Empowerment of patients with end-stage renal disease--a randomized controlled trial

The purpose of the study is to investigate the effectiveness of an empowerment program on empowerment level, self-care self-efficacy and depression in patients with end-stage renal disease. The study was a randomized controlled trial; qualified patients in two dialysis centers of major hospitals in southern Taiwan were randomly assigned into an empowerment group (n=25) and a control group (n=25). The empowerment program included identification of problem areas for self-management; exploration of emotions associated with these problems; development of a set of goals and strategies to overcome these problems to achieve these goals; creation and implementation of behavioral change plans; and stress management.The outcomes measured were the Empowerment Scale, the Strategies Used by People to Promote Health and the Beck Depression Inventory. Data were collected at baseline and 6 weeks following intervention. Primary statistical analysis was by means of t-test and analysis of covariance. The results indicated that scores of the empowerment (t(48)=6.54, p<0.001), self-care self-efficacy (F(1,47)=10.82, p=0.002) and depression (t(48)=2.49, p=0.03) in the empowerment group have a significantly greater improvement than the control group.     

The efficacy of massage as a nightly bedtime routine on infant sleep condition and mother sleep quality: A randomized controlled trial

Backgroundand Purpose: Infants' sleep disorders and parents' insufficient sleep are common problems in the infant care. The current study was conducted to assess the effectiveness of infant massage on infants' night-time sleep condition and mothers’ sleep quality.Methods140 number of 15–20 days old infants were randomly put into two different groups, one with bedtime messages and the other with normal infant routine care. For the intervention group, in addition to usual bedtime procedures such as changing diapers and breastfeeding, a 15-min massage was done before sleep for a period of two weeks. For the control group, only the usual above-mentioned bedtime procedures were followed. One week before the intervention, at the end of the first week, and two weeks after the intervention, the information was recorded for both groups. The Brief Infant Sleep Questionnaire, a personal information submission form, and Pittsburgh Sleep Quality Index for the mothers were the tools used to gather data in this study.ResultsInfants in two control and experimental groups showed meaningful differences in variables such as, sleep latency (P = 000, eta = 0.099), number of night waking (P = 0.03, eta = 0.027), and longest continuous sleep period (P = 0.03, eta = 0.026). As for other variables related to the infants' sleep, no meaningful differences were observed. In this study, there was no indication of a meaningful difference in the mother's overall night-time sleep quality between the two groups (P = 0.184, eta = 0.012) except for the duration of the mother's night-time sleep (P = 0.028, eta = 0.026) and the reduction of maternal sleep disorder (P = 0.020 eta = 0.029). As for other sub-factors of maternal sleep quality, no meaningful differences were seen.ConclusionThe findings of this study indicated that infants’ bedtime massages would improve some of the sleep markers of mothers and infants, and therefore, can be suggested as a practical, harmless, and cost-free method to improve sleep.     

Acupoints massage in improving the quality of sleep and quality of life in patients with end-stage renal disease

BACKGROUND: Traditional Chinese acupressure is a noninvasive technique that employs pressure and massage to acupoints in order to stimulate the balance of life energy that promotes health and comfort. Sleep disturbance is common in patients with end-stage renal disease but no intervention studies have addressed this problem. Aim. The purpose of the present study was to test the effectiveness of acupoints massage for patients with end-stage renal disease and experiencing sleep disturbances and diminished quality of life. METHODS: The study was a randomized control trial. A total of 98 end-stage renal disease patients with sleep disturbances were randomly assigned into an acupressure group, a sham acupressure group, and a control group. Acupressure and sham acupressure group patients received acupoints or no acupoints massage three times a week during haemodialysis treatment for a total of 4 weeks. The measures included the Pittsburgh Sleep Quality Index, Sleep Log, and the Medical Outcome Study - Short Form 36. FINDINGS: The results indicated significant differences between the acupressure group and the control group in Pittsburgh Sleep Quality Index subscale scores of subjective sleep quality, sleep duration, habitual sleep efficiency, sleep sufficiency, and global Pittsburgh Sleep Quality Index scores. Sleep log data revealed that the acupressure group significantly decreased wake time and experienced an improved quality of sleep at night over the control group. Medical Outcome Study - Short Form 36 data also documented that acupressure group patients experienced significantly improved quality of life. CONCLUSION: This study supports the effectiveness of acupoints massage in improving the quality of sleep and life quality of end-stage renal disease patients, and offers a noninvasive therapy for sleep-disturbed patients.     

