The Effects of Different Acupressure Protocols on Agitation of Institutionalized Elderly with Dementia

• Main Authors: Sung-Hui Ni, 倪頌惠
• Other Authors: Li-Chan Lin
• Format: Others
• Language: zh-TW
• Published: 2005
• Online Access: http://ndltd.ncl.edu.tw/handle/49991967949986433180

碩士 === 國立陽明大學 === 臨床護理研究所 === 93 === Problem behavior is a major concern for elderly with dementia and their caregivers. Caregivers in families or nursing homes would like to learn skills that help reduce problem behaviors, thus enhancing the overall quality of care. Many problem-solving strategies have been developed to reduce dementia patents’ anxieties and help them to maintain physical and mental comfort. These strategies include complementary therapies such as herbal medicine, relaxation therapy, aromatherapy, massage and acupressure. Acupressure is widely applied in care giving because it is safe, effective, easy to learn and administer, low in cost and is rooted in Chinese culture. The purpose of this study was to investigate the effectiveness of acupressure in improving agitation of elderly with dementia in institutions. A quasi-experimental design was used. Subjects were chosen from a nursing home and three long-term care facilities. 34 subjects met the sampling criteria and 30 of these participated in this study. Subjects were divided into three groups; experimental group I, experimental group II and control group. In experimental group I, subjects received acupressure treatment I with Sishencong (Ex-HN1) and Fengch (GB20) as the main acupoints, with Shnmn (HT7) and Neiquan (PC6) as accessory acupoints. In experimental group II, subjects received acupressure treatment II with Shnmn (HT7), Neiquan (PC6), Fengch (GB20), Baihui (GV20), and Sanyinjiao (SP6) as acupoints. The control group received no acupressure intervention. Both experimental group I and II received acupressure programs lasting 4 weeks, with six sessions per week and 15 minutes per session. The indicators used to determine the effects of acupressure included scores from the Cohen-Mansfield agitation inventory, records of observed agitation during activities, the physical reaction checklist, the relaxation checklist, and the level of patient care difficulty. SPSS 11.5 for Windows was used to analyze all obtained data. The results of the study showed significant differences in the CMAI between pre-and-post tests in experimental group I compared to the control group. Among the experimental group I results, physically non-aggressive behavior and verbally agitated behavior showed significant decreases. No significant difference was found for pre- and post-test CMAI results in experimental group II. During acupressure sessions, both experimental groups exhibited significant decreases in the frequency of agitation. Experimental group I showed significant decreases in aggressive behavior, physically non-aggressive behavior, and verbally agitated behavior. Experimental group II showed significant decreases in physically non-aggressive behavior. The blood pressure, pulse, temperature and relaxation scores were significantly lower during the acupressure treatment. Experimental group I showed significant differences of systolic pressure, pulse, and relaxation weekly, while no significant differences were found in experimental group II. Experimental group I showed significant decreases in the care difficulty score, whereas experimental group II showed no significant difference. Among demographic variables, sex was negatively correlated with the change in scores of the CMAI, aggressive behavior, and physically non-aggressive behavior. Use of restraints was positively correlated with aggressive behavior score changes, but negatively correlated with verbally agitated behavior. Duration of restraint was negatively correlated with the score changes of verbally agitated behavior and relaxation. Cognitive function was positively correlated with verbally agitated behavior score changes. Based on these research findings, the use of acupressure to treat the agitation of elderly with dementia is significantly effective. It can help them relax and lower the level of caring difficulty. Nursing facilities can prolong the effectiveness of acupressure through lessening the use of restraints and eliminate the interfere of environment. he use of acupressure on the agitation of elderly with dementia is recommended as an agitation problem-solving strategy. The results indicate an alternative management approach for dementia patients is available for care givers and the positive results suggest further research is needed.