IRCT2014061717237N3 IRCT 2014-09-17 Vice Chancellor for Research and Technology Deputy of Golestan University of Medical Sciences The effect of Acupressure on sleep quality and anxiety The effect of acupressure on sleep quality and anxiety in hemodialysis patients 2014-03-20 anticipated 75 Complete https://irct.ir/trial/15895 interventional Randomization: Randomized, Blinding: Double blinded, Placebo: Used, Assignment: Parallel, Purpose: Supportive, Other design features: Randomization strategies: Considering sleep quality level, patients were allocated to three matched intervention, placebo and control groups. Allocation will be achieved using stratified random allocation. 3 Chronic Renal failure. Intervention 1: Intervention group: Acupressure will be done on true acupoints (hand Shenmen, PC6 and Yintang) by using 3 to 4 kg pressure, with the practitioners' thumb in a period of two revolutions per second.The intervention will conduct three times a week for a month. Intervention 2: Placebo group: Massage will done in pseudo points with about 1 to 1.5 cm distance near to the true acupoints three times a week for a month. Intervention 3: Control group: Without any intervention. During the study, If any intervention is required to modifying patients' anxiety and sleep disturbance, they will be excluded from study. Introduction: In the end stage of renal disease, the patient is dependent on the alternative therapies of the kidney such as hemodialysis to continue the survival. The treatment with hemodialysis may provide the possibility of more survival for the patients, but it has an impact on the patients' physical and mental performance because of many complications and the patients' stressors and might stricken them to the psychological disorders. Sleep disturbance and anxiety are common problems in hemodialysis patients. This study was done to determine the effect of acupressure on sleep quality and anxiety of hemodialysis patients. Materials and methods: This study was done by the double-blind clinical trial on 74 hemodialysis patients at the hospital of 17Shahrivar of Borazjan in Bushehr province in 2014. First, eligible patients was chosen through a purposive sampling and then they were allocated into three intervention, placebo and control groups according to the sleeping score by classified random allocation method . In the acupressure group, the points of Shen Men in hand (HT7), pericardium 6 (PC6) and Yintang was pressured in three minutes, three times a week for four weeks during hemodialysis. In the group of sham points, the massage with the same technique was done in the distant of 1.5-2 cm from the mentioned points and control group was received usual cares. Data collection was done using 2 questionnaires; Spielberger State-Trait Anxiety Inventory and Pittsburgh Sleep Quality Index which was completed twice, before and after intervention, by the interview method. The sleeping chart was completed from before intervention till one week after intervention daily by patients. Data were analyzed in SPSS-16 software using the chi-square, Dunnett test, ANOVA, t-test and their nonparametrictests. Results: There was a significant difference comparing pre- and post-intervention data. The finding showed that, there was a significant relation between acupressure and sleep quality. The score of patients in acupressure group decreased from 12.1 to 7 after the intervention and this difference was significantin all components of sleep quality. The score of sleep quality in sham groupdecline from11.5 to 10.1 and significant difference in total score and parts to sleep and sleep disorders were observed too, but in the control group there was not significant difference in sleep quality and its components. Before the intervention, there was no significant difference between three groups with regard sleep habits, type of illness and drug use, quality of sleep and anxiety. But after the intervention, sleep quality difference between sham and acupressure group increased from 0.64 to 3.1 (about 3 times), and a control group of 0.74 significant difference to 4.4 (approximately 4-fold) increase. Sleep quality components including subjective sleep latency to sleep, sleep duration, sleep disorders and dysfunction as well as significant differences between the groups were observed, but there was no significant difference between three groups for score of sleep quality and hypnotic medication use . Sleep chart in one month showed in acupressure group, nighttime awakenings decreased compared to sham and control groups. The anxiety score decreased from 49.4 to 38.6 after the intervention in acupressure group. The mean anxiety score of sham and control group decreased from 47.8 to 46.04 and after from 49.4 to 51.2, respectively, but this difference was not significant changed. In addition,there was significant differences in the three groups after intervention in anxiety score. As Differences between sham and acupressure group decreased from 1.6 before intervention to -7/4 after intervention, and difference between acupressure and control groups increased from -0.4 to 12.6 after intervention. According to the study results, acupressure was effective as 44.5 percent in sleep quality and 21.8 percent in improving the anxiety of patients. Conclusions: The study findings confirmed the application of the acupressure as a non-pharmacological and complementary method in the points of hand Shen Men, Yintang and Pc6 in the increase of sleep quality and decrease of anxiety of hemodialysis patients.