终末期肾病维持性血液透析患者生活质量及相关因素研究

目的调查终末期肾病(ESRD)维持性血液透析(HD)患者的生活质量,分析相关因素。方法①用肾脏疾病生活质量简表(KDQOL-SF)对66例ESRD维持性HD患者进行生活质量评分;②分析一般情况、透析情况和各实验室指标对患者生活质量的影响。结果单因素分析发现不同年龄组、工作状况、文化程度、医疗负担以及内瘘手术次数的患者KDQOL-SF分值差异存在显著性(P<0.01,P<0.01,P<0.05,P<0.01,P<0.01),60岁以上、未就业、文化程度较低、医疗负担较大、内瘘手术次数多的ESRD维持性HD患者生活质量较差;未发现血红蛋白、血清白蛋白等实验室指标与KDQOL-SF分值之间的相关性。结论年龄、工作状况、文化程度、医疗负担、内瘘手术次数均对ESRD维持性HD患者生活质量产生影响。     

Impact of beta-blockers on sleep in patients with mild hypertension: a randomized trial between nebivolol and metoprolol

Introduction  Sleep is an innate and essential part of human life. Various aspects of sleep are negatively affected by beta-blockers. We compared the impact of two beta-blockers, metoprolol succinate (extended release) and nebivolol, on sleep quality in patients with stage 1 hypertension. Methods  This was a prospective, randomized, open-label, parallel-group study. Eligible patients were administered the Pittsburgh Sleep Quality Index (PSQI) questionnaire by a blinded interviewer and were randomized to receive metoprolol (starting dose 25 mg) or nebivolol (starting dose 2.5 mg) once daily for 6 weeks. The first dose was administered before patients left the clinic. Visits were scheduled for 1, 2, 4, and 6 weeks after the initiation of therapy. At the end of the study, patients were readministered the PSQI questionnaire by the same interviewer, as before blinded to treatment allocation. Results  A total of 22 patients in the nebivolol group and 17 patients in the metoprolol group completed the study and were included in the data analysis (mean age of patients, 40.7 years). At study entry, systolic blood pressure (BP), diastolic BP, and PSQI scores were similar in the two groups. Over 6 weeks of treatment, systolic and diastolic BP normalized in both groups. Global PSQI score improved significantly in patients in the nebivolol group, whereas it worsened in the metoprolol group. The difference in effect of two beta-blockers was statistically significant (P<0.001). Conclusion  Nebivolol was associated with improved sleep (as assessed by the PSQI), whereas metoprolol was associated with a worsening of sleep characteristics.     

Role of yoga therapy in improving digestive health and quality of sleep in an elderly population: A randomized controlled trial

IntroductionConstipation and sleep disturbances commonly affect elderly population results in compromised physical and mental health. Mind-body interventions like yoga not only address the mental and physical health but also promote healthy ageing. This study evaluates the effect of 3 months yoga intervention on the sleep and constipation related quality of life (QoL) among the elderly.Materials and methodsNinety six participants aged between 60 and 75 who did not had any history of yoga practice for past 1 year and having a zubrod score of 0–2 were randomized in to yoga (n = 48) or waitlisted control (n = 48). The yoga group received yoga interventions at a frequency of 3 sessions per week for 3 months. Pittsburg Sleep Quality Index (PSQI) and Patient Assessment of Constipation QoL (PAC-QOL) were used to assess the improvement. Intention to treat analysis method was used to include the drop-out participants.ResultsEighty one participants (Yoga = 48, waitlisted control = 33) completed the study. Wilcoxon's sign rank test has shown that the yoga group had statistically significant changes in most of the parameters in PSQI and PAC-QOL (P ≤ 0.05). Mann Whitney test revealed that yoga group has better improvement in the sleep quality and constipation related QOL (P ≤ 0.05) compared to the controls.DiscussionThe results signify yoga can ease old age related issues like constipation and insomnia. This is encouraging for inclusion of yoga as a daily practice regimen to improve the constipation and sleep related quality of life in elderly population.     

