Effects of Auricular Acupressure in Patients on Hemodialysis.

BACKGROUND: Although studies on the effectiveness of self-management in limiting fluid intake in patients on hemodialysis have been conducted extensively, xerostomia, which is a powerful stimulus of fluid intake, has received scarce attention. PURPOSE: The purpose of this study was to examine the effects of a 4-week auricular acupressure treatment on xerostomia, salivary flow rate, interdialytic weight gain, constipation, and diet-related quality of life in patients on hemodialysis in Korea. METHODS: This was a randomized controlled trial. Sixty patients on hemodialysis were randomly assigned to either the experimental group (n = 30) or the control group (n = 30). The experimental group received an auricular acupressure intervention, which included the application of skin tape with a Semen vaccariae seed on the five auricular acupoints, including the large intestine (CO7), San Jiao (CO17), middle triangular fossa (TF3), spleen (CO13), and upper tragus (TG1), for 4 weeks. The control group received only the application of skin tape without a seed on the same auricular acupoints for the same period. The outcome variables were as follows: xerostomia, measured using the visual analog scale; salivary flow rate, measured using the unstimulated whole saliva absorbed in oral cotton; interdialytic weight gain; the constipation assessment scale score; and the Quality of Life Related to Dietary Change Questionnaire results. RESULTS: The experimental group scored significantly better than the control group in terms of xerostomia (p = .004), salivary flow rate (p = .010), constipation (p = .009), and diet-related quality of life (p < .001). CONCLUSIONS/IMPLICATIONS FOR PRACTICE: Auricular acupressure may be an important tool for alleviating the negative symptoms of xerostomia and for improving quality of life in patients on hemodialysis. Nurses caring for patients on hemodialysis with both xerostomia and constipation may teach auricular acupressure to help patients self-manage their discomfort.

Correlations Between Auricular Tenderness and Symptoms in Korean Adults.

The purpose of this study was to examine the correlation between auricular tenderness and subjective symptoms. A descriptive correlational study design was followed, which was also the second analysis of a randomized controlled trial. This study was performed in the Republic of Korea from September 2013 to February 2017. The Patient Health Questionnaire-9, the Constipation Assessment Scale, and the Nicotine Dependence Syndrome Scale were used. One hundred thirty-three participants displayed ear tenderness, whereas 84 participants did not. Adults with auricular tenderness reported more symptoms, such as sputum, rhinitis, constipation, stress, mood swings, and depressive symptoms compared with adults without (with tenderness: 4.14 ± 2.94, without tenderness: 2.92 ± 2.45; t = 3.32, P = .001). Finally, auricular acupressure points were positively correlated with various symptoms such as sputum, constipation, nicotine addiction, stress, cough, and rhinitis. Auricular palpation could be used to detect a disease at an early stage.

The Effect of Auricular Acupressure and Positive Group Psychotherapy With Motivational Interviewing for Smoking Cessation in Korean Adults.

The aim of this study was to investigate the effects of positive group psychotherapy with auricular acupressure on tobacco withdrawal symptoms and smoking cessation. This study used a randomized controlled trial design. Participants were randomly assigned to 1 of 3 groups: group 1 (counseling and auricular acupressure), group 2 (counseling and placebo acupressure), and the control group (self-help for smoking cessation). Positive group psychotherapy and auricular acupressure were performed once a week for 6 weeks. The smoking cessation rates for 1 year in groups 1 and 2 were higher than that in the control group (9.5%, 15.6%, and 0%, respectively; odd ratio: 7.98, P = .019, n = 109). There was a significant difference of tobacco withdrawal symptoms among the 3 groups over 4 weeks (F = 2.9, P = .04). The mean differences between week 1 and week 4 among the 3 groups were statistically significant (4.7 ± 6.96, 5.18 ± 7.9, and 0.14 ± 7.15, F = 4.25, P = .018).

Combining Education With Auricular Acupressure to Facilitate Smoking Cessation in Young Adults.

