[[alternative]]The Effect Of Acupoint Stimulation On Heart Rate Variability, Anxiety And Pain For Patients With Hemorrhoidectomy

[[abstract]]痔瘡是最常見的肛門疾病，而針對嚴重的痔瘡患者，手術是為最佳根除痔瘡之選擇，手術使人疼痛、感覺焦慮以及心率產生變化。而經皮穴位電刺激屬於非侵入性療法，且簡單方便、易被接受。因此，本研究旨在探討經皮穴位電刺激對於痔瘡切除術後患者心率變異、焦慮、疼痛之影響。本研究為前、後測實驗性研究設計，其中實驗組於術後給予經皮穴位電刺激措施，對照組僅提供常規照護。取樣於北部某教學醫院痔瘡切除術後患者，共82名，平均年齡為50.31歲。成效評量指標為心率變異、焦慮程度、疼痛程度及止痛劑使用情形。研究資料以IBM SPSS 20.0視窗版套裝軟體進行資料分析，描述性統計以次數分配、百分比、平均值和標準差等分析；推論性統計以卡方檢定、獨立樣本t檢定、相依樣本t檢定等分析。研究結果顯示：實驗組與對照組組間之口服止痛劑(t=1.41，p=.162)、肌肉注射止痛劑 (t=-1.97，p=.054)、Morphine (t=.00，p=1.000) 等劑量無顯著差異。實驗組與對照組組間之焦慮程度 (t=2.35，p=.021)、疼痛程度(t=5.19，p=.000)有顯著差異。實驗組與對照組組間之SDNN (t=.39，p=.669)、HF (t=.92，p=.362)、LF (t=1.07，p=.290)、LF/HF (t=-.11，p=.912) 無顯著差異。本研究顯示，經皮穴位電刺激對於痔瘡切除術後患者焦慮、疼痛皆有改善，可視為一種輔助療護。建議未來研究在本研究架構下，可增加介入措施次數或增加測量次數，以追蹤其趨勢變化。[[abstract]]The hemorrhoids are the most common anal disease. For patients who diagnosed severe hemorrhoids, surgical operation is the best choice. However, the surgical operation makes people suffer from pain, anxiety and heart rate variability change. Transcutaneous electrical nerve stimulation is noninvasive, simple and convenient, and economical. The purpose of the study was investigate the effect of acupoint stimulation in heart rate variability, anxiety and pain for patients with hemorrhoidectomy. A pre-posttest experimental research design was used. The experimental group was given four times transcutaneous electrical nerve stimulation, and the control group did not. Patients (n=82) who underwent hemorrhoidectomy were recruited from a teaching hospital, with the average age of 50.31 years. The main outcomes included heart rate variability, anxiety score, pain score and analgesics dose usage. The SPSS 20.0 windows software was used to analyze data, involving description (frequency, percentage, mean, and standard deviation) and inference (chi-square test, independent samples t-test, paired t-test). The result showed significant differences are the heart rate variability with SDNN (t = 3.10, p = .003) and HF (t = 2.56, p = .015)in the experimental group, the HF within the group (t = 2.61, p = .013) and LF (t = 2.47, p = .018) in the control group , the anxiety between the experimental group and control group (t = 2.35, p = .021 ), the anxiety in the experimental group (t = 11.93, p = .000) and in the control group (t = 11.73, p = .000), in the pain score between the experimental group and control group (t = 5.19, p = .000). However, in the heart rate variability with SDNN(t = .39, p = .669), HF (t = .92, p = .362), LF (t = 1.07 , p = .290), LF / HF (t = - .11, p = .912) between the experimental group and control group, the LF (t = .52, p = .608), LF / HF (t = -1.35, p = .185) in the experimental group, the SDNN (t = 1.64, p = .108) and the LF / HF (t = - .45, p = .656) in the control group. In the oral NSAID dose (t = 1.41, p = .162), intramuscular NSAID dose (t = -1.97, p = .054),intramuscular Morphine dose (t = .00, p = 1.000) between the experimental group and control group had no significantly differences. This study supports that transcutaneous electrical nerve stimulation improved anxiety and pain for patients with hemorrhoidectomy. Transcutaneous electrical nerve stimulation may be seen as an adjunct care. The research suggests that transcutaneous electrical nerve stimulation for patients with hemorrhoidectomy is all have the improvement of anxiety and pain, transcutaneous electrical nerve stimulation may be seen as an adjunct care. Suggestions for future research in the framework of this study, can increase the number of interventions or increase number of measurements to track its trends