Effect of acupressure on sleep quality of middle-aged and elderly patients with hypertension

PurposeTo evaluate the effect of acupressure on blood pressure and sleep quality in middle-aged and elderly patients with hypertension.MethodsA total of 75 elderly hypertensive patients with sleep disorders were randomly divided into either an experimental group (n = 38) or a control group (n = 37). All subjects received conventional treatment and health guidance. The experimental group also received acupressure treatment. The score of PSQI (Pittsburgh Sleep Quality Index) and blood pressure were measured and recorded before and after the treatment.ResultsAfter the intervention, the systolic (SBP) and diastolic blood pressure of the experimental group decreased significantly (p < 0.01). There was a significant difference in SBP between the groups (p < 0.01). After four weeks of intervention, the total PSQI score in the experimental group was significantly lower compared to the control group (p < 0.01).ConclusionAcupressure can lower SBP and effectively improve the sleep quality in middle-aged and elderly patients with hypertension.     

The effect of applying pressure to the LIV3 and LI4 on the symptoms of premenstrual syndrome: A randomized clinical trial

ObjectiveTo evaluate the effect of simple acupressure protocol in LIV3, LI4 and placebo points on the quality of life (QOL) in women with premenstrual syndrome (PMS).MethodThis paper reports a randomized, single blinded clinical trial. 97 participants (students in of Hormozgan University of Medical Sciences, Iran) with PMS were allocated to three groups to receive 20 min acupressure on different acupoints for 14 days before menstruation for three consecutive menstrual cycles (training and then two cycles self applied acupressure). The acupoints were LIV3 and LI4; one group received acupressure at a placebo point. Each participant completed the PSST scale (to determine PMS severity), HADS scale (for depression and anxiety), and quality of life SF12.ResultsThe number of people with moderate/severe PMS decreased in LIV3 and LI4 acupressure groups by the second and third cycles compared with the placebo group (p < 0.04).Moreover, depression and anxiety scores significantly decreased in the LIV3 and LI4 groups by the second and third cycles compared with the placebo group (p < 0.05).Analyzing the score of SF12 fields in the second and third cycles showed a significant difference in all dimensions between the intervention and placebo groups. There was no significant difference between LIV3 and LI4 acupressure groups in decrease of PMS symptoms, anxiety and depression and improving SF12scores (p < 0.05).ConclusionPerforming the simple acupressure protocol at LIV3 and LI4 is an effective method to decrease the severity of PMS symptoms, anxiety and depression, and to improve the QOL. Pressure at LIV3 and LI4 appears to be equally effective.     

穴位指针法对终末期肾病患者睡眠质量的影响

目的探讨穴位指针法对终末期肾病患者睡眠质量的影响。方法对40例伴有睡眠障碍、匹兹堡睡眠质量指数(PSQI)评分7-18分的终末期肾病住院患者,在常规治疗和护理的基础上增加穴位指针法进行干预,施穴时间2-3min/穴,1次/d,疗程为4周,随访3个月。采用PSQI测评干预前后睡眠情况,并比较干预前后不良主诉发生情况。结果干预4周后,患者PSQI总分及睡眠质量、入睡时间、睡眠时间、睡眠效率、睡眠障碍、日间功能障碍6个因子评分均明显下降(P0.05),不良主诉发生率降低(P0.01)。随访3个月,患者仍能维持较好的睡眠质量,PSQI总分与干预结束时比较差异无统计学意义(P0.05)。结论穴位指针法能有效改善终末期肾病患者睡眠质量。     

Effectiveness of acupressure for residents of long-term care facilities with insomnia: A randomized controlled trial

Background

Acupressure on the Shenmen point (indexed as HT7) can improve insomnia, but there has been no longitudinal study to evaluate its efficacy for residents of long-term care facilities. No evidence from the existing literature indicates how long its efficacy can be maintained after stopping acupressure.

