[[alternative]]The effects of foot reflexology on anxiety, dyspnea, and weaning parameters among prolong mechanical ventilation patients

[[abstract]]長期使用呼吸器病人常經歷到焦慮與呼吸困難的感受，使得病人無法成功的脫離呼吸器。本研究之目的旨在探討足部按摩(foot reflexology)對於長期呼吸器病人的焦慮、呼吸困難和自發性呼吸參數之成效。採實驗型前測和後測重複測量設計，在北台灣一醫學中心之呼吸治療中心收集資料。研究對象為經診斷為呼吸衰竭且連續使用呼吸器介於21天至63天，經嘗試脫離呼吸器未成功，且需長期使用呼吸器者。研究對象隨機分派至足部按摩組(n=8)或控制組(n=12)。實驗組接受常規性照護和連續5天，每天45分鐘的足部按摩；控制組則僅接受常規性照護。研究測量包括焦慮視覺類比量表、呼吸困難視覺類比量表、生理指標（收縮壓、平均血壓、心跳速率、呼吸速率）和自發性呼吸參數。研究結果發現足部按摩組之焦慮程度和呼吸困難明顯的比控制組低(p < .05)。且足部按摩組之收縮壓、平均血壓、心跳速率及呼吸速率下降的次數明顯多於控制組（p<.05）。進一步的，足部按摩組之潮氣量、最大吸氣壓力、快淺呼吸指標明顯的優於控制組（p<.05）。本研究結果可提供健康照護專業人員照護長期使用呼吸器病人之重要依據，以減輕病人的焦慮和呼吸困難，以協助病人早日脫離呼吸器，進而提升照護品質。[[abstract]]Patients with prolonged mechanical ventilation often experience severe anxiety and dyspnea that interfere the effectiveness of weaning off from mechanical ventilation (PMV). The purpose of this study was to investigate the efficacy of foot reflexology on anxiety, dyspnea and weaning parameters in prolong mechanical ventilation patients. The study is a repeated measure experimental design. Data were collected from respiratory care centers of medical center in northern Taiwan. The sampling criteria include diagnosed respiratory failure patients who have been dependent on ventilator for more than 21days but less than 63 days, and had an unsuccessful weaning process. A total of twenty qualified subjects were enrolled and randomly assigned either to an intervention group (n=8) or a control (n=12) group. Patients in an intervention group received the usual nursing care plus 45 minutes of foot reflexology therapy daily for five consecutive days. Patients in the control group received the usual nursing care only. Outcome measures included visual analogue scales of dyspnea and anxiety, and physiological parameters. Using generalized estimation equations (GEE) and controlling for confounding variables, results indicated that patients in the intervention group significantly decreased anxiety and dyspnea, improved physiological indicators and weaning parameters compared with those of the control group (p < .05). The findings of this study provided an alternative intervention for nurses who are taking care patients with prolonged mechanical ventilation