Abstract
Background: Patients with chronic kidney disease (CKD) undergoing hemodialysis often experience complex and variable fatigue, which significantly impacts their quality of life. Several factors can cause this fatigue, including the dialysis procedure itself and conditions such as depression, anemia, sleep disorders, and restless leg syndrome. Non-pharmacological methods, such as non-invasive acupoint stimulation, have been used to manage fatigue. However, a systematic review of the literature is needed to determine the effectiveness of this approach. Purpose: To evaluate the effectiveness of non-invasive acupoint stimulation as a complementary therapy in reducing fatigue levels in patients undergoing hemodialysis. Method: The databases Google Scholar, ResearchGate, and ProQuest were used to identify English-language research publications from 2013 to 2024. These publications included two from Iran, one from Turkey, one from India, one from Korea, and two from Taiwan. The selection of publications followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Quality evaluation was conducted using the Joanna Briggs Institute (JBI) Critical Appraisal Skills Program. Results: Findings indicate that all evaluated non-invasive acupoint stimulation methods significantly reduced fatigue. Electrical stimulation techniques, including electro-stimulation and Transcutaneous Electrical Acupoint Stimulation (TEAS), demonstrated consistent effectiveness. Manual acupressure and auricular acupressure also showed significant improvements in fatigue levels. Additionally, radiation stimulation using far-infrared light yielded promising results. Variations in the number of stimulation points, session duration, and total intervention length still produced significant reductions in fatigue, suggesting that non-invasive acupoint stimulation methods can be effective despite methodological differences. Conclusion: Non-invasive acupoint stimulation methods show great potential in managing fatigue in hemodialysis patients. Despite methodological variations, all studies reported significant fatigue reductions, supporting the integration of non-invasive acupoint stimulation methods into clinical practice to improve patients' quality of life. Further research is needed to develop intervention protocols and confirm these findings.
Published Version
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