Objective

The aim of this study was to evaluate the effectiveness of acupressure on the Shenmen point for residents of long-term care facilities with insomnia.

Methods

Fifty residents with insomnia in long-term care facilities were enrolled in a randomized controlled trial, with 25 participants allocated to the experimental group and 25 participants to the control group. For a 5-week period, the experimental group received standard acupressure on the HT7 points of both wrists, whereas the control group received only light touch on the same places. Insomnia was measured with the Athens Insomnia Scale-Taiwan form (AIS-T). Participants’ self-reported scores were done at baseline, during the 5-week period, and after intervention. This study was analyzed on an intention-to-treat procedure.

Results

The experimental group has significantly better scores on the AIS-T compared to the control group, not only during the intervention period, but also extending after intervention, as shown by generalized estimating equations (p < 0.05).

Conclusions

Offering acupressure on a regular basis has the potential to improve insomnia in residents of long-term care facilities. Acupressure on the HT7 point may improve insomnia for up to 2 weeks after the intervention.     

塔里木盆地玛南地区奥陶系鹰山组串珠特征及勘探前景

目的 探讨延续护理对阻塞性睡眠呼吸暂停综合征患者生存质量的影响.方法 将61例阻塞性睡眠呼吸暂停综合征出院患者按随机数字表分为对照组30例和观察组31例,对照组予常规出院指导及定期门诊随访,观察组在常规出院指导基础上实施延续护理.分别在患者出院后3月、6月用Epworth嗜睡评价量表、睡眠紊乱指数及特异性健康相关生存质量问卷评价患者的生存质量,出院后3月比较两组患者呼吸机使用依从性.结果 观察组患者Epworth嗜睡评分、睡眠紊乱指数评分低于对照组,两组评分比较有统计学意义（P＜0.05）;观察组生存质量问卷各维度评分高于对照组,两组评分比较有统计学意义（P＜0.05）;呼吸机使用依从率观察组96.8%、对照组56.7%,两组比较,x2=13.641,P＜0.05.结论 延续护理可提高阻塞性睡眠呼吸暂停综合征患者的生存质量.     

Effects of acupressure on chemotherapy-induced nausea and vomiting-a systematic review with meta-analyses and trial sequential analysis of randomized controlled trials

BackgroundAcupressure has been used as an effective way in treating with stomach upset. However the efficacy of acupressure in preventing chemotherapy-induced nausea and vomiting is uncertain.ObjectiveTo assess the effectiveness of acupressure on three categories of chemotherapy-induced nausea and vomiting.Data sourcesDatabases had been retrieved from inception through February 2016 for the randomized controlled trials in accordance with the inclusion criteria, including PubMed, Cochrane Central Register of Controlled Trials, Web of Science, EMBASE, Science Direct, CINAHL, China Biology Medicine, Chinese National Knowledge infrastructure, Wan Fang and Database for Chinese Technical Periodicals. Additional studies were identified through hand searches of bibliographies and Internet searches.DesignSystematic review with meta-analyses and trial sequential analysis of randomized controlled trials.Review methodsTwo reviewers selected relevant eligible articles, critical appraisal of the methodological quality was conducted on the basis of using Cochrane Handbook. A standardized Excel form was used to extract information. Meta-analysis and trial sequential analysis was performed using software RevMan 5.3 and TSA 0.9.ResultsTwelve studies with 1419 patients were included. Only three studies were assessed as high quality, one study was evaluated as moderate, and eight studies were evaluated as poor. The meta-analysis showed that acupressure reduced the severity of acute (SMD = −0.18, 95% CI −0.31 to −0.05, p < 0.01) and delayed (SMD = −0.33, 95% CI −0.64 to −0.01, p = 0.04) nausea. However, there was no benefit effect on the incidence or frequency of vomiting. No definitive conclusions were drawn from the trial sequential analysis.ConclusionThis systematic review suggested a protective effect of acupressure on chemotherapy-induced nausea and vomiting, while more well-designed clinical trials with larger sample size were needed to draw a definitive conclusion.     

