應用耳穴貼壓改善產婦睡眠之成效

Effects of Auricular Acupressure on Improving the Sleep Quality of Puerperae

背景：產婦普遍睡眠品質不佳，過去有研究運用耳穴按壓於護理人員、大學生及原住民老年婦女等健康群體，發現可有效改善睡眠品質，但尚未見探討耳穴按壓對於失眠產婦之成效的相關研究，故引發進行研究之動機。目的：探討耳穴貼壓措施介入對產婦睡眠品質之成效。方法　本研究採前瞻性類實驗性設計，共收案有睡眠品質不佳產婦共60人，實驗組（30人）施予神門穴、心穴、腎穴之耳穴貼壓，控制組（30人）則接受一般常規照顧。運用中文版匹茲堡睡眠量表（Chinese versionof the Pittsburgh Sleep Quality Index）於介入措施前及介入後第21天後，追蹤兩組產婦睡眠品質之改變，以廣義估計方程（generalized estimating equation）統計法比較耳穴貼壓介入後睡眠品質之改善成效。結果　耳穴貼壓於介入後第21天，實驗組之睡眠品質比控制組有顯著改善。於總分、主觀睡眠品質、睡眠時數及睡眠困擾等變項，實驗組改善程度均顯著大於控制組（p ＜ .05）。結論／實務應用　本研究發現，運用耳穴按壓三週，能有效改善產婦失眠的問題，且此非藥物性與非侵入之措施，可增加產婦睡眠之品質。

Background: Puerperae exhibit generally poor sleep quality. Previous studies have shown auricular acupressure aseffective in improving the sleep problems of nurses, college students, and elderly indigenous Taiwanese women. However, no study has yet examined the effectiveness of auricular acupressure in improving the sleep quality of postpartumwomen. Purpose: To explore the efficacy of auricular acupressure (AA) on puerperae who were affected by sleep disturbance. Methods: A prospective quasi-experimental design was used and 60 puerperae with insomnia who scored at least 5on the Chinese version of the Pittsburgh Sleep Quality Index (CPSQI) were recruited at one postpartum centre (a ＂doing-the-month＂ care centre) in northern Taiwan. The experimental group (n = 30) received pasted auricular magneticbeads and acupressure on the Shenmen, Xin, and Shen points. The control group (n = 30) received general nursing directionsabout insomnia only. All participants were assessed using the CPSQI prior to the intervention and on the 21stpost-intervention day. The intervention effects were analysed using the Generalized Estimating Equation (GEE).Results: After three weeks of the AA intervention, the mean global CPSQI score had decreased significantly morein the experimental group than in the control group (p ＜ .05). Furthermore, experimental-group participants reportedbetter sleep quality (p ＜ .05), longer total sleep time (p ＜. 001) and lower sleep disturbance (p ＜ .05) than their control-group peers. Conclusions / Implications for Practice: The present pilot study found complementary AA to be an effective interventionfor treating puerperae with insomnia. This non-pharmacological and nonintrusive intervention for improvingsleep disturbance in puerperae promotes the quality of sleep.