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The purpose of the study was to examine the effects of auricular acupressure (AA) on physiological index, depression, anxiety, and stress in elderly people with hypertension. The verum group received verum AA therapy for 8 weeks. Five different acupressure sites were applied in each group. There was a significant difference in systolic blood pressure between the 2 groups after 8 weeks of AA, whereas a significant difference in pulse pressure was found between the 2 groups after 6 weeks of AA. This study is meaningful in comparing intervention and sham groups, verifying the effects by using physiological and psychological variables, and confirming the effects of repetitive measurement. AA therapy is expected to be a practical and efficient health care intervention for elderly people with hypertension.

Objectives: Cesarean deliveries are one of the primary conditions associated with postoperative decreased motility of the gastrointestinal system and are characterized by acute pain and distention. The aim of the present study was to investigate the application of acupressure and the administration of analgesics for women who underwent cesarean section under spinal anesthesia could be delayed and how spontaneous gastrointestinal system motility could be achieved in the postoperative period.Design: Randomized controlled trialSetting: Private Medipol Nisa Hospital, Istanbul, Turkey Intervention: This trial was conducted with 112 primipara pregnant women who delivered via cesarean sec-tion under spinal anesthesia and were randomly assigned into the acupressure (n=52) and control (n=60) groups. The participants in the acupressure group (n=52) were treated for 20 minutes. The participants in the control group (n=60) were treated per the hospital protocol (analgesics for pain, flatulation and defecation, no pharmacological or non-pharmacological application was performed).Results: The time that elapsed for the administration of analgesics was significantly later in the acupressure group than in the control group (p

The aim of this study was to evaluate the effect of acupressure on anxiety and pain of patients undergoing coronary angiography procedures. This study was conducted in a cardiology clinic of the training and research hospital in of a province of southeast Turkey. A randomized control group design was used. Eighty patients who were undergoing coronary angiography were randomly enrolled in intervention and control groups. The intervention protocol included 11 minutes of acupressure that applied to Hegu, Shenmen, and Yintang acupoints. No intervention was applied to the control group. Spielberger's state-trait anxiety inventory and the visual analog scale were used as data-collecting tools. Data were analyzed using t test in independent groups and χ2 test. The mean score of state anxiety of the intervention group was 41.50 ± 3.88, and was statistically significantly lower than the score of the control group after acupressure (P = .000). VASP2 and VASP3 pain intensity of the intervention group was statistically significantly lower than that of the control group after the coronary angiography procedure (P = .000). Acupressure is an effective technique for reducing the pain severity and anxiety among patients undergoing coronary angiography.

Anxiety is an important problem in children in dental clinics. Acupressure may be a useful tool to assist in dental procedures in anxious children.This pilot study was performed to examine the effects of acupressure on dental anxiety in children undergoing restorative procedures.Fourteen children aged 7-10 years and with at least one primary molar with caries on the dentine were included in the study. The participants also needed to score at least one point on the modified Venham Picture Test (VPTm) for the determination of anxiety. The children were randomly allocated to two groups: group A - non-documented points for the reduction of anxiety and induction of relaxation; group B - documented points (EX-HN3, Shen Men of auricular acupuncture). The anxiety scale was administered on three occasions: prior to the application of acupressure; immediately after sitting in the dental chair to undergo restorative treatment; and after removal of acupressure at the end of the restorative procedure. Heart rate (HR) was measured when each child sat in the dental chair, after the removal of carious tissue, and after the removal of acupressure.After the procedure, HR (as an indicator of anxiety) was statistically significantly lower in group B than group A (The children who received acupressure on documented points for the reduction of anxiety had a significantly lower HR after the restorative procedure. No significant between-group difference was found regarding anxiety measured using a psychometric evaluation (VPTm).

Acupressure is a nonpharmacological technique that can be used to control chemotherapy-induced nausea and vomiting (CINV) in children with cancer. To use acupressure as a strategy for managing CINV, oncology nurses must have adequate knowledge and skills to implement the technique in clinical practice. Our study aimed to evaluate the effect of an acupressure training program for pediatric nurses caring for children undergoing chemotherapy. We used a quasi-experimental design. Our sample populations included a convenience sample of 36 pediatric nurses and a purposive sample of 45 children undergoing chemotherapy. We used four tools for data collection: (1) a structured questionnaire comprising two parts: (a) characteristics of nurses and children and (b) assessment of nurses' knowledge; (2) an observational checklist for application of acupressure technique; (3) the Baxter Animated Retching Faces (BARF) scale; and (4) a vomiting assessment sheet. We found that after the training intervention, 94.4% ( n = 34) of nurses had a good level of knowledge and skill implementing the acupressure technique. There was a statistically significant difference in the knowledge and skill of the nurses before and after the training intervention, χ 2 (35, N = 36) = 19.113, p = .000. We concluded that the training program significantly improved the nurses' level of knowledge and skill when caring for children undergoing chemotherapy. We also found that after implementing the training intervention, the frequency and severity of CINV decreased among the children we studied. We therefore recommend that acupressure (in combination with antiemetic medication) be included as part of a protocol for chemotherapy administration in children.

Currently, acupressure is widely accepted as a non-pharmacological therapy for managing pain, nausea and vomiting, and mental health conditions. Since acupressure can be self-administered, clinicians and researchers' interest in information and communication technologies (ICTs) for disseminating acupressure to manage symptoms has increased. This mini review was conducted to examine clinical studies of acupressure using ICTs, with a particular focus on self-acupressure. Through a search of MEDLINE, EMBASE, and CENTRAL, all studies of self-acupressure using ICTs published before December 31, 2021 were collected. Twelve studies met the inclusion criteria. More than half of the studies published since 2020 (4/7, 54.14%) were described as being related to COVID-19. As target conditions, musculoskeletal injuries or pain, cancer-related symptoms, dysmenorrhea, mental health issues, and obesity were considered. The most frequently used acupoints were LI4, LR3, and Shenmen. Moreover, smartphone applications were the most commonly used ICT method to support self-acupressure. In addition to the basic information of self-acupressure, other tools such as timers, reminders, and schedule checkers to facilitate its implementations have been incorporated into the smartphone applications. Recently, there have been some attempts to combine acupressure and ICTs. Although these studies mainly focus on musculoskeletal pain or injuries, recent studies related to mental health have emerged in relation to COVID-19. However, few studies have been conducted to date, making it difficult to fully grasp the trends in this field. Therefore, more studies are needed to evaluate the feasibility and efficacy of combining self-acupressure and ICTs in more diverse clinical areas.

Background: Acupressure and ischemic compression were used for pain treatment of myofascial trigger points (MTrPs). However, there were no previous studies determining what method is more effective in management of myofascial trigger points in neck pain. Objective: to compare the clinical efficiency of cervical acupressure versus ischemic compression of MTrPs in chronic neck pain. Methodology: A single-blind randomized controlled trial on forty-five patients that have been allocated randomly in three groups: The acupressure group (ACG), the ischemic compression group (ICG), and the control group (CG). Acupressure has been applied to the AG patients at the SI 14, SI 15, and GB 21 local acupuncture points, where the ICG has received ischemic compression on MTrPs of the bilateral upper fibers of trapezius. CG has received only traditional physical therapy in the form of the hot pack and muscle energy techniques. Neck pain was assessed by the VAS scale, pressure pain threshold (PPT) was evaluated through an algometer, neck range of motion (NROM) was assessed by Myrin OB goniometer, and function was assessed by neck disability index (NDI). Measurements were taken before and after four weeks of treatment. Results: The results exhibited a statistically substantial enhancement in VAS, PPT, NROM, and NDI in all groups post-treatment (p < 0.05). Despite the lack of significant differences between IC and acupressure, the IC of MTrPs yielded better improvement and the control group revealed the least improvement (p < 0.05). Conclusion: Ischemic compression has been proven to be more effective in handling cervical myofascial pain than acupressure. It is considered a direct manipulative technique for myofascial pain.

