso da acupressão para evolução do trabalho de parto e alívio da dor / The use of acupressure for the progression of labor in childbirth and for pain relief / El uso de la acupresión para evolución del trabajo de parto y alivio del dolor

Esta revisão integrativa teve o objetivo de buscar as evidências disponíveis na literatura que abordassem o uso da acupressão durante a evolução do trabalho de parto e alívio da dor. Realizou-se uma pesquisa nas bases de dados Scopus, Medline, Cinahal e SciELO, viabilizando a inclusão de 10 estudos, publicados entre 2002 e 2012, que aplicaram a acupressão nos pontos Sanyinyiao, Hegu e Zhiyin durante a fase ativa do trabalho de parto. Os resultados demonstraram que a técnica em análise aparenta diminuir os escores de dor e encurtar o tempo da primeira fase do trabalho de parto. Dois dos estudos consultados apresentaram taxas inferiores de cesarianas nos grupos que receberam a invertenção. A acupressão pode figurar como alternativa não invasiva a ser utilizada por enfermeiros e outros profissinais treinados como meio de obter melhora na qualidade do atendimento à parturientes.

This integrative review aimed to seek evidence available in the literature addressing the use of acupressure during the progression of labor and for pain relief. Research was undertaken in the databases Scopus, Medline, Cinahl and SciELO, including 10 studies, published between 2002 and 2012, which applied acupressure on the Sanyinyiao, Hegu and Zhiyin points during the active phase of labor. The results showed that the technique under analysis reduces the pain scores and shortens the duration of the first phase of labor. Two of the studies consulted showed reduced rates of caesareans in the groups which received the intervention. Acupressure can figure as a non-invasive alternative to be used by nurses and other trained professionals as a means of obtaining improvements in the quality of care given to parturient women.

Esta revisión integrativa tuvo el objetivo de buscar evidencias disponibles en la literatura que hablan acerca del uso de la acupresión durante la evolución del parto y alivio del dolor. Fue realizada una investigación en las bases de datos Scopus, Medline, Cinahal y SciELO, viabilizando la inclusión de 10 estudios, publicados entre 2002 y 2012, que aplicaron la acupresión en los puntos Sanyinyiao, Hegu y Zhiyin durante la fase activa del trabajo de parto. Los resultados muestran que la técnica en análisis parece disminuir los niveles de dolor y acortar el tiempo de la primera fase del trabajo de parto. Dos de los estudios consultados presentaron tasas inferiores de cesáreas en los grupos en que fue hecha la intervención. La acupresión puede ser una alternativa no invasiva a ser utilizada por enfermeros y otros profesionales aptos como medio de obtener mejoría en la cualidad del atendimiento a las parturientes.

The beneficial effect of ST-36 (Zusanli) acupressure on postoperative gastrointestinal function in patients with colorectal cancer.

PURPOSE/OBJECTIVES: To evaluate the effectiveness of ST-36 (Zusanli) acupressure on recovery of postoperative gastrointestinal function in patients with colorectal cancer. DESIGN: A longitudinal, randomized, controlled trial design. SETTING: An urban medical center in Taiwan. SAMPLE: 60 patients with colorectal cancer who had undergone abdominal surgery. METHODS: Patients were randomly assigned to two groups, the ST-36 acupressure group (n = 30) and a sham acupressure group (n = 30). Patients in the ST-36 group received an acupressure procedure in a three-minute cycle performed three times per day during the five days after surgery. Patients in the control group received routine postoperative care and sham acupressure. Generalized estimating equations (GEEs) were used to gauge longitudinal effects of the two groups of patients. MAIN RESEARCH VARIABLES: Frequency of bowel sounds, the time to first flatus passage, first liquid intake, solid intake, and defecation. FINDINGS: Patients who received acupressure had significantly earlier flatus passage and time to liquid intake as compared to patients in the control group. Other main variables, including the first time to solid intake and defecation, did not show significant difference between the two groups. The GEE method revealed that all patients had increasing bowel sounds over time, and the experimental group had greater improvement of bowel motility than the control group within the period of 2-3 days postoperatively. CONCLUSIONS: ST-36 acupressure was able to shorten the time to first flatus passage, oral liquid intake, and improve gastrointestinal function in patients after abdominal surgery. IMPLICATIONS FOR NURSING: ST-36 acupressure can be integrated into postoperative adjunct nursing care to assist patients' postoperative gastrointestinal function. KNOWLEDGE TRANSLATION: Few studies have explored the effectiveness of acupressure techniques on promoting bowel sounds. Evidence from this study suggests stimulation of the ST-36 acupressure point can increase bowel sound frequency for patients with colorectal cancer in the first three days after surgery. Application of this technique may improve a patient's comfort after surgery.

