The Effect of Acupressure on Fear and Stress Amounts in Emergency Hemodialysis Patients: A Randomized Controlled Trial

Abstract

Background: Hemodialysis is a standard treatment for patients with end-stage renal disease (ESRD). However, some patients, despite receiving regular care, require emergency hemodialysis, a situation often associated with elevated amounts of fear and stress. Objectives: The present study aimed to evaluate the effect of acupressure on fear and stress amounts in patients undergoing emergency hemodialysis. Methods: This parallel, three-group, randomized controlled trial was conducted at Imam Khomeini Educational and Medical Center in Sari, Iran. Ninety eligible patients undergoing emergency hemodialysis were randomly assigned to acupressure, sham intervention, and control groups (n = 30 per group) using block randomization. Data collection tools included a demographic-medical questionnaire, a mini mental state examination (MMSE), and a Visual Analogue Scale to assess fear and stress. Outcomes were measured at baseline (first hour of intervention), one hour later, two hours later, and immediately before disconnection from the hemodialysis machine. Data were analyzed using SPSS version 23 with Shapiro-Wilk, chi-square, Fisher exact test, analysis of variance (ANOVA), Bonferroni post-hoc test, repeated measures ANOVA (rANOVA), and Cohen's effect size. Results: There were no statistically significant differences in mean fear or stress scores among the three groups at baseline (P > 0.05). However, fear scores differed significantly between groups at the final time point, being lowest in the acupressure group (56.1 ± 6.9), compared to the sham (64.37 ± 12.4) and control (68.67 ± 12.94) groups (P < 0.001). Stress scores showed no significant differences before or one hour after the intervention but differed significantly at two hours (P = 0.034) and before disconnection (P < 0.001). Within-group analysis showed significant reductions in fear and stress over time in all groups (P < 0.001), with the greatest changes observed in the acupressure group. Conclusions: Acupressure significantly reduced fear and stress in patients undergoing emergency hemodialysis. It may be considered a safe, non-invasive complementary therapy in this clinical setting.