OBJECTIVE: With the ongoing opioid crisis, the Centers for Disease Control and Prevention recommends nonpharmacologic therapies (e.g., acupuncture) for treating pain. Multiple agencies, such as the National Institutes of Health and World Health Organization, recognize acupuncture's effectiveness for treating pain, but acupuncture education for providers is scarce. A Workshop to Introduce Acupuncture for Pediatrics (AcuPeds-Workshop) was developed with support from American Academy of Pediatrics to educate providers. Additional funding was given by the Virginia Apgar Academy to evaluate the effects of attending this workshop. MATERIALS AND METHODS: This prospective study used Immediate and 1-Month Post-Workshop (PWS) surveys. The AcuPeds-Workshop components included: history; a literature review; videos of patients receiving acupuncture; and hands-on experience. The workshop was presented at numerous conferences. Attendee survey completion was voluntary. RESULTS: Of 327 attendees, the majority were female, non-Hispanic, and were physicians. At baseline, attendees had: heard of acupuncture, 96%; used it, 28%; and/or had a prior lecture, 13%. In the Immediate-PWS: 97% reported an increase in their knowledge and understanding of the indications for acupuncture; majority correctly addressed 3 clinical application scenarios and contraindications. With respect to attitude: 85% would use acupuncture for themselves and 88% would use it for patients. More than 80% rated the workshop components as useful or very useful. In the One-Month-PWS: majority addressed the same 3 clinical scenarios and contraindications correctly, and 11% considered referring patients for acupuncture. CONCLUSIONS: Attendance at this AcuPeds-Workshop had a positive impact on attendees' knowledge, application of, and attitude about acupuncture. This workshop supports efforts to educate medical providers on this nonpharmacologic pain therapy

Background and purpose: Labour pain is a constantly increasing pain. This study thus aims to determine the effects of acupressure and shower on labour pain and postpartum comfort. Methods: In this randomized controlled trial (RCT), the control group consisted of 40 pregnant women, while the experimental groups consisted of 80 pregnant women in total. The experimental groups received routine labour care and either acupressure or showers upon reaching three cervical dilations (4–5, 6–7 and 8–10 cm). The control group only received routine labour care. A maternal information form (MIF), the Visual Analog Scale (VAS) and the Postpartum Comfort Questionnaire (PPCQ) were used to collect data. Results: Pain was significantly reduced in both of the experimental groups, in contrast to the control group, in all periods of the study (p < 0.001). Postpartum comfort also significantly increased in the experimental groups compared to the control group (p < 0.05). Conclusion: Acupressure and showering are effective in reducing labour pain and increasing postpartum comfort. Midwives and nurses can therefore apply them as inexpensive and easy to administer methods for labour pain relief.

Background Restless legs syndrome (RLS), a neurological disorder, often affects sleep quality in hemodialysis patients. This study aimed to evaluate acupressure's effect on the severity of RLS symptoms and sleep quality in hemodialysis patients with RLS. Material and methods This study is a cluster-randomized crossover pilot study. Patients were randomized to two sequences: acupressure for one month and observation for another month (AC); and observation for one month and acupressure for another month (CA). For the four-week acupressure intervention, patients received 36 min of acupressure three times weekly during their hemodialysis sessions. The acupoints were on the bilateral lower limbs, including Zusanli (ST36), Yanglingquan (GB34), Sanyinjiao (SP6), Xuanzhong (GB39), Chengshan (BL57), and Taichong (LR3). RLS severity and sleep quality (measured with the Pittsburgh sleep quality index, PSQI) were measured at baseline, month 1, and month 2. Results AC sequence (n = 14) was similar to the CA sequence (n = 9) in terms of gender, age, education, employment, marital status, comorbid disease, BMI, duration of dialysis, medication for RLS and insomnia, RLS severity, and PSQI. The general linear mixed model revealed no significant carryover effect on RLS severity, PSQI, and the seven subscales of PSQI. A significant treatment effect (acupressure) was only observed in RLS severity (p = 0.0013) but not in PSQI and the seven subscales. The significant period effect was observed in RLS severity (p = 0.0250) and the subscale of sleep disturbance (p = 0.0021). Conclusion In hemodialysis patients with RLS, acupressure can alleviate the severity of RLS but cannot improve sleep quality.

Chronic low back pain, one of the most common reasons for seeking healthcare services, causes significant negative impacts on individuals and society. Nonpharmacologic therapies and self-management are included in practice guidelines, but their implementation is challenging.To assess the feasibility of using an auricular point acupressure (APA) mobile app as a self-guided tool to learn and self-administer APA to manage chronic low back pain (cLBP) and to compare cLBP outcomes between 2 groups (app vs app + telehealth).A 2-phase study design was used. In phase 1, participants (app group, n = 18) had in-person study visits and installed the app to learn and self-administer APA to manage cLBP. In phase 2, all research activities occurred remotely due to the COVID-19 pandemic, so a second group was recruited (app + telehealth, n = 19). The app + telehealth group underwent a virtual session, installed the app, and were provided the opportunity for questions and verification on the accuracy of the self-administered APA.The participants were recruited by distributing study flyers at outpatient clinics and referrals.Participants with chronic low back pain were eliglbe for the study.Using a quasi-experimental design with a mixed methods approach, all participants were instructed to download the APA app, provided an APA kit (includes seeds embedded within pre-cut squares of adhesive tape), and advised to self-administer APA with guidance from the app for 4 weeks to manage their cLBP. Study outcomes were collected at the preintervention time point as well as postintervention and 1-month follow-up. Interviews were also conducted at the postintervention time point.Of the 37 participants enrolled, six dropped out, and the attrition rate was 16%. Adherence to APA practice was high (85%-94%). After 4 weeks of APA treatment, participants in the app + telehealth group experienced a 29% decrease in pain intensity during the postintervention time point and a 35% reduction during the 1-month follow-up. Similar improvements were noted in pain interference (28%) and physical function (39%) for participants in the app + telehealth group at the 1-month follow-up. These changes are slightly higher compared with those in the app group (21% pain intensity reduction, 23% improved pain interferences, and 26% improved physical function) during the 1-month follow-up. Overall, APA was found to be feasible using the app and the qualitative findings showed acceptability of the intervention in both groups.It is feasible to learn and self-administer APA with an app, supplemented with either in-person or telehealth sessions, presenting a promising intervention toward cLBP self-management. Telehealth was found to boost this intervention effectively.

Constipation is a common complaint and challenge in the elderly. Methods such as acupressure and abdominal massage can be considered for the treatment of constipation in the elderly. This study aimed to compare the effect of abdominal massage and acupressure on constipation in healthy elderly women. In this study, 60 elderly women with constipation participated in two groups. The first group underwent acupressure for 3 minutes every day for 5 days, and the other group underwent classical abdominal massage for 15-20 minutes every day for 5 days. The two groups were followed for a month. Data collection tools included a demographic characteristics questionnaire, Rome III criteria, and constipation assessment scale. The data were analyzed by SPSS18 software. Following the intervention, there was no significant difference between the two groups (p.05). But in the first month, the mean scores of constipation in the abdominal massage and acupressure groups were 6.30 ± 3.47 and 9.03 ± 3.84, respectively, which showed a significant difference between the two groups for that time period (p = .005). Although there was no significant difference between the two methods during the intervention, the severity of constipation did decrease in each group. Also, in the first month after individual intervention, a significant difference was observed between the two groups. We conclude that abdominal massage can be suggested as an applicable and simple method in the treatment of constipation for elderly women.