Shiatsu for midwives: a touch relaxing.

This article outlines how shiatsu can be integrated into midwifery care by both midwives and shiatsu practitioners. It describes what shiatsu is and its value in maternity care. It concludes that there is much potential for the integration of shiatsu into midwifery practice although more research is needed.

The effects of stimulation of acupressure point p6 on postoperative nausea and vomiting: a review of literature.

Postoperative nausea and vomiting (PONV) can complicate and delay patient recovery from general and neuraxial anesthesia. Even with a new generation of anesthetic drugs and antiemetics, a high number of patients are affected by PONV. PONV has a multifactor etiology, but there are ways to reduce its occurrence. Although it is not a traditionally recognized method, stimulation of acupressure points, specifically P6, has been identified as a potentially effective method of reducing PONV. This study is a state of the science paper reviewing research on both pharmacologic and nonpharmacologic prophylaxis and various methods of acupressure. It was conducted to add information to the currently available knowledge regarding PONV in hopes of stimulating the use of acupressure for treatment of PONV. The study is divided into six categories: pathophysiology of PONV, background studies of PONV, nonpharmacologic prophylaxis, pharmacological prophylaxis, acupressure and related techniques, and benefits of routine antiemetic prophylaxis.

The efficacy of acupressure for decreasing agitated behaviour in dementia: a pilot study.

AIMS AND OBJECTIVES: To investigate the efficacy of acupressure in decreasing agitated behaviours associated with dementia. BACKGROUND: Agitated behaviour is found in nearly half of all patients who have dementia. The presence of these behaviours increases the likelihood of injury, weakness, dehydration and lack of sleep and contributes to caregiver frustration and fatigue. DESIGN: This pilot study was designed with subjects receiving both acupressure and the control treatment. Each subject served as his or her own control. Subjects received four weeks of acupressure protocols; to avoid a carry-over effect there was a treatment-free period of one week. Subjects then were visited by one of the investigators for a six-week period. METHODS: Participants were recruited from a nursing home caring specifically for patients with dementia. Twenty of the 31 subjects (64.5 %) completed the study, while 11 were discharged or hospitalized. All the subjects were assigned to an experimental protocol and had a six-week acupressure treatment program. Baseline data were collected in the first week. Individual treatment sessions began at the second week of the study and lasted 15 minutes, twice a day, five days a week for four weeks. After a treatment-free period of one week, all the subjects served as controls undergoing a four-week control protocol consisting of companionship and conversation. RESULTS: Comparison between the control and experimental phases indicated significant differences between the two groups on all outcome measures (Cohen-Mansfield Agitation Inventory, daily agitation records about physical attack, verbal and non-verbal attack and non-physical attack) with better results found during the acupressure phase. CONCLUSIONS: Acupressure is recommended as an efficacious and non-intrusive method for decreasing the agitation behaviours in patients with dementia. RELEVANCE TO CLINICAL PRACTICE: Conducting the acupressure treatment takes 15 minutes. It could provide caregivers with a viable alternative to deal with patients with dementia.

Alternative therapy applications for postoperative nausea and vomiting.

