RESUMO
BACKGROUND: Despite the need to incorporate seniors from various settings into mindfulness-based empirical research, issues of geriatric frailties and non-compliance remain. This study aimed to evaluate the effects of a mindfulness-based elder care (MBEC) program on mental health and spiritual well-being among seniors with disabilities in long-term care residential settings. METHODS: This single-blind, randomized controlled trial (RCT) randomly assigned seventy-seven participants into an MBEC group or control group of an eight-week MBEC program. Participants were assessed every four weeks at baseline (T0), mid-intervention (T1), post-intervention (T2) and follow-up (T3) using the Geriatric Depression Scale Short Form (GDS-SF), the State-Trait Anxiety Inventory (STAI) and the Spiritual Well-Being Scale (SWBS), respectively. RESULTS: Linear mixed model (LMM) showed that MBEC participants' mental health improved significantly after completing the intervention; compared with controls, the MBEC group exhibited significantly lower anxiety (state-anxiety at T2; trait-anxiety at T2 and T3) and fewer depressive symptoms. Spiritual well-being was also significantly enhanced compared to that in the control group. CONCLUSIONS: MBEC has positive effects on both mental health and spiritual well-being outcomes among seniors with disabilities. In long-term care facilities, seniors with abilities have the potential to adhere to and engage in activities of a mindfulness-based intervention. This low risk, easily accessible, and effective 8-week program is recommended to be integrated into regular long-term care institutional routines. TRIAL REGISTRATION: This study was registered with Clinical Trial Registry (ClinicalTrials.gov - U.S. National Library of Medicine #NCT05123261. Retrospectively registered on 07/04/2021.). The CONSORT 2010 guidelines were used in this study for properly reporting how the randomized trial was conducted.
Assuntos
Ansiedade , Depressão , Pessoas com Deficiência , Atenção Plena , Idoso , Humanos , Ansiedade/terapia , Transtornos de Ansiedade , Depressão/terapia , Atenção Plena/métodos , Estados Unidos , Instituições Residenciais , Saúde Mental , Religião e MedicinaRESUMO
The traditional biomedical care approach has been unsatisfactory to meet the complex needs of seniors with long-term multimorbidity and irreversible disability, particularly for those living in residential LTC facilities. This study aimed to develop and evaluate the effectiveness of an 8-week biopsychosocial-spiritual (BPS-S) group intervention with the attempt to enhance quality of life (QoL) and meaning in life among senior residents with disability. This single-blind randomized controlled trail was conducted in eight residential LTC facilities. The primary outcome, 'participants' overall and subdomain QoL', and the secondary outcome, 'meaning in life', were repeatedly assessed, including four time points: before, mid- and post-intervention, and at a 1-month follow-up. A generalized linear mixed model (GLMM) was used to assess between-group differences over time. The post-intervention differences indicated significant higher improvement on senior residents' overall and all 4 domains of QoL, as well as their meaning in life, between the baseline and both times of post-intervention and 1-month follow-up. On the other hand, participants' family QoL have improved immediately in the midst of intervention. This study provides preliminary evidence to support the feasibility and effectiveness of an 8-week BPS-S group therapy. We recommend the BPS-S be integrated into routine institutional care activities to help maximize senior residents' own capacity for self-healing, achieve a state of harmonious balance between body, mind, social and spiritual relationships; and in turn, enhance holistic health of this group.
Assuntos
Psicoterapia de Grupo , Qualidade de Vida , Humanos , Idoso , Método Simples-CegoRESUMO
AIMS: To identify key factors influencing institutional nurses' self-perceived competencies in spiritual care. BACKGROUND: In the past decade, interest in spiritual care has been increasing; however, in long-term care facilities, limited knowledge is available about nurses' competencies in spiritual care. METHODS: The cross-sectional study was conducted with 202 nurses in 11 long-term care facilities. Data were collected in a survey using the Spirituality and Spiritual Care Rating Scale, the Nurse Spiritual Care Therapeutics Scale, the Spiritual Care Competence Scale and demographic questions. Data were analysed using stepwise linear regression. RESULTS: Study findings revealed that nurses' perceptions of spirituality and spiritual care, frequency of spiritual care provision and self-satisfaction with the spiritual care given all significantly predicted overall spiritual care competence, which together explain 58% of the total variance. CONCLUSIONS: Improving nurses' perceptions of spirituality and spiritual care and encouraging the performance of spiritual care may be an effective pathway to enhance the spiritual care competence of institutional nurses. IMPLICATIONS FOR NURSING MANAGEMENT: Additional continuing education on spiritual care topics and the establishment of clear guidance and support from institutional administrators are required to enable nurses to deal with spiritual issues as they arise and improve the quality of holistic care.