Objectives To test the effect of noninvasive self-performed acupressure therapy as an add-on to pharmacological treatment to manage knee main and to evaluate the improvement of pain due to intervention according to age and body mass index. Methods In the study, 240 participants were assigned into three groups (1) KAP group (verum acupressure and pharmacological treatment) (2) Comparison Group 1 (sham acupressure and pharmacological treatment), and (3) Comparison Group 2 (pharmacological treatment only). Outcome measures were subscales of Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), Visual analog scale and 36-item Short-Form Health Survey. Intention–to–treat analysis was used and missing data was deal with multiple imputation method. The general linear mixed model was carried out to assess the differences between the study groups at different durations (3 months, 6 months, and 1 year). Results Compared with CG-1 and CG-2, participants of the KAP group reported considerable improvements in WOMAC pain (mean difference: −2.50 units; 95% CI, 3.74–1.25, and mean difference: −1.69 units; 95%CI, −3.24 to −0.13 respectively) at 1 year. Similarly, VAS pain, stiffness, and physical function were also improved among the participants of KAP group. Conclusion Self-administered acupressure has an additive effect to the pharmacological treatment to improve pain, stiffness, and physical function as compared to pharmacological treatment only.

Labor pain is the main issue that happens to women during delivery. In Brazil, labor pain can reach over 50% of the natality rate in a hospital, which is the highest percentage in the world. If labor pain is neglected, mothers can experience depression and distress related to their sexual activity. It will also increase the demand for sectio caesarea delivery. One of the methods to relieve labor pain with no continuous provision of medicine, effective cost, and relatively low risk is acupressure. The objective of this study is to examine the effectiveness of acupressure therapy on relieving labor pain during the Active Phase of the First Stage. This study applied a literature review research method by searching and examining previous journal articles that match the inclusion criteria and exclusion criteria. The journal articles were obtained from the Google Scholar database, ResearchGate, Wiley Online Library, and Elsevier with the keywords Acupressure, Labor Pain or Akupresur, Nyeri Persalinan. From thirteen articles analyzed, nine articles suggest LI4 acupressure point which is placed at metacarpal between the thumb and index finger. The majority of articles claim that severe pain occurs during labor before being intervened. Meanwhile, all articles state that acupressure is effective in relieving labor pain during the Active Phase of the First Stage.

У статті подано аналіз ефективності застосування комплексної методики фізичної реабілітації дітей зі сколіозом в умовах поліклініки. У дослідженні взяли участь 174 дитини дошкільного віку зі сколіозом І ступеня. До плану лікувально-відновлювальних заходів були включені: цілодобове дотримання ортопедичного режиму, щоденні заняття лікувальною гімнастикою (спеціальні симетричні, асиметричні та деторсійні вправи), лікувальний масаж з елементами точкового масажу, лікувальне плавання, електростимуляція м’язів, лікувальна хореографія, коригуюча гімнастика після денного сну (виконання ігрових вправ у початковому положенні лежачи з метою підготовки м’язів до активної та ефективної роботи у вертикальному положенні). Завдяки проведенню комплексу реабілітаційних заходів вдалося нормалізувати функціональні можливості хребта у 24,1 % дітей, досягнути покращення постави в 42,6 % хворих та стабілізувати сколіотичний процес у 28,7 % пацієнтів.

BACKGROUND Depression is recognized as a major public health problem with a substantial impact on individuals and society. Complementary therapies such as acupressure may be considered a safe and cost-effective treatment for people with depression. An increasing body of research has been undertaken to assess the effectiveness of acupressure in various populations with depression, but the evidence thus far is inconclusive. AIM To examine the efficacy of acupressure on depression. METHODS A systematic literature search was performed on PubMed, PsycINFO, Scopus, Embase, MEDLINE, and China National Knowledge (CNKI). Randomized clinical trials (RCTs) or single-group trials in which acupressure was compared with control methods or baseline in people with depression were included. Data were synthesized using a random-effects or a fixed-effects model to analyze the impacts of acupressure treatment on depression and anxiety in people with depression. The primary outcome measures were set for depression symptoms. Subgroups were created, and meta-regression analyses were performed to explore which factors are relevant to the greater or lesser effects of treating symptoms. RESULTS A total of 14 RCTs (1439 participants) were identified. Analysis of the between-group showed that acupressure was effective in reducing depression [Standardized mean differences (SMDs) = -0.58, 95%CI: -0.85 to -0.32, P < 0.0001] and anxiety (SMD = -0.67, 95%CI: -0.99 to -0.36, P < 0.0001) in participants with mild-to-moderate primary and secondary depression. Subgroup analyses suggested that acupressure significantly reduced depressive symptoms compared with different controlled conditions and in participants with different ages, clinical conditions, and duration of intervention. Adverse events, including hypotension, dizziness, palpitation, and headache, were reported in one study. CONCLUSION The evidence of acupressure for mild-to-moderate depressive symptoms was significant. Importantly, the findings should be interpreted with caution due to study limitations. Future research with a well-designed mixed method is required to consolidate the conclusion and provide an in-depth understanding of potential mechanisms underlying the effects.

Although hemodialysis treatment is one of the main treatment methods in chronic kidney failure, it also causes many health problems. A variety of complementary and integrative therapies are used to relieve or minimize hemodialysis symptoms. Fatigue (60%-97%) is also one of these problems. Therefore, we have conducted a systematic review to determine the effect of complementary and integrative therapies on fatigue in hemodialysis patients. Relevant studies published from 2005 to 2019, in PubMed, EBSCOhost, ScienceDirect, and Cochran Library databases have been reviewed. In the study, initially, 21 039 pieces of data were obtained, and then 14 randomized controlled studies meeting the inclusion criteria were reviewed. The methodological qualities of the articles included in the study were determined by using the quality evaluation checklist in Jadad randomized controlled studies. In the literature, acupressure, aromatherapy, reflexology, massage, and yoga practice were found to be applied to hemodialysis patients and be effective in reducing pain and anxiety as well as improving sleep quality. It is recommended that these methods be included in the routine clinical care of patients receiving hemodialysis.

(1) Background: Various procedures were performed on patients with persistent spinal pain syndrome (PSPS), but the clinical effect and safety were insufficient. The study was to examine the effects of auricular acupressure (AA) on low back pain, neuropathy, and sleep in patients on PSPS. (2) Methods: This was a randomized, single-blind, placebo-controlled study conducted from 1 March 2022 to 31 July 2022. The participants who had at least one lumbar surgery were randomly assigned to either the experimental group (n = 26) or the placebo control group (n = 25). All participants received 6 weeks of AA intervention. To validate the effects of the intervention, pressure pain thresholds (PPT), the Visual Analogue Scale (VAS), douleur neuropathique 4 (DN4) questions, the Pittsburgh Sleep Quality Index (PSQI), and actigraphy with a Fitbit Alta were conducted. The data were analyzed with SPSS/WIN ver. 27.0, using a t-test and repeated-measures ANOVA. (3) Results: The findings showed that there were significant differences in pain (back VAS p = 0.003, leg VAS p = 0.002, PPT p = 0.008), neuropathy (DN4 p = 0.034), and sleep actigraphy (sleep efficiency p = 0.038, number of awake p = 0.001, deep sleep stage p = 0.017). (4) Conclusions: We conclude that AA is an effective, safe, cost-effective, non-invasive nursing intervention that can improve pain, neuropathy, and sleep in patients on PSPS.