The potential for postoperative nausea and vomiting is present in any patient who undergoes surgery and both are unpleasant and potentially dangerous consequences of surgery. Three types of complementary and alternative therapies that may help patients with postoperative nausea and vomiting include acupressure, acupuncture, and aromatherapy.

Acupressure for nausea and vomiting in cancer patients receiving chemotherapy.

Practitioners working with patients undergoing chemotherapy regularly encourage them to use acupressure in the form of Sea Bands for the relief of treatment-related nausea and vomiting. This mini-review sets out to uncover and examine the evidence base for this recommendation. A mini systematic review was carried out to identify randomized controlled trials comparing the use of acupressure plus usual care with usual care alone. The population was adult patients receiving cancer chemotherapy. The outcome was nausea or vomiting duration or intensity. Searches on Medline, Embase, AMED, the Cochrane Library, Cancerlit and Cinahl identified two randomized controlled trials involving 482 patients with compared acupressure to no intervention control. The results suggest that acupressure may decrease nausea among patients undergoing chemotherapy but further work is required before conclusively advising patients on the efficacy of acupressure in preventing and treating chemotherapy-induced nausea.

The effect of acupressure with massage on fatigue and depression in patients with end-stage renal disease.

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, chi 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.

Effects of LI4 and BL 67 acupressure on labor pain and uterine contractions in the first stage of labor.

Acupressure is said to promote the circulation of blood and qi, the harmony of yin and yang, and the secretion of neurotransmitters, thus maintaining the normal functions of the human body and providing comfort. However, there has been little research-based evidence to support the positive effects of acupressure in the area of obstetric nursing. The purpose of this study is to determine the effect of LI4 and BL67 acupressure on labor pain and uterine contractions during the first stage of labor. An experimental study with a pretest and posttest control group design was utilized. A total of 127 parturient women were randomly assigned to three groups. Each group received only one of the following treatments, LI4 and BL67 acupressure, light skin stroking, or no treatment/conversation only. Data collected from the VAS and external fetal monitoring strips were used for analysis. Findings indicated that there was a significant difference in decreased labor pain during the active phase of the first stage of labor among the three groups. There was no significant difference in effectiveness of uterine contractions during the first stage of labor among the three groups. Results of the study confirmed the effect of LI4 and BL67 acupressure in lessening labor pain during the active phase of the first stage of labor. There were no verified effects on uterine contractions.

Acupressure for nausea: results of a pilot study.

PURPOSE/OBJECTIVES: To compare differences in nausea experience and intensity in women undergoing chemotherapy for breast cancer between those receiving usual care plus acupressure training and treatment and those receiving only usual care. DESIGN: Single-cycle, randomized clinical trial. SETTING: Outpatient oncology clinic in a major teaching medical center and a private outpatient oncology practice. SAMPLE: Seventeen women participated in the study. The typical participant was 49.5 years old (SD = 6.0), Caucasian (59%), not married/partnered (76%), on disability (53%), born a U.S. citizen (76%), and heterosexual (88%); lived alone (59%); had at least graduated from high school (100%); and had an annual personal income of $50,000 or greater (65%). METHODS: The intervention included finger acupressure bilaterally at P6 and ST36, acupressure points located on the forearm and by the knee. Baseline and poststudy questionnaires plus a daily log were used to collect data. MAIN RESEARCH VARIABLES: Nausea experience measured by the Rhodes inventory of Nausea, Vomiting, and Retching and nausea intensity. FINDINGS: Significant differences existed between the two groups in regard to nausea experience (p < 0.01) and nausea intensity (p < 0.04) during the first 10 days of the chemotherapy cycle, with the acupressure group reporting less intensity and experience of nausea. CONCLUSIONS: Finger acupressure may decrease nausea among women undergoing chemotherapy for breast cancer. IMPLICATIONS FOR NURSING PRACTICE: This study must be replicated prior to advising patients about the efficacy of acupressure for the treatment of nausea.