부산대학교 도서관

ontrolled trial to investigate the effects of auricular acupressure on pruritus, skin dryness, and depression in hemodialysis patients. The study period was between September 9th 2019 and November 23rd 2019. Fifty six hemodialysis patients agreed to participate in the study and were randomly assigned: 27 in experimental group and 27 in control group, after excluding three dropouts. Auricular acupressure was done on 5 reaction points (shenmen, heart, kidney, lung and occiput) alternately in both ears. Auricular acupressure was applied to experimental group, while control group was observed without intervention for the first 5 weeks, and the intervention was crossed over between the groups in another 5 weeks. The study outcomes were pruritus, pruritus-associated sleep disturbance, and depression. Skin dryness was measured with trans-epidermal water loss and stratum corneum hydration content. SPSS WIN 22.0 statistical program was used for the analysis. Normality was tested with Shapiro-Wilk test. Categorical variables were expressed as number (percentage) and continuous variables were expressed as mean ± standard deviation. Difference was tested with χ2-test or Fisher's exact text for categorical variables, and t-test or Mann-Whitney U test for continuous variable. The research hypothesis was tested by Mann-Whitney U test and Wilcoxon signed-rank test. The additional analysis was done by Friedman test, and the post-hoc analysis was done by Bonferroni correction.The study results are summarized as following.1) Hypothesis No. 1: 'The degree of pruritus will be reduced with auricular acupressure’ was supported by the study: z=-3.97, p< .001.2) Hypothesis No. 2: 'The degree of pruritus-associated sleep disturbance will be reduced with auricular acupressure.’ was supported by the study: z=-2.97, p= .003.3) Hypothesis No. 3: 'The amount of trans-epidermal water loss will be decreased with auricular acupressure.' was partly supported by the study. In the study, trans-epidermal water loss was decreased in arms (z=-2.23, p= .026) and trunk (z=-1.97, p = .049), but not in the leg (z=-1.76, p=.079).4) Hypothesis No. 4: ‘The level of stratum corneum hydration contents will be increased with auricular acupressure.’ was not supported by the study. The arm (z=-0.48, p= 0.628), trunk (z=-1.37, p= .170), and legs (z=-0.18, p= .856) were not significantly affected by the intervention.5) Hypothesis No. 5: ‘The degree of depression will be reduced with auricular acupressure.’ was not supported by the study. There was no significant difference according to the intervention: z=-0.35, p= .721. In summary, 5 weeks’ auricular acupressure had a significant effect on the relief of pruritus and the degree of pruritus-associated sleep disturbance. This may be because auricular acupressure may improve trans-epidermal water loss. According to this study, auricular acupressure was proved to be easy, simple, safe, and effective. Also there is no limitation in time and space. Therefore it may be an effective nursing intervention for pruritus in hemodialysis patients. Future large studies need to be followed to confirm the present study.
본 연구는 이압요법이 혈액투석 환자의 소양증, 피부건조, 우울에 미치는 효과를 규명하기 위한 무작위 대조군 실험연구이다. 연구기간은 2019년 9월9일부터 11월23일까지이며, 혈액투석을 받는 환자로 연구참여에 동의한 대상자 56명을 실험군과 대조군으로 무작위 배정하였다. 그 중 탈락자를 제외한 실험군 27명과, 대조군 27명이 연구에 참여하였다. 실험군에게 5곳의 귀 반응구역인 신문, 심장, 신장, 폐, 뒷머리에 5주간 첩압하였고, 대조군은 실험군의 처치가 끝난 5주 후에 실험군과 동일한 방법으로 이압요법 중재를 진행하였다. 관련 종속변수는 소양증, 소양증으로 인한 수면방해, 우울을 측정하였고, 피부건조로는 경피수분 손실량과 각질층 수분함량을 측정하였다. 자료분석은 SPSS WIN 22.0통계프로그램을 이용하였으며 수집된 자료에서 대상자의 일반적인 특성과 질병관련 특성은 실수와 백분율, 평균과 표준편차, χ2-test, Mann-Whitney U test, t-test, Fisher’s exact test로 확인하였고, 종속변수에 대한 정규성 검정은 Shapiro-Wilk normality test로 확인하였다. 연구가설 검정은, Mann-Whitney U test, Wilcoxon signed-rank test로 하였으며, 추가 분석은 Friedman test로 하였고, 사후 검정은 bonferroni로 분석하였다. 본 연구에서 이압요법 효과에 대한 연구결과는 다음과 같다.제1가설 : ‘이압요법을 적용받은 실험군은 적용받지 않은 대조군 보다 소양증 정도가 감소할 것이다.’는 이압요법을 적용받은 실험군의 소양증이 대조군에 비해 통계적으로 유의한 감소를 보여(z=-3.97, p