Assuntos
Enfermeiras e Enfermeiros , Terapias Espirituais , Estudos Transversais , Humanos , Assistência de Longa Duração , Espiritualidade , Inquéritos e QuestionáriosRESUMO
AIM: To determine whether acupressure can prevent or relieve the adverse drug reactions (ADRs) of anti-tuberculosis drugs. BACKGROUND: People receiving drug treatment for TB often experience ADRs that may cause them to stop taking their medication. Acupressure is a form of traditional Chinese medicine that can be applied to alleviate or prevent disease symptoms. DESIGN: A double-blinded, repeated-measures clinical trial in hospitals in Taiwan was carried out from April 2015 - May 2017. METHODS: Convenience sampling was used to select 32 people (15 for the experimental group and 17 for the control group) aged >20 years who were taking anti-tuberculosis drugs. The people were randomized to receive 4-week of true acupressure and 4-weeks of sham acupressure. Acupressure therapy was given by a researcher in all cases. Both groups received treatment once per day on weekdays, with 15 min for each acupressure session. Outcomes (gastrointestinal irritation and adverse skin reactions) were assessed according to the people feedback and the physicians' recordings during the treatment course, and during monthly follow-up visits for 6 months thereafter. RESULTS: Both groups typically experienced gastrointestinal irritation and adverse skin reactions within 2 months of beginning anti-tuberculosis drug treatment. The 4-weeks intervention involving relevant acupressure points successfully relieved both types of side effects in both immediate and delayed manner. CONCLUSIONS: When correctly implemented, acupressure can prevent and relieve the ADRs of anti-tuberculosis drugs, and motivate people to complete their treatment course.
Assuntos
Acupressão/métodos , Antituberculosos/efeitos adversos , Antituberculosos/uso terapêutico , Toxidermias/fisiopatologia , Efeitos Colaterais e Reações Adversas Relacionados a Medicamentos/terapia , Trato Gastrointestinal/fisiopatologia , Tuberculose/tratamento farmacológico , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Ensaios Clínicos Controlados Aleatórios como Assunto , Taiwan , Resultado do TratamentoRESUMO
BACKGROUND: Older adults in residential settings frequently suffer from functional decline, mental illness, and social isolation, which make them more vulnerable to spiritual distress. However, empirical evidence of the interrelationships between physiopsychosocial variables and spiritual well-being are still lacking, limiting the application of the biopsychosocial-spiritual model in institutional healthcare practice. AIMS: To explain the mechanisms by which these variables are linked, this cross-sectional study tested a causal model of predictors of spiritual well-being among 377 institutionalized older adults with disability using a structural equation modeling approach. METHODS: The primary variables in the hypothesized model were measured using the Barthel Index for functional ability, the Geriatric Depression Scale-short form for depression, the Personal Resources Questionnaire 85-Part 2 for perceived social support, and the Spiritual Well-Being Scale for spiritual well-being. RESULTS: The model fit indices suggest that the hypothesized model had a reasonably adequate model fit (χ2 = 12.18, df = 6, p = .07, goodness-of-fitness index [GFI] = 0.99, adjusted GIF index [AGFI] = 0.93, nonnormed fit index [NFI] = 0.99, comparative fit index [CFI] = 0.99). In this study, perceived social support and depression directly affected spiritual well-being, and functional ability indirectly affected spiritual well-being via perceived social support or depression. In addition, functional ability influenced perceived social support directly, which in turn influenced depression and ultimately influenced spiritual well-being. DISCUSSION: This study results confirm the effect of physiopsychosocial factors on institutionalized older adults' spiritual well-being. However, the presence and level of functional disability do not necessarily influence spiritual well-being in late life unless it is disruptive to social relationships and is thus bound to lead to low perceived social support and the onset of depression. LINKING EVIDENCE TO ACTION: The findings address the fact that the practice of spirituality is multidimensional and multileveled. Psychosocial interventions for institutionalized elders with disabilities should focus on increasing nurse-patient interaction and providing access to meaningful social activities to improve mental health and spiritual well-being.
