Effect of acupressure on constipation in patients undergoing hemodialysis: A randomized double-blind controlled clinical trial

Document Type: Original Research Article

Authors

1 Student Research Committee, Gonabad University of Medical Sciences, Gonabad, Iran

2 Social Development and Health Promotion Research Center & Department of Nursing, Faculty of Nursing and Midwifery, Gonabad University of Medical Sciences, Gonabad, Iran

3 Department of Medical Physics, Faculty of Medicine, Gonabad University of Medical Sciences, Gonabad, IR Iran.

4 Department of Nutrition, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, IR Iran

Abstract

Objective: Constipation is one of the most common digestive problems in patients undergoing hemodialysis. It has a negative effect on quality of life in these patients. As routine treatments are not effective in this regard, complementary therapies may help to overcome this condition. This study aimed to investigate the effect of acupressure on constipation in patients undergoing hemodialysis.
Materials and Methods: This was a randomized double- blind placebo- controlled clinical trial conducted in 2014.A convenience sample of 70 patients undergoing hemodialysis was selected from hemodialysis units of three hospitals affiliated to Mazandaran University of Medical Sciences, Mazandaran, Iran. Patients were randomly assigned to intervention or control group. Intervention group received acupressure in acupressure points three times a week for four weeks during hemodialysis. In control group, acupressure was delivered in false points. We assessed the frequency of defecation in the two groups before and after the study. The study instruments consisted of a demographic questionnaire, and a data sheet for documenting constipation frequency.
Results: The results indicated a significant difference between intervention group (13.73±3.63) and control group (10.06±3.77) in frequency of defecation during the fourth week of intervention (p<0.001). Regarding quality of stool, there was a meaningful difference between the groups in the fourth week in a way that the stool in the intervention group was more natural and in the control group, it was thicker and more adhesive.
Conclusion: Acupressure seems to be an effective complementary treatment for constipation in patients undergoing hemodialysis.

Keywords

Main Subjects


Andrews CN, Storr M. 2011. The pathophysiology of chronic constipation. Can J Gastroenterol Hepatol, 25(Suppl B): 16B-21B.

Atashpeikar S, Jalilazar T, Heidarzade M. 2012. Self-care ability in hemodialysis patients. J Caring Sci, 1:  31-35.

Chao H.-L, Miao SJ, Liu PF, Lee HH, Chen YM, Yao CT, Chou HL. 2013. The beneficial effect of ST-36 (Zusanli) acupressure on postoperative gastrointestinal function in patients with colorectal cancer. Oncol Nurs Forum, 40: E61-68.

Chen M.-L, Lin LC, Wu SC, Lin JG. 1999. "The effectiveness of acupressure in improving the quality of sleep of institutionalized residents. J Gerontol A Biol Sci Med Sci, 54: M389-M394.

Cho YC, Tsay SL. 2004. "The effect of acupressure with massage on fatigue and depression in patients with end-stage renal disease. J Nurs Res, 12:  51-54.

Fang Y-Y, Wang P-L, Tsai C-M, Hsieh M-H. 2012. Application of acupressure as a constipation intervention method in patients with acute coronary artery diseases: a systematic review. Sigma theta tau internationals 23rd international nursing research congress, Brisbane.

Hammer J, Osterreicher C, Hammer K, Koch U, Traiendi O, Kovarik J. 1998. Chronic gastrointestinal symptoms in hemodialysis patients. Wien Klin Wochenschr, 110:  287-291.

Lehnhardt A, Kemper MJ. 2011. Pathogenesis, diagnosis and management of hyperkalemia. Pediatric nephrology, 26:  377-384.

Lew S. 2001. The digestive tract. Handbook of Dialysis: 601-610.

Maa S. 2005. Application of acupressure in nursing practice. Hu Li Za Zhi, 52:  5-10.

Murtagh FE, Addington-Hall J, Higginson IJ. 2007. The prevalence of symptoms in end-stage renal disease: a systematic review. Adv Chronic Kidney Dis, 14:  82-99.

Rogers J. 2011. How to manage chronic constipation in adults. Nursing times, 108:  12- 16.

Sorouri M, Pourhoseingholi MA, Vahedi M, Safaee A, Moghimi-Dehkordi B, Pourhoseingholi A, Habibi M, Zali MR. 2010. Functional bowel disorders in Iranian population using Rome III criteria. Saudi J Gastroenterol, 16:  154-160.

Stark ME. 1999. Challenging problems presenting as constipation. Am J Gastroenterol, 94:  567-574.

Stein A. 2005. Acupressure guide: alleviate headaches, neck and joint pain, anxiety attacks and other ailments, author house. available at:https://scholar.google.com in: 10/1/ 2018.

Sun JL, Sung MS, Huang MY, Cheng GC, Lin CC. 2010. Effectiveness of acupressure for residents of long-term care facilities with insomnia: a randomized controlled trial. Int J Nurs Stud, 47: 798-805.

Tsai H. 2011. The Effectiveness of acupressure on improving bowel movement in long-term care patient (Thesis).

Tsay SL, Chen ML. 2003. Acupressure and quality of sleep in patients with end-stage renal disease—a randomized controlled trial.  Int J Nurs Stud, 40: 1-7.

Tsay SL, Cho YC, Chen ML. 2004. Acupressure and transcutaneous electrical acupoint stimulation in improving fatigue, sleep quality and depression in hemodialysis patients. Am J Chin Med, 32: 407-416.

Tsay S. L,Rong JR, Lin PF. 2003. Acupoints massage in improving the quality of sleep and quality of life in patients with end‐stage renal disease. J Adv Nurs, 42: 134-142.

Vatarii, I. 2011. The effect of acupressure on quality of sleep in hemodialysis patients. J Med Sci 11: 236-240.

Wang X and Yin J. 2015. Complementary and Alternative Therapies for Chronic Constipation. Evid Based Complement Alternat Med. 2015:1-11.

Xing JH, Soffer EE. 2001. Adverse effects of laxatives. Diseases of the colon & rectum, 44: 1201-1209.

Yang LY, Yates P, Chinn CC, Kaot K.  2010. Effect of acupressure on thirst in hemodialysis patients. Kidney Blood Press Res, 33: 260-265.