Young adults rarely use pharmacotherapy to cease smoking. This prospective experimental study was performed using a nonpharmacotherapy design. Smoking cessation education combined with auricular acupressure may be more attractive. The key factor for superior smoking cessation was the decrease of nicotine dependence in the early stage of smoking cessation.

Effects of Auricular Acupressure on Pain Management: A Systematic Review.

OBJECTIVE: Nearly half of hospitalized patients in the United States have reported experiencing pain even while undergoing treatment for pain. Analgesic use is the most common type of treatment for pain management. Many patients who experience pain seek nonpharmacologic interventions to manage their pain, including forms of complementary or alternative medicine such as auricular acupressure (AA). DESIGN: This study conducted the first systematic review of the studies that have evaluated the effect of AA as an adjunct on pain management. DATA SOURCES: We searched PubMed, CINAHL, Embase, Google Scholar, and Wiley for randomized controlled trials on AA. REVIEW/ANALYSIS METHODS: The pain outcomes were pain severity and analgesic consumption. Methodologic quality was also evaluated. Fifteen randomized controlled trials were included in this analysis. RESULTS: Twelve studies reported statistically significant improvement in the pain outcomes of AA treatment compared with the sham or standard care groups. When methodologic quality was assessed, the selected studies had medium quality, but there was a lack of high quality. This supports that the use of AA for patients may enhance self-management for their pain. However, the small number of studies and the lack of consistent rigorous methodology across the studies preclude definitive statements regarding the effectiveness of AA. CONCLUSION: The nursing implications based on this review is that education about AA and complementary or alternative medicine therapies for health care providers may assist them in providing pain control for their patients. In addition, we need to continue research to build on evidence on the effect of AA on pain management.

Efficacy of Non-Invasive Auricular Acupressure for Treating Constipation in Leukemia Patients Undergoing Chemotherapy: A Systematic Review.

BACKGROUND: The aim of this systematic review was to evaluate the available evidence from randomized controlled trials (RCTs) of auricular acupressure (AA) therapy for preventing constipation in leukemia patients undergoing chemotherapy. METHODS: We searched 5 English databases and 4 Chinese databases, from their inception until August 2017. Quantitative syntheses of RCTs were conducted using RevMan 5.3 software. Study selection, data extraction, and validation were performed independently by 2 reviewers. Cochrane criteria for risk-of-bias were used to assess the methodological quality of the trials. RESULTS: Five RCTs met the inclusion criteria, and most were of low methodological quality. All RCTs compared AA + routine care with routine care alone. Our analysis found that complementary effects of AA can improve the scores of the Bristol Stool Form (BSF), the Constipation Assessment Scale (CAS), and the Patient Assessment of Constipation-Quality of Life (PAC-QOL). However, the same positive results were not found in terms of the Fatigue Severity Scale (FSS), the EuroQoL 5-domain (EQ-5D), and the Hospital Anxiety Depression Scale (HADS). CONCLUSIONS: Overall, as a potential safety therapy, AA may be recommended in addition to routine care including use of laxatives to prevent constipation in leukemia patients undergoing chemotherapy. In the future, more rigorous RCTs must be conducted to overcome the limitations of our existing data and to confirm the effect and safety of AA for managing constipation in leukemia patients undergoing chemotherapy.

[Implementation of auricular acupuncture by the NADA protocol in geriatric patients suffering from major depression : A mixed methods feasibility study]. / Implementierung von Ohrakupunktur nach dem NADA-Protokoll bei geriatrischen Patienten mit einer depressiven Episode : Eine Machbarkeitsstudie mit gemischten Methoden.