Background: Nausea and vomiting are among the most common medical problems during pregnancy, affecting 80% of mothers. Objectives: This study was conducted as a randomized controlled experimental study to determine the effect of acupressure applied by a wristband to the pericardium 6 (PC6) point on nausea and vomiting during pregnancy. Methods: The study population consisted of 74 pregnant women between 6-14 weeks of gestation who were experiencing nausea and vomiting. The study data was collected with personal information from the Pregnancy-Unique Quantification of Emesis Scale (PUQE). Experimental and control groups were selected by a simple random method. The experimental group wore acupressure wristbands for one week, while the control group did not use any method to alleviate nausea and vomiting. One week later, the PUQE scale was applied to both groups. Results: The acupressure wristbands decreased the nausea and vomiting scores of the pregnant women in the experimental group without statistical significance but did not change the nausea and vomiting scores of the pregnant women in the control group. Conclusion: Acupressure wristbands can be used to prevent nausea and vomiting during pregnancy. 2-s2.0-85163662584 PMID: 37381030

Background Many patients choose complementary and alternative medicine (CAM) to treat various conditions. Among osteoarthritis patients, acupressure is a popular CAM treatment. In Iran, Ghamz (a Persian acupressure technique) uses for musculoskeletal ailments like knee pain. Aims To examine the potential efficacy of Ghamz on osteoarthritis outcomes. Design Clinical Trial. Settings Randomized, single-blind, sham-controlled clinical trial. Participants/Subjects Eighty patients with diagnosed knee osteoarthritis, age over 35 years old. Methods Eighty adult patients with confirmed knee osteoarthritis from three outpatient clinics were recruited. Participants were randomly assigned either to intervention or placebo groups using sham acupressure. The primary outcomes included Knee injury and Osteoarthritis Outcome Score (KOOS) parameters and pain scores measured using the visual analog scales (VAS). Results Seventy-two individuals completed the trial and were included in the analysis. At baseline, there was no difference between the mean scores of both outcomes. After the intervention, the group receiving Ghamz therapy experienced an improvement in KOOS parameters, including symptoms, pain, activity daily livings, sport, recreation function, and quality of life. The mean pain score in the intervention group was significantly decreased from 5.89 at the beginning study to 4.11 at the end of the study, while the pain score did not change substantially in the sham group. These findings remained consistent after adjusting for covariates of age, weight, and pre-treatment. Conclusions This study supports evidence that Ghamz therapy provides an effective option for short-term knee pain relief in patients with knee osteoarthritis. Additional studies are recommended to confirm these findings.

PURPOSE More than 86% patients experience moderate to severe pain after thoracoscopic surgery. A combination of diverse nonpharmacological pain relief methods is a developing trend for pain management. The purpose of this study was to explore the effect of acupressure in reducing pain after thoracoscopic surgery. DESIGN A Randomized controlled study with purpose sampling was used for this study. Patients who underwent thoracoscopic surgery at a medical center in central Taiwan were enrolled. Study data was collected from September 2020 to April 2021 after the approval of the institutional review board. A total of 100 participants were randomized into two groups (49 and 51 in the experimental and control groups, respectively). METHODS Participants in the experimental group received acupressure at the Neiguan (PC6) and Shenmen (HT7) acupoints thrice a day for 2 days, whereas those in the control group received routine treatment and did not receive acupressure. The measurement included questionnaires for the collection of general information, physiological information, and disease rating scale. The Visual Analogue Scale-Pain (VAS-P) was used to measure the severity of pain. SPSS statistical software was used for data analysis. Independent sample t-test and chi-squared test were used for descriptive statistics, and paired t-test and linear mixed model were used to examine the effect of acupressure in alleviating pain. FINDINGS After acupressure intervention, the pain score of the experimental group was lower than that of the control group, and this difference was significant β = 17.76, p < 0.001 on day 1 after intervention; β = 19.80, p < 0.001 on day 2 after intervention. The postoperative pain score in the experimental group on day 2 after intervention was significantly lower than that in the control group (t = 2.039, p = 0.044). After the subjects received acupressure, pain index significantly decreased after considering the interaction between time and group (p < 0.001). Regardless of the type of surgery, there were significant differences in pain index when the interaction between time and group was considered (p < 0.001). CONCLUSIONS This study provided an experimental basis that acupressure can help in pain management in patients after thoracoscopic surgery, and the pain relief results become more significant as the duration of intervention increases. CLINICAL RELEVANCE Acupressure is effective in relieving postoperative pain in any type of thoracoscopic surgery. Nurses can use acupressure to help control pain in patients after thoracoscopic surgery.

Based on data from Riskesdas 2018, which states that the most common diseases in the elderly are Non-Communicable Diseases (PTM), such as hypertension, arthritis, stroke, Chronic Obstructive Pulmonary Disease (COPD) and Diabetes Mellitus (DM). In addition to having an impact on the physical condition of the elderly, the aging process also has an impact on their psychological condition. Improving health services for the elderly is needed to realize healthy, quality, and productive elderly in their old age. Health services for the elderly must be provided early on, namely at the pre-elderly age (45-59 years). One of the methods of implementing demgam is to carry out health development for the elderly, one of which is by taking preventive measures with foot exercises, acupressure and home care. Therefore, the target of this community service activity is the elderly who live in Simalingkar B Village, Medan Tuntungan District. The number of elderly who participated in this activity was 30 elderly. This activity was carried out for 2 days consisting of four vital signs examinations, two foot exercises and two times of acupressure. The implementation of this activity is the STIKes Mitra Husada Medan Nursing Study Program. The results of the activity evaluation show that foot exercises, acupressure and vital signs are routine activities carried out in Simalingkar B Village, Medan Tuntungan District. Through routine vital sign checks, it can control the health quality of the elderly. In addition, this activity can be a preventive measure against the symptoms of diseases that often occur in the elderly.

Background: Law of the Republic of Indonesia No. 36 of 2009 concerning traditional health services (Yankestrad), namely articles 1, 48, 59, 60 and 61. Acupressure is included in Yankestrad skills that are easy, cheap, simple, effective, and without any side effects. harmful. Acupressure at the Large Intestine 4 Point (LI4) based on the literature is able to reduce labor pain in the first stage of the active phase. Methods: This type of research is quasi-experimental with a pre-test and post-test research design. The samples were divided into two groups, the treatment group and the control group. Results: Based on the results of the research that has been carried out, it can be concluded as follows: Active phase I labour pain before being given Acupressure Therapy for primigravida mothers in PMB Aceh Besar District averaged 7.35. Active phase I labour pain after being given Acupressure Therapy to primigravida mothers in PMB Aceh Besar District decreased by an average of 5.47. Conclusions: There are differences in labour pain in the stage-I of active phase in the Acupressure therapy group with the Routine care group for the stage-I of labour for primigravida mothers in PMB Aceh Besar District.

Background Patients admitted to the intensive care units encounter many complications due to the nature of the disease and invasive medical procedures such as intubation and mechanical ventilation. Among these complications, agitation is a frequently-observed and serious problem. Objectives This study aimed to investigate the effect of Shiatsu massage on agitation in mechanically ventilated patients. Methods In this randomized controlled trial, a total of 68 mechanically ventilated patients were selected and then randomly assigned to two groups of intervention and control. Patients in the intervention group received three 5-minute periods of Shiatsu massage with a 2-minute break between them, while patients in the control group only received a touch on the area considered for the message. Data were collected before and after the intervention using the Richmond Agitation-Sedation Scale (RASS) and then analyzed using IBM SPSS Statistics for Windows, version 25.0 (IBM Corp., Armonk, N.Y., USA). Results The results showed that the level of agitation significantly decreased in the intervention group compared to the control group (p=.001). Conclusion Application of shiatsu massage seems to be effective in managing agitation in mechanically ventilated patients. Further studies with greater sample size and longer follow-up period are needed to confirm the current findings.