Assuntos
Geriatria/tendências , Psicologia/normas , Qualidade de Vida/psicologia , Espiritualidade , Idoso , Idoso de 80 Anos ou mais , Estudos Transversais , Prática Clínica Baseada em Evidências/métodos , Feminino , Humanos , Masculino , Psicometria/instrumentação , Psicometria/métodos , Inquéritos e Questionários , TaiwanRESUMO
AIMS AND OBJECTIVES: This study aimed to evaluate the level of care quality received by disabled older patients residing at home vs. those residing in institutions. BACKGROUND: Taiwan has an aging society and faces issues of caring for disabled older patients, including increasing needs, insufficient resources and a higher economic burden of care. DESIGN: Retrospective study extracting patient data from Taiwan's National Health Insurance database. METHODS: We enrolled 76,672 disabled older patients aged 65 years and older who resided at home or institutions and had submitted claims for coverage of National Health Insurance for home care received for the first time between 2004-2006. Propensity score matching was applied to create a home-care group and an institutional-care group with 27,894 patients each. Indicators of care quality (emergency services use, hospitalisation, infection, pressure ulcers, death) within the first year were observed. RESULTS: The home care group had significantly higher emergency services use, fewer hospital admissions and fewer infections, but had significantly higher occurrence of pressure ulcers. The institutional-care group had significantly lower time intervals between emergencies, fewer deaths, lower risk of emergencies and lower pressure ulcer risk. Males had significantly higher emergency services use than females, and higher risk of hospital admission and death. CONCLUSIONS: Care quality indicators for elder care are significantly different between home care and institutional care. The quality of home care is associated with higher emergency services use and pressure ulcer development, and institutional care is associated with number of infections and hospitalisations. RELEVANCE TO CLINICAL PRACTICE: Care quality indicators were significantly different between home-care and institutional-care groups and were closely associated with the characteristics of individual patients' in the specific settings. Nursing capabilities must be directed towards reducing unnecessary care quality-related events among high-risk disabled older patients.
Assuntos
Pessoas com Deficiência , Serviços de Assistência Domiciliar , Institucionalização , Qualidade da Assistência à Saúde , Fatores Etários , Idoso , Idoso de 80 Anos ou mais , Serviços Médicos de Emergência , Feminino , Hospitalização , Humanos , Masculino , Programas Nacionais de Saúde , Estudos Retrospectivos , TaiwanRESUMO
OBJECTIVES: To examine adherence to relaxation guided imagery in women experiencing preterm labor as well as predictors influencing adherence. METHODS: This study used a longitudinal follow-up approach. Each of the 57 participating women received a mini-MP3 player containing a 13-minute relaxation guided imagery audio program that they were instructed to follow daily until giving birth. Follow-up interviews were conducted weekly. A generalized estimating equation was used to predict adherence. RESULTS: The total adherence rate was 58%. Higher adherence was predicted by the presence of at least a college degree (p=0.006), greater perceived stress (p=0.006), a higher risk of preterm delivery (p<0.001), and greater relaxation effects (p=0.028). Older maternal age was associated with lower adherence (p=0.001). In addition, adherence decreased significantly over time (p<0.001). Adherence was not related to marital status, employment, parity, the baseline level of anxiety, or hospitalization. CONCLUSIONS: Pregnant women with a high risk for preterm birth and greater perceived stress showed higher adherence to relaxation guided imagery. For women with a lower adherence to relaxation guided imagery, health care professionals may consider individual preferences regarding relaxation techniques.
