The Effect of Body Acupressure on Blood Pressure and Fatigue Levels in Individuals Suffering From Hypotension During Hemodialysis: A Randomized Controlled Trial.

Background/Aim Since hypotension is one of the most common complications experienced during hemodialysis (HD), and there are studies indicating that stimulation of the P6 (Neiguan) acupuncture point affects blood pressure, this study examines the effect of acupressure performed on this point on blood pressure regulation as well as its effect on symptoms such as hypotension-associated fatigue and pain. This randomized controlled trial was conducted in order to determine the effect of 12-session body acupressure, performed by electrostimulation device, on blood pressure, headache, and fatigue level in individuals suffering from hypotension during hemodialysis. Methods The study was conducted with a total of 135 patients, including 67 patients in the intervention group and 68 patients in the placebo group at four hemodialysis centers located in two city centers. The data were gathered using a questionnaire, visual analog scale (VAS) for pain and fatigue, and the Piper fatigue scale. The forms were administered at the beginning of the application (first follow-up) and four weeks later (second follow-up). In the intervention group, the electrostimulation device was attached to the Neiguan (p6) acupuncture point and operated at the third hour of each dialysis session three times a week for one month. In the placebo group, the device was attached to the same acupuncture point but its batteries were removed and it was not operated. At the end of the four-week application, the forms were administered again. One-way analysis of variance, t test, Student-Newman-Keuls test, Pearson correlation analysis, Chi-square, McNemar test and McNemar Bowker test were used to assess the data. Results It was found that systolic and diastolic blood pressure levels were higher in all sessions in the intervention group compared to the placebo group (P < .05). In the first follow-up, no difference was observed between the groups in terms of the scores of VAS pain, VAS fatigue, and Piper fatigue scale (P > .05); whereas, in the second follow-up, it was determined that VAS pain scores, VAS fatigue scores, and affective, sensory, and total scores of the Piper fatigue scale decreased in the intervention group compared to the placebo group (P < .05). Conclusions As a conclusion; it was found that body acupressure, which was performed on the Neiguan (P6) acupuncture point using electrostimulation device, provided the systolic and diastolic blood pressure regulation and decreased VAS pain severity, VAS fatigue severity, and total score and subscale mean Piper fatigue scale scores.

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