Background Some pain, fatigue, and gastrointestinal adverse events were observed in potential association with injection of COVID-19 vaccines, while there was no preventive intervention for it. We aim to investigate the efficacy of auricular acupressure (AA) therapy in preventing and relieving AEFI after injection of COVID-19 vaccine. Methods The study design is a randomized, multicentre, three-arm controlled, single-blind trial. Participants meeting the inclusion criteria will be advertised and enrolled and assigned in the medical institutions randomly for post-injection observation. No less than 360 participants will be randomized into one of three groups: auricular acupressure group, sham auricular acupressure group, and wait-list group. Interventions will be performed immediately and will happen 4 to 5 times per day for 5 days. The primary clinical outcomes will be quality and quantity evaluation among participants who reported any AEFI and who reported local pain at injection site. Secondary outcomes will concern headache, muscle and (or) joint pain, fatigue, nausea, vomiting, diarrhoea, and other potential events. All the outcomes will be assessed at baseline and 1, 3, 5, 7, and 14 days after the injection. Both intention-to-treat and per-protocol analyses will be performed, with significance level determined as 5%. Discussion Results of this trial will help to clarify the value of auricular acupressure therapy in preventing and relieving overall and certain adverse events following immunization after injection of COVID-19 vaccine. Trial registration China Clinical Trial Registry (ChiCTR) (ChiCTR2100043210). Registered on 8 February, 2021.

Background Health care workers face occupational stressors that may lead to burnout and secondary traumatic stress. Strategies to mitigate the negative psychological impact on frontline workers are urgently needed. Objective The purpose of this study was to evaluate the effect of auricular acupuncture or acupressure, as compared with ear massage, on anxiety, burnout, and caring capacity in health care workers. Results were stratified on the basis of subject's level of belief in traditional Chinese medicine. Methods This prospective randomized trial with an open, parallel-group design was conducted at a 334-bed Level II pediatric trauma center. Participants were randomized to one of three groups: (1) auricular acupuncture, (2) auricular seed acupressure, or (3) auricular massage. Interventions were delivered over 3 weeks. Self-reported State-Trait Anxiety Inventory (STAI), Professional Quality of Life (ProQOL), and Caring Ability Inventory (CAI) scores were analyzed using a pre-/posttest design. Univariate analysis, Fisher's exact test, and analysis of variance (ANOVA) were performed to assess group differences. Results A total of 117 (36%) of 325 eligible participants consented to participate in the study. Seed acupressure treatment (n = 14, 35.9%, one male, 13 females) was associated with a reduction in burnout (ANOVA, p = .04) and secondary traumatic stress (p = .03). This effect remained significant after adjusting for individual pretest scores (ANOVA, p = .05). The studied interventions did not have a significant effect on STAI, ProQOL, or CAI scores. Conclusions Auricular acupressure is a safe, effective, and practical strategy to reduce burnout and secondary traumatic stress and may support health care workers' ability to develop caring relationships with patients and families.

Low back pain is defined as located pain and discomfort below the costal margin and above the superior gluteal line, with related pain in the lower limb, and repeated incorrect posture of work activities that demand effort with excess of flexion, rotation, vibration on the chest and carrying weight, being chronic if its persists for three months or more. This research aimed to find out the efficacy of accupressure on Dachangshu, Shenshu, and Yaoyangquan points using pretest-posttest group design by comparing the mean decrease in pain threshold, RMDQ and Test Straight Leg between control using Dingchuan and Waihuaijian points and therapy group using Shenshu, Dachangshu, and Yaoyangquan acupoints twice a day with paired T test formula. The mean decreased in pain threshold VAS, RMDQ and Test Straight Leg obtained form therapy group toward 16 elderly above 45 years for 4 weeks showed that there is a significant result (p=0,000). In conclusion, accupressure therapy using Dachangshu, Shenshu and Yaoyangquan can be used to treat low back pain.

Objective Knee osteoarthritis is a prevalent degenerative joint disease and seriously affects the athletic abilities of middle-aged and elderly patients. Acupressure is a traditional non-pharmacological intervention that promotes blood circulation and muscle activity. Self-administrated acupressure and exercise can be potential management for knee osteoarthritis. Design It is a randomized and controlled trial for knee osteoarthritis self-treatment. Settings Cangzhou Hospital. Interventions 221 patients with knee osteoarthritis were recruited and randomly divided into 4 groups: control group ( n = 55), exercise group ( n = 56), acupressure group ( n = 55) and exercise & acupressure group ( n = 55). In the first eight weeks, corresponding training courses were provided to different groups of patients. The patients were asked to carry out their own corresponding interventions for 16 weeks. The patient‘s condition was evaluated in the sixteenth week. Main measures The Western Ontario and McMaster Universities global scores of knee osteoarthritis patients were assessed at the 8th and 16th week of our trial. Results Self-administered acupressure and exercise significantly decreased visual analogue scale (3.75 ± 1.89 versus 2.93 ± 1.73, p Conclusion Self-administrated exercise and acupressure alleviate the arthritic symptoms (swelling, pain, joint dysfunction and joint deformities) and improve the joint functions, supporting its potential use in the clinical management for osteoarthritis.

Background of the study: Nausea and vomiting are among the most common and distressing symptoms that patients with cancer endure, both as a result of anti – neoplastic treatment and from the disease itself, and significantly affect patients selfcare, coping abilities, and quality of life. Effective management of these individual symptom's response must be there throughout the cancer treatment. Since the acupressure is an easily applicable method regardless of time and place, cost effective, self-controlled and noninvasive method, it can be used to treat chemotherapy induced nausea and vomiting among clients with cancer receiving chemotherapy. The purpose of this study is to assess the effectiveness of non-pharmacological method, acupressure as a treatment modality to relieve nausea and vomiting among patients receiving chemotherapy. Methodology: A quasi-experimental pretest posttest design was adopted. The study sample comprised of 80 women admitted with ovarian cancer and cancer cervix receiving second and third cycle of chemotherapy. Non probability purposive sampling technique was adopted. Self-administered modified Rhode's index scale was administered to the women with reproductive organ cancer receiving second and third cycle of chemotherapy. The level of CINV was assessed by asking the women to indicate the level of chemotherapy induced nausea and vomiting being experienced by them. Results: Findings of this study revealed that acupressure has an effect on the women with ovarian and cervix cancer who were receiving chemotherapy by decreasing the level of CINV. Conclusion: Acupressure will be an effective adjunctive in controlling chemotherapy induced nausea and vomiting (CINV) and it can be tried in any oncological setting of clinical practice.

Because of the fear of the use of pharmacological agents, many pregnant women are opting to use alternative management modalities either as primary management or to compliment standard contemporary medical practices. The traditional complementary physical interventions of acupuncture, acupressure, and electrostimulation have a long tradition of use in traditional Chinese medical practice and are advocated for the management of antenatal conditions such as spontaneous miscarriages, gastrointestinal, respiratory, and urinary problems. They have also been advocated as useful to help the process of labour in promoting a cephalic delivery, induction/augmentation of labour and pain relief. Postpartum these modalities have been said to help the secretion and production of milk. While a number of studies, some randomized controlled, have suggested a potential role for these traditional complementary physical interventions, systematic reviews have generally failed to show a definite conclusive beneficial role and all reviews generally suggest the need for further controlled research in the field. Since no adverse effects appear to be associated with the use of these modalities in pregnancy, such modalities of management can be considered but only as an adjuvant to standard pharmacological management after a full clinical assessment has ruled out underlying pathology.