Assuntos
Imagens, Psicoterapia/métodos , Trabalho de Parto Prematuro/psicologia , Cooperação do Paciente/estatística & dados numéricos , Terapia de Relaxamento/métodos , Estresse Psicológico/terapia , Adulto , Feminino , Seguimentos , Humanos , Estudos Longitudinais , Gravidez , Adulto JovemRESUMO
BACKGROUND: One of the most common symptoms observed in patients with dementia is agitation, and several non-pharmacological treatments have been used to control this symptom. However, because of limitations in research design, the benefit of non-pharmacological treatments has only been demonstrated in certain cases. The purpose of this study was to compare aroma-acupressure and aromatherapy with respect to their effects on agitation in patients with dementia. METHODS: In this experimental study, the participants were randomly assigned to three groups: 56 patients were included in the aroma-acupressure group, 73 patients in the aromatherapy group, and 57 patients in the control group who received daily routine as usual without intervention. The Cohen-Mansfield Agitation Inventory (CMAI) scale and the heart rate variability (HRV) index were used to assess differences in agitation. The CMAI was used in the pre-test, post-test and post-three-week test, and the HRV was used in the pre-test, the post-test and the post-three-week test as well as every week during the four-week interventions. RESULTS: The CMAI scores were significantly lower in the aroma-acupressure and aromatherapy groups compared with the control group in the post-test and post-three-week assessments. Sympathetic nervous activity was significantly lower in the fourth week in the aroma-acupressure group and in the second week in the aromatherapy group, whereas parasympathetic nervous activity increased from the second week to the fourth week in the aroma-acupressure group and in the fourth week in the aromatherapy group. CONCLUSIONS: Aroma-acupressure had a greater effect than aromatherapy on agitation in patients with dementia. However, agitation was improved in both of the groups, which allowed the patients with dementia to become more relaxed. Future studies should continue to assess the benefits of aroma-acupressure and aromatherapy for the treatment of agitation in dementia patients. TRIAL REGISTRATION: ChiCTR-TRC-14004810; Date of registration: 2014/6/12.
Assuntos
Acupressão/métodos , Aromaterapia , Demência/complicações , Agitação Psicomotora/terapia , Idoso , Idoso de 80 Anos ou mais , Feminino , Frequência Cardíaca , Humanos , Masculino , Agitação Psicomotora/etiologia , Resultado do TratamentoRESUMO
AIM: This paper is a report of an experimental study of the effects of relaxation-training programme on immediate and prolonged stress responses in women with preterm labour. BACKGROUND: Hospitalized pregnant women with preterm labour experience developmental and situational stress. However, few studies have been performed on stress management in such women. METHODS: An experimental pretest and repeated post-test design was used to compare the outcomes for two groups in northern Taiwan from December 2008, to May 2010. A total of 129 women were randomly assigned to an experimental (n = 68) or control (n = 61) group. The experimental group participants were instructed to listen daily to a 13-minute relaxation programme. Measurements involved the stress visual analogue scale, finger temperatures, State Trait Anxiety Inventory, Perceived Stress Scale and Pregnancy-related Anxiety. Two-way analysis of variance and hierarchical linear modelling were used to analyse the group differences. RESULTS: Compared with those in the control group, participants in the experimental group showed immediate improvements in the stress visual analogue scale scores and finger temperatures. The State Trait Anxiety Inventory-State subscale score for the experimental group was significantly lower than that for the control group (P = 0·03). However, no statistically significant differences for the Perceived Stress Scale and Pregnancy-related Anxiety scores were found between the experimental group and the control group. CONCLUSIONS: The relaxation-training programme could improve the stress responses of women with preterm labour.
Assuntos
Trabalho de Parto Prematuro/terapia , Complicações na Gravidez/terapia , Cuidado Pré-Natal , Terapia de Relaxamento/métodos , Estresse Psicológico/terapia , Adaptação Psicológica , Adulto , Análise de Variância , Ansiedade/terapia , Pesquisa em Enfermagem Clínica , Feminino , Dedos/irrigação sanguínea , Hospitalização , Humanos , Modelos Lineares , Tocologia , Trabalho de Parto Prematuro/enfermagem , Trabalho de Parto Prematuro/psicologia , Gravidez , Complicações na Gravidez/enfermagem , Complicações na Gravidez/psicologia , Teoria Psicológica , Fluxo Sanguíneo Regional , Terapia de Relaxamento/educação , Índice de Gravidade de Doença , Temperatura Cutânea/fisiologia , Estresse Psicológico/enfermagem , Estresse Psicológico/fisiopatologia , Taiwan , Fatores de Tempo , Resultado do TratamentoRESUMO
