| Summary: | 碩士 === 高雄醫學大學 === 護理學研究所碩士班 === 96 === The purpose of this study is to examine the effectiveness of acupressure in regards to the Quality of Sleep, Fatigue and Energy (perceived energy and meridian energy) of Head and Neck Cancer Patients receiving Chemotherapy. Purposive sampling is used in this study of 58 Head and Neck Cancer Patients (PSQI＞5) receiving Chemotherapy from the Head and Neck Cancer units of a medical center in Southern Taiwan. An experimental design is used for this study. By controlling the effect of hypnotics, age, and gender (male), subjects are randomly assigned to either an experimental group or a control group. The experimental group has 25 subjects, and the control group has 33 subjects. The total sample size is 58 subjects. The experimental group received two weeks of acupressure protocol. The sessions were conducted five days per week, two times per day with one session in the morning and one in the evening. Each session lasted 12 minutes. The control group did not receive the acupressure protocol. Five series of data were collected from the fifty eight subjects during the one month experiment. Research instruments include the Demographic Inventory of Patients, Pittsburgh Sleep Quality Index, Richards-Campbell Sleep Questionnaire, Revised Piper Fatigue Scale, Fatigue Visual Analogue Scale of Energy Subscale, The Well-Being Picture Scale, Credibility of Acupressure Rating Scale, and Ryodraku. Statistical analysis of all collected data were performed with descriptive analysis, Chi-Square, two-sample t-test, paired t-test, one-way ANOVA, two-way ANOVA with repeated measures, three-way ANOVA with repeated measures, and Pearson’s product-moment correlation.
Results: Acupressure significantly improved the quality of daily sleep, as well as the sleep quality in the previous one month of Head and Neck cancer patients receiving chemotherapy. Subjective sleep quality, sleep latency, sleep duration, habitual sleep efficiency, sleep disturbance were all significantly improved. Fatigue and the cognitive/mood of fatigue went down significantly. Subject’s energy was also significantly better (Fatigue Visual Analogue Scale of Energy Subscale). But the use of sleep medication and daytime dysfunction of Pittsburgh Sleep Quality Index; behavioral/severity; affective meaning, and sensory of fatigue; perceived energy(Well-Being Picture Scale); and 24 meridian energy, average meridian energy, upper and lower limbs ratio, left blood and right qi, yin yang ratio prove not to affect energy significantly. In experimental group, during post measure, there was a significant positive relationship between the Richards-Campbell Sleep Questionnaire and Credibility of Acupressure. Pre measure Head and Neck cancer patients and experimental group post measure Ⅳ, experienced energy and well-being that had a significantly high, medium positive relationship between Fatigue Visual Analogue Scale of Energy Subscale and the Well-Being Picture Scale. But experimental group post measure Ι did not show a significant association between the Richards-Campbell Sleep Questionnaire and the Credibility of Acupressure. Experimental group post measure Ι, post measureⅡ, and post measureⅢ were found not to have according to the Fatigue Visual Analogue Scale of Energy Subscale and Well-Being Picture Scale, energy that did not significantly correspond with their well-being. The Fatigue Visual Analogue Scale of Energy Subscale and Well-Being Picture Scale of the pre measure Head and Neck cancer patients and experimental group post measure Ι, post measureⅡ, post measureⅢ, and post measure Ⅳ did not have a significant correlation with the average value of meridian energy.
In addition, pre measure head and neck cancer patients were found to have a significantly lower value of lung meridian, pericardium meridian, heart meridian, small intestine meridian, and large intestine meridian (on left and right hands), lower value of spleen meridian and bladder meridian (on left and right legs), lower value of stomach meridian on the right leg, lower average meridian energy, and a lower yin yang ratio than the healthy people. The rest had no significant difference. Subjects in both experimental groups and control groups were shown to have a significantly lower average value of meridian energy than that of healthy people in pre-measure, post-measure I and post-measure II. In post-measure III and IV, no significant difference was detected in the average value of subjects in the experiment and control groups as well as a healthy person. In post-measure I, those in the experiment group tended to have a lower yin yang ratio than that of a healthy adult. However, there was no significant difference in the yin yang ratio of those in the control group and a healthy adult. There was no significant difference in the yin yang ratio of subjects in the experimental group, control group and healthy individuals in pre-measure, post-measure II, post-measure III, and post-measure IV. In pre-measure, post-measure I, post-measure II, post-measure III, and post-measure IV, subjects in both the experiment group and control group did not display a significant difference in upper limb and lower limb ratio and left blood right qi than healthy individuals.
Based on the research results and a thorough literature review, we suggest that four week long acupressure research study be conducted. Continuous intervention shall result in better treatment effectiveness. On the other hand, when evaluating effectiveness, post measure of meridian energy value should be taken within 20 or 60 minutes after the introduction of acupressure intervention. An improvement in meridian energy level will be observed. Furthermore, in every measurement of this study, since the energy level is shown differently in the different measures, we may ask what energy is and whether we are able to measure energy with The Well-Being Picture Scale. In the future, both qualitative and quantitative study shall be conducted to discuss and clarify the relationship between well-being and energy. Due to the difference of subjective energy measure and objective measure of the average value of meridian energy (physical fitness), this study also proposes that relevant studies shall be conducted to sort out the difference between them. This study serves as a reference for medical practitioners to help improve sleep quality, fatigue problems, and energy levels of Head and Neck cancer patients receiving chemotherapy.
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