Objective: Taking pain under control is important to calm the individual and reduce complications. This research was conducted with the aim of determining the effect of Acupressure or Reiki interventions on the levels of pain and fatigue of stage III and IV cancer patients receiving palliative care. Method: The research was a single-blind, repeated measures, randomized controlled study. Research data were collected between February and November 2022. The research sample consisted of Acupressure and Reiki intervention groups and a control group with 52 patients in each group for a total of 156 patients. Acupressure or Reiki was applied to their intervention groups for a total of eight sessions of 20 min each over four weeks, once a day on two days a week. Data were collected by means of a patient description form, an analgesic follow-up form, the Numeric Pain Rating Scale, and the Brief Fatigue Inventory. Results: In comparison with the control group, a significant reduction was seen over time in the levels of pain (p < 0.001), analgesic use (p < 0.001), and fatigue (p < 0.001) in the Acupressure or Reiki intervention groups. Conclusion: Acupressure or Reiki interventions were found to effective in reducing levels of pain, analgesic use, and fatigue. It was seen that in addition to their use in routine nursing care, both treatments can be accepted as effective nursing interventions that reduce pain and fatigue in stage III and IV cancer patients receiving palliative care.

To assess the effects of acupressure on lactation.A literature search was conducted via Cumulative Index to Nursing and Allied Health Literature (CINAHL), Embase, and PubMed using keyword search terms acupuncture, Tuina and breastfeeding, human lactation or human milk and excluded auricular. Inclusion criteria were articles in English with no restriction on publication date. We included acupuncture as well as acupressure to ensure that relevant articles were not missed.After duplicates were removed, our initial search yielded 217 articles. Using the PRISMA checklist (Liberati et al., 2009), six articles met inclusion criteria (five research studies, one case study). Preliminary evidence suggests acupressure offers a promising and inexpensive method of enhancing secretory activation following cesarean and vaginal term and late preterm births, specifically when performed at acupoints CV 17, ST 18, and SI 1.Human milk is the optimal source of infant nutrition. Concern of low milk supply is most often cited as the cause for early supplementation with formula as well as early cessation of breastfeeding. Acupressure may be helpful in improving milk supply in early postpartum, but more research on acupressure and lactation is warranted.

Background: The understanding of back-pain as one of the commonest clinical presentations, made the path to the present study. More than three-quarters of the world’s population experience back-pain at some time in their lives Purpose: The present study has evaluated the selected Naturopathic therapeutic procedures on individuals with low back-pain. Methods: Thirteen patients were selected for the study and randomly divided into two groups, viz., Group A, Naturopathic group and Group B, Control group. One patient discontinued. Naturopathic group was treated with mud pack, aromatherapy massage with Eucalyptus oil, acupressure, steam, wet trunk pack, exercises, relaxation and breathing exercises. Advice for life style and diet was given for patients of both the groups. The effect of the therapy was assessed subjectively and objectively. Particular scores drawn for Naturopathic group and control group were indi vidually analyzed before and after treatment and the values were compared using standard statistical protocols. Results: Naturopathic intervention revealed 100% relief in both subjective and objective parameters (i.e., 6 out of 14 parameters showed statistically highly significant P < 0.01 results, while 8 showed significant results P < 0.05). Conclusion: Statis tically highly significant results of this study point out the successful management of the multi factorial low back-pain with a multi focused Naturopathic treatment approach. Such encouraging results may pave the way for a future study on a large sample in a longer duration incorporating clinical investigations.

Background. Sleep is recognized as an all-important physiological process, which also contributes to maintaining several bodily functions and systems. According to the Pittsburgh Sleep Quality Index (PSQI), also known as the most widely used tool in the field of subjective assessment of self-perceived sleep quality, a combination of acupoints could be more effective than single acupoint treatment in improving sleep quality. Methods. The present study was based on the extracted eligible studies rooted in a previous meta-analysis that worked on the basis of association rule mining and examined the potential kernel acupoint combinations for improving sleep quality. Results. Depending on the Apriori algorithm, we summarized 26 acupoints as binary data from the 32 eligible studies based on a previous meta-analysis and analyzed them. The top 10 most frequently selected acupoints were HT7, SP6, PC6, KI1, GV20, EM5, EX-HN3, EX-HN16, KI3, and MA-TF1. Furthermore, as deduced from 21 association rules, the primary relevant rules in the combination of acupoints are (EX-HN3, EX-HN16)=>(GV20) and (HT7, KI1)=>(PC6). Conclusions. In order to use acupuncture to improve sleep quality, integrating (EX-HN3, EX-HN16, GV20) with (HT7, KI1, PC6) acupoints could be deemed as the kernel acupoint combination.

The high prevalence of hypertension is a problem for public health status, so hypertensivepatients need to get safe treatment from side effects of medication, because treatment mustbe carried out in the long term. In this study, researchers conducted acupressure therapy toreach lower blood pressure in hypertensive patients. This study used a quasi-experimentalwith one group pre and post-test design. The sample in this study involved 15 hypertensivepatients where hypertension drugs were still consumed. The results of this study showed thatafter being given acupressure therapy, systolic blood pressure decreased by 15people anddiastolic pressure decreased by 12 people and increased by 3 people. Before being giventherapy, the mean systolic blood pressure was 164.02 mmHg and after acupressure therapyit decreased to 141.44 mmHg, and the mean diastolic pressure before therapy was 91.49mmHg and decreased after therapy to 86.71mmHg. The results of the paired t test showedthat diastolic blood pressure (p value = 0.000) and diastolic blood pressure (p value =0.000), meaning that there was an effect of acupressure therapy on lowering blood pressure.Acupressure therapy is effective forlowering blood pressure, so it is hoped that this modalitytherapy can also be implemented in government health care facilities by health workers,especially nurses in order to reduce the side effects of medical treatment.

As there is a high propensity for patients with advanced malignancy to experience refractory dyspnea, it is necessary for physicians to be well-versed in the management of these patients’ dyspneic symptoms. For symptomatic treatment of cancer patients with dyspnea, both pharmacologic and non-pharmacologic methods should be considered. The main source of pharmacologic symptom management for dyspnea is oral and parenteral opioids; benzodiazepines and corticosteroids may serve as helpful adjuncts alongside opioid treatments. However, oxygen administration and nebulized loop diuretics have not been shown to clinically benefit dyspneic cancer patients. Applying non-pharmacologic dyspnea management methods may be valuable palliative therapies for advanced cancer patients, as they provide benefit with negligible harm to the patient. Advantageous and minimally harmful non-pharmacologic dyspnea therapies include facial airflow, acupuncture and/or acupressure, breathing exercises, cognitive behavioral therapy, music therapy, and spiritual interventions. Thus, it is vital that physicians are prepared to provide symptomatic care for dyspnea in advanced cancer patients as to minimize suffering in this patient population during definitive cancer treatments or hospice care.

Background and Purpose: Fatigue control in hemodialysis (HD) patients requires a multidisciplinary approach. This study aimed to comprehensively review the available research literature regarding the nonpharmacological interventions used for reducing fatigue among Iranian HD patients. Methods: In this systematic review, an extensive search of the literature was conducted on PubMed, Web of Science, and Scopus databases, using the keywords related to the purpose. Also, the Persian equivalent of these keywords was searched in Iranian databases, such as Iranmedex and Scientific Information Database (SID) from the inception to June 16, 2020. Results: Of 2,761 articles, 25 studies were included in the review. Among a total of 1,748 Iranian HD patients with a mean age of 54.17 (SD = 12.27) years, 61.38% were male. Interventions such as educational-based programs (n = 5), nutrition-based programs (n = 2), massage therapy (n = 3), exercise-based programs (n = 4), relaxation technique (n = 3), combination of relaxation technique and inhalation aromatherapy (n = 1), energy therapy (reflexology and acupressure) (n = 3), and mind-guided imagery (n = 1) were effective in reducing fatigue in Iranian HD patients. Discussion/Conclusion: These simple, low-cost, and practical interventions can be used for the reduction of fatigue among HD patients by nurses. However, future well-designed studies are recommended to confirm the efficacy of these and other potentially effective interventions for reducing fatigue in HD patients.