BACKGROUND: Prenatal maternal stress is associated with adverse birth outcomes. Few studies have been published on the effectiveness of relaxation techniques focusing on women with preterm labour. OBJECTS: The object of this study was to examine the effectiveness of a relaxation training program on pregnancy outcomes in women experiencing preterm labour. DESIGN: A single-blinded, controlled clinical trial was used. SETTINGS: The study was conducted in two hospitals. Both of the study hospitals located in northern Taiwan are also large teaching hospitals and share the same treatment protocols of preterm labour. PARTICIPANTS: Inclusion criteria were being pregnant and diagnosed with preterm labour, singleton, hospitalized at time of entry into the study, at gestation between 20 and 34 weeks, and having a cervical dilatation of less than 3 cm. Exclusion criteria were if they had one or any combination of the following: antepartum hemorrhage, infection, hypertension, gestational diabetes mellitus, or immunologic disease. METHODS: The experimental group (n=68) participants received a mini mp3 player containing a 13-min relaxation audio program, which they were instructed to follow daily, while the control group (n=59) received only routine prenatal care. Pregnancy outcomes were obtained from medical charts after each woman gave birth. RESULTS: Survival analysis demonstrated that the experimental group had a significant pregnancy prolongation compared to the control group (p=0.048). Participants receiving the relaxation training program had a significant lower proportion of extreme preterm birth, a higher rate of not being admitted to a NICU, and a lower rate of stay days within 30 days when compared with the control group. No significant differences were found on pregnancy outcomes in terms of the rate of preterm birth, low birth weight, Apgar score at 1 and 5 min, mode of birth, and perinatal mortality between the two groups. CONCLUSIONS: Relaxation training for women with preterm labour is effective in delaying of delivery and enhancing positive pregnancy outcomes. This relaxation intervention is cost-effective, noninvasive, and easily applicable in women with preterm labour.
Assuntos
Trabalho de Parto Prematuro , Resultado da Gravidez , Terapia de Relaxamento , Adulto , Índice de Apgar , Parto Obstétrico , Feminino , Humanos , Recém-Nascido , Unidades de Terapia Intensiva Neonatal/estatística & dados numéricos , Admissão do Paciente , Gravidez , Método Simples-Cego , Natimorto , TaiwanRESUMO
AIMS: To study the effect of a music programme during lunchtime on problem behaviour among institutionalised older residents with dementia. BACKGROUND: Symptoms of dementia among older people include depression, problems with memory, insomnia and problem behaviours. Problem behaviour has been identified by families and nurses as the greatest challenge that needs to be addressed. Several studies have found that music therapy can reduce problem behaviours among dementia sufferers and, based on this finding, music has been recommended for incorporation as part of dementia management. DESIGN: This study used a quasi-experimental design with an eight-week time series follow-up. The intervention was background music when residents had their lunch meal. METHODS: A purposive sampling technique was used. Forty-one participants were selected from an institution housing residents with dementia located in a city in Taiwan. RESULTS: The mean age of participants was 81.68 (SD 6.39) years old. The mean score for Mini-Mental State Examination (MMSE) was 10.66 (SD 6.85). The mean of Barthel Activity of Daily Living score was 56.83 (SD 38.12). The results showed that the music programme reduced, significantly, physical and verbal aggressive behaviour among the older residents with dementia. The study identified that there was a one-week time lag between the implementation of the music programme and a significant effect on the residents. CONCLUSIONS: The results from this study suggested that music is able to reduce the degree of problem behaviours among the older residents with dementia and this helps to ease work-load of nurse aides and nurses during meal times. RELEVANCE TO CLINICAL PRACTICE: The results may serve as a reference for the future treatment of problem behaviour among the older with dementia.
