Akut inmeli hastalarda akupresürün fizyolojik parametreler, anksiyete ve uyku kalitesi üzerine etkisi: Randomize kontrollü çalışma
The effect of acupressure on physiological parameters, anxiety and sleep quality in acute stroke patients: A randomized controlled trial
Yazar: DİLEK YILMAZ
Danışman: PROF. DR. YASEMİN YILDIRIM USTA
Bolu Abant İzzet Baysal Üniversitesi / Lisansüstü Eğitim Enstitüsü / Hemşirelik Ana Bilim Dalı
Derece: Doktora, 2021
Konu: Hemşirelik = Nursing ; Nöroloji = Neurology
Dizin: Akupresür = Acupressure ; Anksiyete = Anxiety ; Fizyolojik parametreler = Physiological parameters ; Hemşirelik = Nursing ; Uyku kalitesi = Quality of sleep ; İnme = Stroke

Özet:
İnme, tıbbi olarak acil bir durumdur ve hastaların %25'i inmeden 24-48 saat sonra nörolojik olarak kötüleşmektedir. Akut dönem inme hastalarına sağlanan güvenli ve etkili bir bakım, iyileşme süreci ve komplikasyonların önlenebilmesi için oldukça önemlidir. Akut inme geçiren hastalarda prognozun kötüleşmesinde ve komplikasyonların ortaya çıkmasında düzensiz vital bulgular, düşük uyku kalitesi ve anksiyete gibi semptomlar önemli rol oynamaktadır. Bu semptom ya da komplikasyonların giderilmesinde uygulanan hemşirelik girişimleri arasında, yan etkisi olmayan, maliyet açısından düşük, uygulanması kolay ve etkili olduğu belirtilen akupresürün etkisini araştırmak için planlanan bu randomize kontrollü çalışmada, örneklemi 64 hasta (müdahale= 32, plasebo= 32) oluşturmaktadır. Müdahale grubuna, inmenin ilk 72 saati içinde 12 saat arayla 3 gün boyunca toplamda 6 akupresür uygulaması, plasebo grubuna ise yalancı akupresür uygulaması yapılmıştır. Her uygulama öncesi ve sonrası hastaların vital bulguları, her uygulama sonrası ise anksiyete ve uyku düzeyleri kayıt altına alınmıştır. Verilerin toplanmasında "Hasta Bilgi Formu", "Ulusal Sağlık Enstitüsü İnme Skalası (NIHSS)", "Modifiye Barthel Günlük Yaşam Aktiviteleri İndeksi (MBI)", "Spielberger Durumluk- Süreklilik Anksiyete Ölçeği (Stait-Trait Anxiety Inventory/STAI)", "Richard-Campbell Uyku Ölçeği (RCUÖ)" ve "Fizyolojik Parametreleri Değerlendirme Formu" kullanılmıştır. Veriler değerlendirilirken tanımlayıcı istatistikler, bağımsız t testi, Mann Whitney U testi, bağımlı t testi, varyans analizi ve Friedman testi kullanılmıştır. Akupresür uygulaması sonrası, gruplar arasında durumluk anksiyete ve RCUÖ puan ortalamalarında istatistiksel olarak anlamlı bir fark olduğu (p<0.05), anksiyete düzeyinin azaldığı ve uyku kalitesinin arttığı bulunmuştur. Ayrıca akupresür uygulaması sonrası gruplar arasında DKB, nabız, solunum ve oksijen satürasyonu değerleri arasında istatistiksel olarak anlamlı bir fark bulunmuştur (p<0.05). Akupresürün kullanımı kolay ve etkili bir uygulama olabileceği ve klinikte hemşireler tarafından bağımsız olarak kullanılabileceği düşünülmektedir. Ayrıca akut inme hastaları için medikal tedaviye yardımcı bir uygulama olarak önerilebilir. 