Актуальность. В комплексном лечении и реабилитации пациентов с наиболее распространенными заболеваниями с успехом используют различные методы рефлексотерапии (РТ). Среди них достойное место занимает акупрессура (АП) — массаж, выполняемый методом надавливания подушечками пальцев в зонах биологически активных точек с помощью общепринятых приемов. Существуют отдельные публикации, посвященные положительным результатам применения РТ при хроническом панкреатите (ХП) и сахарном диабете (СД) 2 типа, однако они требуют дальнейшей разработки и доказательности. Цель исследования: изучить эффективность комплексной реабилитации больных хроническим панкреатитом с сопутствующим сахарным диабетом с включением в нее курса акупрессуры в сочетании с питьевыми минеральными водами (ПМВ) Сходницкого месторождения по влиянию на клиническое течение, параметры эндогенной интоксикации и состояние про- и антиоксидантного статуса. Материалы и методы. Обследовано 53 пациента с ХП и сопутствующим СД. Средний возраст пациентов составил (52,86 ± 0,83) года; средняя продолжительность заболевания — (10,96 ± 0,39) года. Больных разделили на две группы в зависимости от комплексов реабилитационного лечения. Первая группа (30 больных) получала комбинацию общепринятого лечения по протоколу (ОЛ) с включением адеметионина (сублингвальные таблетки агепта по 400 мг) в течение одного месяца и курса питьевых минеральных вод по предложенной методике (ОЛ + ПМВ). Вторая группа (23 пациента) дополнительно к ОЛ + ПМВ получала курс АП по разработанной авторами схеме на основе рекомендаций киевской (Мачерет Е.Л. и др.) и пекинской школ РТ (Конг Лин) из 11 сеансов (ОЛ + ПМВ + АП). Результаты. Улучшение самочувствия пациентов и уменьшение интенсивности симптомов и синдромов ХП у пациентов под влиянием реабилитационных программ констатировали в обеих группах на основе анализа количества пациентов с имеющимися клиническими признаками в динамике лечения и по данным тестирования по специальному опроснику GSRS. Высокая эффективность предложенной программы с акупрессурой доказана по уменьшению количества пациентов с болевым синдромом на 50 % в I группе и на 68,97 % — во второй; по динамике возрастания суммарного показателя качества жизни по опроснику GSRS — соответственно в 1,7 и 2,2 раза (p < 0,001); по динамике снижения индекса эндотоксикоза — на 31,61 и 53,40 % соответственно (p < 0,001); по динамике роста уровня антиоксидантной системы защиты глутатиона (SH-групп) — на19,45 и 36,08 % (p < 0,001). Выводы. Включение курса акупрессуры по предложенной схеме из 11 сеансов в программу месячной комплексной реабилитации с применением гепатотропного сублингвального препарата адеметионина и курса питьевых минеральных вод Сходницкого месторождения в течение 14 дней при хроническом панкреатите в коморбидности с сахарным диабетом 2 типа привело к более высокому уровню эффективности. Это доказало целесообразность использования курса акупрессуры в реабилитации таких пациентов.

Introduction: The prevalence of pregnancy anxiety is around 14-54%, highest in the first and third trimesters. Acupressure attracts attention as a non-pharmacological therapy for natural relaxation. The research aims to determine the effect of acupressure therapy on anxiety levels. Method: This study was conducted at the Health Centers of Tamalanrea Jaya and Antang, the study used a quasi-experimental design with the pre and post test approach in the intervention group and the control group. The total of research subjects 40 trimester III pregnant mothers who had experience anxiety. The intervention group (21 samples) with acupressure therapy and the control group (19 samples) with placebo therapy. Measuring anxiety using the Hamilton Anxiety Rating Scale (HARS). Result: in the intervention group, the mean of anxiety before the intervention was 26.6 and after the intervention was 22.3 (p value

Die Selbstakupunktur wird seit vielen Jahren nicht nur in China angewendet, die wissenschaftlichen Untersuchungen dazu sind aber sehr sparlich. Es gibt Hinweise, vor allem in chinesischer Sprache, dass eine Selbstakupunktur mit Nadeln durchaus praktikabel moglich ist und auch im Bereich der Lehre dort selbstverstandlich angewendet wird. Zur Behandlung einzelner Krankheiten existieren aber nur sehr wenige relevante wissenschaftliche Arbeiten. Ziel dieser kurzen Ubersichtsarbeit ist es, diese Publikationen aus der Sicht der Wissenschaft zu beleuchten und auch neue Varianten wie beispielsweise die selbstapplizierte Lasermedizin in den Fokus des Interesses zu stellen. Ein wichtiger Punkt ist auch jener, dass die Selbstakupunktur mit Nadeln selbstverstandlich immer nur nach den gultigen Gesetzen des jeweiligen Landes erfolgen kann und darf. Die Fragestellung, wie man Tradition und Innovation auf dem Gebiet der Selbstakupunktur effizient kombinieren kann, wird auch hier eine der Herausforderungen fur die Entwicklung der Akupunktur in der heutigen modernen Gesellschaft sein.

Background: Type 2 diabetes has become a major global public health concern characterized by dysregulation of carbohydrate, lipid and protein metabolism, and results from impaired insulin secretion, insulin resistance or a combination of both Abstract: Acupressure lowers the blood glucose level through a massage at the point of the meridian, which can trigger the calming and uplifting response in the body, Resistive exercise is often recommended for patients with type 2 diabetes to improve physical conditioning and glycemic control. Aim of Study: The current study was conducted to compare between: Effect of resistive exercise and Acupressure on blood glucose level in type 2 diabetes. Subjects and Methods: Sixty patients (34 male 26 female) with type 2 diabetes participated in this study their age ranging from 35 to 60 years. They were selected from outpatient clinic in Internal Medicine, Luxor General Hospital. Group A: Received acupressure therapy (AT on point (Sp-6) which found atone palm width above the tip of inner ankle bone on the back of the shinbone, 3 minutes and repeated 3 times per session on both legs for three times per week for 12 weeks, in addition to hypoglycemic drugs. Group B: Received resistive exercise using dumbbell and sandbag, intensity of exercise for each muscle group determined after assessment of ten repetition maximum (10RM) 40% to 60% of 1RM (1 set 10 repetitions) used for 30 minute 3 time per week for 12 week beside their medication. 10RM reevaluated every 2 week and after 2 week load increase to 2 set 10 repetitions. Method of evaluation was measurement of random blood glucose level measured before starting and after each session glycosylated hemoglobin (HbA1c) fasting blood glucose level, 2 hour post prandial and glucose level and insulin level measured before starting and after end of program. Results: There was a significant decrease in randomized blood glucose, fasting blood glucose and increase in insulin level with no significant differences in HA 1 C and 2 hour post prandial in acupressure group when compared with resistive exercise group. Conclusion: Acupressure is more effective than resistive exercise as a complementary alternative medicine & can be helpful in reducing blood glucose level and increasing insulin levels in type 2 diabetic patients.

Background: Management of various discomforts require unique observations and knowledge of variety of treatment options. The present study aimed to examine the effectiveness of application evidence-based measures on alleviating minor discomforts during 1st trimester of pregnancy. A quasi- experimental design was used. The study was conducted at the Antenatal clinics at Ain Shams University Maternity Hospital. A Purposive sample of one hundred and three pregnant women were included in the study, all women were received the intervention. Data were collected through using three tools (A structured interviewing questionnaire, pregnancy symptoms inventory (PSI)& Weekly follow up sheet). In addition to Arabic Evidence based guide for alleviating minor discomforts during 1st trimester of pregnancy. The main results of the study were the following: All pregnant women that suffered from the current discomforts (nausea and vomiting, heartburn, and constipation) followed the evidence-based guide which designed by the researcher that involved instructions related to lifestyle modification besides, one of the following were used: herbal therapy, acupressure, and aromatherapy. Additionally, the present study demonstrates that there is highly significant difference between responses rate at before and after the intervention related to (nausea &vomiting, heartburn, and constipation). This significance in women response rate led to positive effect in decreasing frequency of current discomforts (nausea& vomiting, heartburn, and constipation) at before and after intervention. The current study concluded that evidence-based guide had a positive effect on alleviating minor discomforts during 1st trimester of pregnancy. The following is recommended: Inclusion of leaflet or booklet about evidence-based measures for alleviating minor discomforts during pregnancy as a hospital protocol for guiding nurses in application.