Assuntos
Controle Comportamental/métodos , Sintomas Comportamentais/prevenção & controle , Demência/enfermagem , Serviços de Alimentação , Musicoterapia , Idoso , Idoso de 80 Anos ou mais , Demência/psicologia , Feminino , Instituição de Longa Permanência para Idosos , Humanos , Masculino , Casas de Saúde , Método Simples-Cego , TaiwanRESUMO
OBJECTIVES: To explore the effectiveness of acupressure and Montessori-based activities in decreasing the agitated behaviors of residents with dementia. DESIGN: A double-blinded, randomized (two treatments and one control; three time periods) cross-over design was used. SETTING: Six special care units for residents with dementia in long-term care facilities in Taiwan were the sites for the study. PARTICIPANTS: One hundred thirty-three institutionalized residents with dementia. INTERVENTION: Subjects were randomized into three treatment sequences: acupressure-presence-Montessori methods, Montessori methods-acupressure-presence and presence-Montessori methods-acupressure. All treatments were done once a day, 6 days per week, for a 4-week period. MEASUREMENT: The Cohen-Mansfield Agitation Inventory, Ease-of-Care, and the Apparent Affect Rating Scale. RESULTS: After receiving the intervention, the acupressure and Montessori-based-activities groups saw a significant decrease in agitated behaviors, aggressive behaviors, and physically nonaggressive behaviors than the presence group. Additionally, the ease-of-care ratings for the acupressure and Montessori-based-activities groups were significantly better than for the presence group. In terms of apparent affect, positive affect in the Montessori-based-activities group was significantly better than in the presence group. CONCLUSION: This study confirms that a blending of traditional Chinese medicine and a Western activities program would be useful in elderly care and that in-service training for formal caregivers in the use of these interventions would be beneficial for patients
Assuntos
Acupressão , Demência/terapia , Agitação Psicomotora/terapia , Idoso , Idoso de 80 Anos ou mais , Estudos Cross-Over , Método Duplo-Cego , Feminino , Processos Grupais , Humanos , MasculinoRESUMO
Acupressure is a longstanding treatment in traditional Chinese medicine, and involves the stimulation of certain acupoints by pressing with the fingers or moving limbs or joints slowly to promote health or offer comfort. Acupressure treatment, which conforms to the same principles as acupuncture, is characterized by the pressing of acupuncture points and sense of chi. Chi is regarded as the universal life energy and the vital potential that is inborn in each person and which maintains that person until death. Sleep disturbance, pain and agitation are common health problems in gerontological nursing. Both pharmacological and non-pharmacological forms of treatment have been applied to deal with the problems. Studies have revealed, however, that the benefits that the elderly derive from drug use might not outweigh the adverse effects of such treatment. Non-pharmacological forms of treatment, like acupressure, though, not only caused no side effects, but also relieved the symptoms. Also, nurses, nurse's aides, or elderly people who have received training in acupressure can administer this non-pharmacological treatment independently. Therefore, this paper addresses common health problems in the elderly, such as sleep disturbance, pain, and agitation, the principles and maneuvers of acupressure, and application of acupressure in the elderly.
Assuntos
Acupressão/métodos , Idoso , Doença de Alzheimer/terapia , Humanos , Manejo da Dor , Transtornos do Sono-Vigília/terapiaRESUMO
OBJECTIVES: The onset of depression is often triggered by breathlessness in persons with chronic obstructive pulmonary disease (COPD). It is hypothesized that these are the psychologic consequences of chronic dyspnea. Lessening dyspnea might alleviate depressive symptoms. Acupressure has been shown in other studies to produce relaxation. The aim of this study was to determine if it would lessen dyspnea and reduce depression in patients with COPD. SUBJECTS AND DESIGN: Subjects diagnosed with COPD were chosen from one medical center and three regional hospitals in Taipei, Taiwan. A randomized, block experimental design was used, with subjects and the data collector blinded. Using age, gender, pulmonary function, smoking, and steroid use as matching factors, 44 subjects were randomly assigned to either the true acupressure or the sham acupressure groups. The true acupressure group received a program of acupressure using appropriate acupoints that promote relaxation and relieve dyspnea. The sham acupressure group received acupressure using sham acupoints different from the meridians and ganglionic sections of the true acupressure group. Both acupressure programs lasted 4 weeks, with five sessions per week that lasted 16 minutes per session. OUTCOME MEASURES: The Geriatric Depression Scale (GDS) and Dyspnea Visual Analogue Scale (DVAS) were administered prior to the program as a baseline, and again following the completion of the 4-week program. Oxygen saturation and other physiological indicators were measured before and after each session. RESULTS: The results of this study showed that the GDS scores, DVAS scores, oxygen saturation, and physiological indicators of the true acupressure group were significantly improved, compared to those of the sham acupressure group. CONCLUSIONS: These findings provide health professionals with an evidence-based intervention to use with persons with COPD. Applying this acupressure program in clinical practice, communities, and long-term care units may lessen chronic dyspnea and depression in persons with COPD.
Assuntos
Acupressão/métodos , Depressão/terapia , Dispneia/terapia , Doença Pulmonar Obstrutiva Crônica/terapia , Idoso , Depressão/etiologia , Dispneia/etiologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Medição da Dor/métodos , Doença Pulmonar Obstrutiva Crônica/complicações , Qualidade de Vida , Testes de Função Respiratória , Método Simples-Cego , Inquéritos e Questionários , Taiwan , Fatores de Tempo , Resultado do TratamentoRESUMO
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.