BACKGROUND: The number of elderly patients with depression has steadily increased in recent years; therefore, new treatment options and therapy approaches are urgently needed to improve treatment in this patient group. The aim of this project was to evaluate the additional application of auricular acupuncture according to the NADA protocol in patients treated in a daytime ward in terms of acceptability and feasibility. METHODS: A total of 20 psychogeriatric patients from a daytime clinic suffering from major depression (ICD-10: F32-F33) received auricular acupuncture in addition to the standard treatment three times per week over a treatment course of 3 weeks. Semi-structured interviews were conducted with the participants and the therapeutic team and qualitative content analyses were carried out. Depression, cognition, quality of sleep and quality of life were assessed using validated quantitative instruments. RESULTS: There was a 95 % utilization of the therapy. The qualitative analysis showed a high acceptance by all participants. The dominant perception by the patients was a positive expectation and conviction that acupuncture was an effective form of therapy without side effects, which could contribute to recovery. The majority of patients also felt that there was an improvement in the symptoms. The quantitative analysis revealed significant improvements in the target parameters. CONCLUSION: The acceptance of the intervention by the patients and the willingness of the interdisciplinary team underlines the feasibility of this implementation within a fixed therapeutic concept. The significant pre-post improvements indicated a potential benefit and should be verified in further efficacy studies.

Exploring Self-Reported Benefits of Auricular Acupuncture Among Veterans With Posttraumatic Stress Disorder.

PURPOSE: Auricular acupuncture treatments are becoming increasingly available within military treatment facilities, resulting in an expansion of nonpharmacologic treatment options available to veterans with posttraumatic stress disorder (PTSD). This study aimed to explore the self-reported benefits of auricular acupuncture treatments for veterans living with PTSD. DESIGN: A qualitative research methodology, thematic content analysis, was used to analyze data. METHOD: Seventeen active duty veterans with PTSD provided written comments to describe their experiences and perceptions after receiving a standardized auricular acupuncture regimen for a 3-week period as part of a pilot feasibility study. FINDINGS: A variety of symptoms experienced by veterans with PTSD were improved after receiving auricular acupuncture treatments. Additionally, veterans with PTSD were extremely receptive to auricular acupuncture treatments. Four themes emerged from the data: (1) improved sleep quality, (2) increased relaxation, (3) decreased pain, and (4) veterans liked/loved the auricular acupuncture treatments. CONCLUSIONS: Veterans with PTSD reported numerous benefits following auricular acupuncture treatments. These treatments may facilitate healing and recovery for veterans with combat-related PTSD, although further investigations are warranted into the mechanisms of action for auricular acupuncture in this population.

Status and strategies analysis on international standardization of auricular acupuncture points.

OBJECTIVE: To supply literature for developing an international standard of auricular acupuncture points. METHODS: Electronic database searches were conducted in the Chinese National Knowledge Infrastructure and VIP, and the Western databases, Pubmed, the National Science and Technology Library, and the German Journal of Acupuncture, from 1990 to April, 2012. We also searched the documents of international symposiums for auricular acupuncture points (AAPs). Keywords were "auricular points", "auricular acupuncture points", "ear points", or "auriculotherapy". RESULTS: Basic and clinical research on AAPs was performed in China, the United States, France, and Germany. Clinical AAP research was done in Italy, Austria, Switzerland, Spain, the UK, Holland, Japan, Russia, and Africa. However, AAP research was not communicated internationally. The World Federation of Acupuncture-Moxibustion Societies recommended international standard of auricular acupuncture points (ISAAPs). Standardized nomenclature and locations of AAPs would provide a solid basis to draft an international standard organization. CONCLUSION: Experts need to find common points from different countries or regions, provide evidence of different ideas, and list the proposal as a recommendation for an international standard.

[Debating some issues on the national standard Standardized Manipulation of Acupuncture and Moxibustion, part 3: Auricular Acupuncture].

The main difficulties and disputable problems on develping the national standard Standardized Manipulation of Acupuncture and Moribustion, Part 3: Auricular Acupuncture are debated in this paper from the three aspects of its meaning, scientific basis and key point. The difficult points mainly include manipulation standandization of auricular acupuncture, basis and science of the standards stipulated, selection of technical terms and definition, and why only the four kinds of manipulations are used for auricular acupuncture. Finally, the authors suggest that the Standardized Manipulation of Acupuncture and Moxibustion, Part 3: Auricular Acupuncture needs further to be studied and improved.