Background: chronic obstructive pulmonary disease (COPD) is a leading cause of morbidity and mortality worldwide. Dyspnea has considered the most common health problem among patients with COPD; non pharmacological management of dyspnea decreases its grade. Aim: to evaluate the effect of acupressure versus pursed lip breathing techniques on physiological parameter and dyspnea grade among patient with COPD. Design: A quasi-experimental design was utilized. Sample: It included 80 adult patients and divided into two groups as a group (1) acupressure group (n=40) and group (2) pursed lip breathing techniques (n=40). Setting: the study was conducted at the chest unit at Alexandria main university hospital. Tools: (1) socio-demographic data questionnaire, (2) Modified medical research council scale (MMRC), and (3) physiological parameter. Results: There was a decrease in dyspnea grade post-pursed-lip breathing group more than acupressure group and there was a statistically significant difference between two groups about dyspnea by the end of the 4th week and respiratory rate & oxygen saturation. Conclusion: Pursed-lip breathing was effective therapy for patients with COPD to improve dyspnea, physiological parameter, and oxygen saturation, while acupressure has a minimal significant effect on dyspnea grade. Recommendation: Prospective study should be designed to determine the stability of the effect of acupressure to control dyspnea.

Objective To evaluate race and gender variations in complementary and alternative medicine (CAM) use for knee osteoarthritis (OA) (unadjusted and adjusted for demographic and clinical factors). Methods A secondary analysis of cross‐sectional data was conducted. The sample included Veterans Affairs patients 50 years of age or older with symptomatic knee OA. Current use of various CAM therapies was assessed at baseline. Logistic regression models were used to compare race and gender differences in the use of specific CAMs. Results The sample included 517 participants (52.2% identified as African American [AA]; 27.1% identified as female). After adjusting for demographic and clinical factors, AA participants, compared with white participants, were less likely to use joint supplements (odds ratio [OR]: 0.53; 95% confidence interval [CI], 0.31‐0.90]); yoga, tai chi, or pilates (OR: 0.39; 95% CI: 0.19‐0.77); and chiropractic care (OR: 0.51; 95% CI: 0.26‐1.00). However, they were more likely to participate in spiritual activities (OR: 2.02; 95% CI: 1.39‐2.94). Women, compared with men, were more likely to use herbs (OR: 2.42; 95% CI: 1.41‐4.14); yoga, tai chi, or pilates (OR: 2.09; 95% CI: 1.04‐4.19); acupuncture, acupressure, or massage (OR: 2.45; 95% CI: 1.28‐4.67); and spiritual activities (OR: 1.68; 95% CI: 1.09‐2.60). The interactive effects of race and gender were significant in the use of herbs (P = 0.008); yoga, tai chi, or pilates (P = 0.011); acupuncture, acupressure or massage (P = 0.038); and spiritual activities (P < 0.001). Conclusion There are race and gender differences in the use of various CAMs for OA. As benefits and limitations of CAM therapies vary, clinicians must be aware of these differences.

BACKGROUND Fatigue, a common complaint reported by patients with cancer or in survivorship, has been negatively associated with quality of life, emotional health, and cognitive functions. Acupressure, a traditional Chinese medicine, has been increasingly practiced in clinical and community settings. However, little evidence supports the beneficial effects of acupressure on the reduction of general, physical, and mental fatigue in cancer survivors. OBJECTIVE The aim of this study was to examine the effect of acupressure on fatigue in cancer survivors and the moderators of the effect of acupressure on cancer-related fatigue relief. METHODS Databases, namely, PubMed, Embase, CINAHL, and ProQuest, were searched from their inception to July 17, 2020. No language and publication period restrictions were applied. Only randomized controlled trials that examined the effects of acupressure on cancer-related fatigue were included. A random-effects model was used for data analyses. RESULTS Fourteen articles involving 776 participants with cancers were included. Acupressure considerably alleviated cancer-related general, physical, and mental fatigue (g = -0.87, -0.87, and -0.37) compared with controls. Increasing female percentage of participants significantly reduced the effects of acupressure on fatigue (B = -0.01, P < .001). The executor and operation approach as well as treatment period during chemotherapy did not moderate the effects of acupressure on fatigue relief. CONCLUSION Acupressure is effective at alleviating cancer-related fatigue. IMPLICATIONS FOR PRACTICE Health professionals and patients can use acupressure to alleviate fatigue during and after chemotherapy. Nursing personnel could incorporate acupressure into clinical practice as part of a multimodal approach to alleviating fatigue in cancer survivors.

Background. Arteriovenous fistula (AVF) puncture pain is an inevitable problem for maintenance hemodialysis (MHD) patients and may seriously endanger the physical and mental health of patients with MHD. Studies have shown that drug or nondrug measures can reduce AVF puncture pain, but much improvement is needed. When combined with compound lidocaine cream (CLC) in the treatment of AVF puncture pain, auricular point acupressure (APA)—a therapeutic method in which specific points on the auricle of the outer ear are stimulated to treat various disorders of the body—and the therapeutic value and synergistic effects of auriculotherapy merit further investigation. Methods. 120 MHD patients were recruited at blood purification centers in three hospitals between January 2016 and April 2019. After completion of the baseline survey, all patients were randomly divided by the envelope method into a control group, APA group, CLC group, and APA combined with CLC, with 30 subjects per group. The numerical rating scale (NRS) of pain was used to measure the pain before intervention and 1, 4, and 8 weeks after intervention. The State-Trait Anxiety Inventory (STAI), General Comfort Questionnaire (GCQ), blood pressure, and heart rates were obtained before and after the intervention. Results. Pain, anxiety, comfort, blood pressure (BP), and heart rates (HR) of the three groups were better than those of the control group; the difference was statistically significant ( P < 0.05 ). In addition, the APA combined with CLC group was better than the APA group and CLC group, respectively, in those outcomes ( P < 0.05 ). Conclusion. Both APA and CLC can effectively relieve AVF puncture pain, and the combined application has more outstanding effects.

Fatigue is an enervating symptom of prolonged dialysis of patients and significantly impacts the health related quality of life of dialysis patients. Reduction of fatigue in dialysis patients is a challenging task for any health care provider. Fatigue develops during long term dialysis usually due to chronic health conditions associated with prolonged dialysis. The contributing factors for fatigue in end stage renal disease (ESRD) patients may be broadly classified into physiological, psychological / behavioural, socio-demographic and dialysis related factors. It is known that some of these factors are modifiable leading to reduction in fatigue. A multidisciplinary health care strategy comprising alternative therapy such as acupressure; mind based therapy such as meditation, deep breathing and yoga; body based therapies such as physical activity, therapeutic exercise, body massage; biological based therapy such as diet and nutrition shall help to reduce the fatigue in dialysis population. Conclusion: To improve the patient care and health related quality of life in dialysis patients, nurses should develop a framework for decreasing the fatigue. This concept paper describes the various therapies available for reducing the fatigue and discusses the ways of including these supportive and alternative therapies into regular medical care. Key words: Fatigue, ESRD, hemodialysis, alternative and supportive therapy