Year of Publication

2010

Degree Name

Doctor of Philosophy (PhD)

Document Type

Dissertation

College

Nursing

Department

Nursing

First Advisor

Dr. Sherry Warden,

Abstract

Constipation is the most common gastrointestinal complaint in the United States, resulting in about 2 million annual visits to the doctor.

The purposes of this dissertation were to: 1) describe four theories of traditional Korean medicine; 2) review mechanisms of acupuncture and moxibustion and develop a conceptual model; 3) review findings from randomized controlled trials that tested the effects of acupressure used for the management of symptoms such nausea, pain, and dyspnea; 4) examine the reliability and validity of the Patient Health Questionnaire-9 (PHQ-9) in heart failure patients with constipation compared to those with gastrointestinal disease; 5) describe how Korean women experienced constipation and how constipation affected the quality of life and the experience of using complementary and alternative medicine for constipation; 6) test the effect of acupressure on constipation and to examine the quality of life and depressive symptoms in cancer patients with constipation.

Meridian theory explains that acupressure stimulates meridians, a network of energy pathways in the body to increase the flow of bio-energy. Authors of 48 studies supported that acupressure reduced nausea and vomiting during pregnancy, pain, fatigue, and dyspnea.

The Patient Health Questionnaire-9 (PHQ-9) was used to examine the depressive symptoms in cancer patients with constipation, but has not been tested in patients with constipation. Therefore, in this study, the psychometric properties of PHQ-9 were tested in patients with constipation. Cronbach’s alphas for the Patient Health Questionnaire were .89 and the correlation between the PHQ-9 and the BDI-II (Beck Depression Inventory) was .81 (p<.01) in 382 heart failure patients with constipation.

Ten Korean women reported that living with constipation is a stressful and uncomfortable experience which impacts daily activity, lifestyle, social relationships, and diet.

In this pilot study, three out of five patients in the acupressure group reported that acupressure was effective in improving constipation. Cancer patients with less than a four-month history of constipation had less depressive symptoms and higher quality of life compared to patient with more than a four-month history of constipation. In conclusion, acupressure can be a safe and cost effective alternative medicine for constipation.

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