Assuntos
Acupressão/métodos , Demência/complicações , Agitação Psicomotora/prevenção & controle , Acupressão/enfermagem , Acupressão/normas , Pontos de Acupuntura , Idoso , Idoso de 80 Anos ou mais , Protocolos Clínicos , Efeitos Psicossociais da Doença , Estudos Cross-Over , Feminino , Humanos , Masculino , Avaliação em Enfermagem , Pesquisa em Avaliação de Enfermagem , Casas de Saúde , Variações Dependentes do Observador , Projetos Piloto , Agitação Psicomotora/diagnóstico , Agitação Psicomotora/etiologia , Índice de Gravidade de Doença , Taiwan , Fatores de Tempo , Resultado do Tratamento , Carga de TrabalhoRESUMO
BACKGROUND: Patients with chronic obstructive pulmonary disease (COPD) suffer from dyspnoea in their daily life and this may be increased by anxiety. Acupressure may promote relaxation and relieve dyspnoea. Thus, it is appropriate to explore the effectiveness of acupressure on dyspnoea in patients with COPD. AIMS: To compare outcomes of acupressure using sham acupoints on different meridians and ganglionic sections with that using true acupoints, in patients with COPD who are living at home. METHODS: Patients diagnosed with COPD were selected from a medical centre and three regional hospitals in Taipei. A randomized block experimental design was used. Using age, sex, pulmonary function, smoking, and steroid use as matching factors, 44 patients were randomly assigned either to a true acupoint acupressure or a sham group. The true acupoint acupressure group received a programme to decrease dyspnoea. Those in the sham group received acupressure using sham pressure points. Both acupressure programmes consisted of five sessions per week lasting 16 minutes per session, extending over 4 weeks for a total of 20 sessions. Before acupressure was initiated and at the conclusion of the 20th session, the Pulmonary Functional Status and Dyspnoea Questionnaire-modified scale and the Spielberger State Anxiety scale were administered, and a 6-minute walking distance test was performed. Physiological indicators of oxygen saturation and respiratory rate were measured before and after every session. RESULTS: The results of this study showed that the pulmonary function and dyspnoea scores, 6-minute walking distance measurements, state anxiety scale scores, and physiological indicators of the true acupoint acupressure group improved significantly compared with those of the sham group. CONCLUSIONS: The findings suggest that acupressure can be used as a nursing intervention to improve dyspnoea in patients with COPD.
Assuntos
Acupressão/métodos , Dispneia/terapia , Doença Pulmonar Obstrutiva Crônica/enfermagem , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Masculino , Doença Pulmonar Obstrutiva Crônica/prevenção & controle , Resultado do TratamentoRESUMO
BACKGROUND: Post-operative nausea and vomiting is a common complication following general anaesthesia. Traditional Chinese medicine indicates that acupressure therapy may reduce nausea and vomiting in certain ailments. AIM(S) OF THE STUDY: The aim of this study was to examine the effect of stimulating two acupressure points on prevention of post-operative nausea and vomiting. DESIGN AND METHODS: A randomized block experimental design was used. The Rhodes Index of Nausea, Vomiting and Retching (INVR) questionnaire was used as a tool to measure incidence. To control the motion sickness variable, the subjects who underwent functional endoscopic sinus surgery (FESS) under general anaesthesia were randomly assigned to a finger-pressing group, a wrist-band group, and a control group. There were 150 subjects in total with each group consisting of 50 subjects. The acupoints and treatment times were similar in the finger-pressing group and wrist-band pressing group, whereas only conversation was employed in the control group. RESULTS: Significant differences in the incidence of the post-operative nausea and vomiting were found between the acupressure, wrist-band, and control groups, with a reduction in the incidence rate of nausea from 73.0% to 43.2% and vomiting incidence rate from 90.5% to 42.9% in the former. The amount of vomitus and the degree of discomfort were, respectively, less and lower in the former group. CONCLUSION: In view of the total absence of side-effects in acupressure, its application is worthy of use. This study confirmed the effectiveness of acupressure in preventing post-operative nausea and vomiting.