对冠状动脉介入治疗患者睡眠质量及影响因素的调查

目的 了解冠状动脉介入治疗(PCI)患者的睡眠质量及影响因素.方法 采用匹兹堡睡眠质量指数(PSQI)量表和影响睡眠因素调查表,对96例择期PCI患者进行调查.结果 PCI患者术前、术后分别有61.46%、87.08%存在睡眠问题,PSQI总分分别是(9.82±4.51)和(12.11±3.99),总分及各成分得分与国内常模相比、术前PSQI总分及各成分得分与术后相比,差异有统计学意义(P<0.05).术前主要影响因素有手术焦虑、噪音、病房陌生感、经济负担、病床不适;术后主要影响因素有体位不适、腰背酸痛、噪音、夜间查房及治疗护理、排尿困难等.结论 PCI患者睡眠质量较差,以术后为甚,应采取积极的护理措施,控制各种影响因素,提高睡眠质量.     

不安腿综合征对血液透析患者生活质量及睡眠质量影响的研究

目的了解北京大学第一医院肾内科血液透析中心不安腿综合征(RLS)的患病率,对其严重程度进行量化评分,并初步探讨RLS的影响因素及其严重程度对睡眠质量和生活质量的影响。方法以我院108例因慢性肾功能不全进行维持性血液透析治疗的患者为研究对象。不安腿综合征的诊断采用国际不安腿综合征研究小组制定的不安腿诊断标准量表。以匹兹堡睡眠质量指数(PSQI)和简明健康状况调查表(SF-36量表)分别进行生活质量和睡眠质量评估。记录患者的透析方案、生化指标及治疗用药等资料,探讨RLS的影响因素。随机抽取一组不伴RLS患者为对照组,进一步评估RLS对睡眠质量和生活质量的影响。结果①我院血液透析中心RLS患者共14例,男性7例,女性7例,其患病率为13%。②RLS患者与不伴RLS患者在年龄、性别、透析龄、每周透析时间,尿素清除率,透析前血肌酐、尿素氮、血红蛋白、红细胞压积、铁蛋白、转铁蛋白饱和度、钙、磷、钙磷乘积、全段甲状旁腺激素(iPTH)等生化指标,以及是否使用铁剂、钙离子拮抗剂等治疗方面均未发现差异。③RLS组PSQI为(10.86±5.48),不伴RLS组PSQI为(4.93±4.73),两者间差异具有显著性(P=0.005)。但RLS严重程度仅与主观睡眠质量具有相关性(P<0.05),与SF-36分值呈负相关(r=-0.661,P=0.01)。结论我中心维持性血液透析患者中RLS患病率为13%。RLS患者的睡眠较差,主要表现在主观睡眠质量、睡眠时间、习惯睡眠效应、日间功能等方面。同时维持性血液透析RLS患者的RLS严重程度影响到患病者的生活质量。     

老年人睡眠呼吸暂停综合征的睡眠质量调查

INTRODUCTIONObstructivesleepapneasyndrome（OSAS）isoneofthecommonsleepdisorders，especiallyintheelderly．PatientswithOSASusu－allycomplainofexcessivedaytimedrowsinessandtiredness，lackofconcentration，memoryimpairment，andsometimespsychologicaldisturbances．Asaresultofthesesymptomsandfunctionalimpair－ments，OSASpatientsoftenreporthavingapoorsleepquality犤１－２犦．Inthisstudy，wewereinterestedinevaluatingthesubjectivesleepqualityinelderlypatientssufferingfromOSAS．MATERIALSAND…