ANAHTAR KELİMELER: İnme, akupresür, uyku kalitesi, anksiyete, fizyolojik parametre
ABSTRACT
THE EFFECT OF ACUPRESSURE ON PHYSIOLOGICAL PARAMETERS, ANXIETY AND SLEEP QUALITY IN ACUTE STROKE PATIENTS: RANDOMIZED CONTROLLED TRIAL
PHD THESIS
DİLEK YILMAZ
BOLU ABANT IZZET BAYSAL UNIVERSITY
INSTITUTE OF GRADUATE STUDIES
DEPARTMENT OF NURSING
(SUPERVISOR: PROF. DR. YASEMİN YILDIRIM USTA)
BOLU, DECEMBER 2021
(XII + 143) 
 	
Stroke is a medical emergency, with 25% of patients having a neurological worsening 24-48 hours after stroke. Safe and effective care provided to acute stroke patients is very important for the recovery process and prevention of complications. Symptoms such as irregular vital signs, poor sleep quality and anxiety play an important role in worsening the prognosis and the emergence of complications in patients with acute stroke. In this randomized controlled study, which was planned to investigate the effect of acupressure application, which was stated to be low in cost, easy to apply and effective, among the nursing interventions applied to relieve these symptoms or complications, the sample consisted of 64 patients (intervention= 32, placebo= 32). In the intervention group, a total of 6 acupressure applications were applied for 3 days with 12-hour intervals within the first 72 hours of the stroke, and sham acupressure was applied to the placebo group. The vital signs of the patients before and after each application, and their anxiety and sleep levels after each application were recorded. In data collection, "Patient Information Form", "National Institute of Health Stroke Scale (NIHSS)", "Modified Barthel Activities of Daily Living (MBI)", "Spielberger State-Trait Anxiety Inventory (STAI)", "Richard-Campbell Sleep Scale (RCUQ)" and "Physiological Parameters Evaluation Form" were used. While evaluating the data, descriptive statistics, independent t test, Mann Whitney U test, dependent t test, analysis of variance and Friedman test were used. After acupressure application, it was found that there was a statistically significant difference in the mean scores of state anxiety and RSS between the groups (p<0.05), the level of anxiety decreased and sleep quality increased. In addition, a statistically significant difference was found in DBP, pulse, respiration and oxygen saturation values between the groups after acupressure application (p<0.05). It is thought that acupressure can be an easy and effective application and can be used independently by nurses in the clinic. It can also be recommended as an adjunct to medical treatment for acute stroke patients.

KEYWORDS: Stroke, acupressure, sleep quality, anxiety, physiological parameter

Abstract:
(XII + 143) 
 	
Stroke is a medical emergency, with 25% of patients having a neurological worsening 24-48 hours after stroke. Safe and effective care provided to acute stroke patients is very important for the recovery process and prevention of complications. Symptoms such as irregular vital signs, poor sleep quality and anxiety play an important role in worsening the prognosis and the emergence of complications in patients with acute stroke. In this randomized controlled study, which was planned to investigate the effect of acupressure application, which was stated to be low in cost, easy to apply and effective, among the nursing interventions applied to relieve these symptoms or complications, the sample consisted of 64 patients (intervention= 32, placebo= 32). In the intervention group, a total of 6 acupressure applications were applied for 3 days with 12-hour intervals within the first 72 hours of the stroke, and sham acupressure was applied to the placebo group. The vital signs of the patients before and after each application, and their anxiety and sleep levels after each application were recorded. In data collection, "Patient Information Form", "National Institute of Health Stroke Scale (NIHSS)", "Modified Barthel Activities of Daily Living (MBI)", "Spielberger State-Trait Anxiety Inventory (STAI)", "Richard-Campbell Sleep Scale (RCUQ)" and "Physiological Parameters Evaluation Form" were used. While evaluating the data, descriptive statistics, independent t test, Mann Whitney U test, dependent t test, analysis of variance and Friedman test were used. After acupressure application, it was found that there was a statistically significant difference in the mean scores of state anxiety and RSS between the groups (p<0.05), the level of anxiety decreased and sleep quality increased. In addition, a statistically significant difference was found in DBP, pulse, respiration and oxygen saturation values between the groups after acupressure application (p<0.05). It is thought that acupressure can be an easy and effective application and can be used independently by nurses in the clinic. It can also be recommended as an adjunct to medical treatment for acute stroke patients.

KEYWORDS: Acupressure, Anxiety, Physiological Parameter, Sleep Quality, Stroke