The Effect of Sujok Therapy on Symptom Burden and Comfort Level in Patients Undergoing Hemodialysis Treatment

The purpose of hemodialysis treatment; to remove metabolic wastes from the blood, to reduce symptoms and complications in patients, and to increase life expectancy and quality. During the hemodialysis treatment process, many comorbidities, complications and symptoms may occur in patients(1). The number of symptoms and the high load of effects in patients negatively affect their quality of life. In addition, life expectancy decreases and mortality rates increase in these patients (2). In order to reduce the burden of symptoms accompanying HD and increase the quality of life, it is necessary to ensure HD sufficiency and maintain physical, mental and biochemical well-being Su Jok therapy is defined as a modern interpretation of acupressure/acupuncture that can be applied to both acute and chronic diseases for symptom improvement and health promotion by using reflection points on the hands and feet(3). According to the Su Jok theory; There is energy flow and circulation in the body, and in case of illness, this energy flow is disrupted in the organ or a part of the body. With Su Jok therapy, it is argued that as a result of the application of various applicators (rings, metal starlets, magnets, etc.) and appropriate plant seeds to the hands and feet, which the energy system considers as stimulating points, the physically sick organ or body area is stimulated. It is stated that as a result of this stimulation, the energy in the body is activated and an improvement in symptoms is observed (4). Su Jok therapy, with the absence of any interference to the body, ease of application and learning, allows patients to apply it on their own with good counseling, and symptom management is also very effective. It is stated that nurses can apply Su Jok therapy as an integrative method in symptom management due to the simple and uncomplicated nature of Su Jok therapy and the need for invasive procedures (5).

Details of Study Design and Method This study is planned as a single-blind placebo-controlled randomized trial. The number of samples to be reached with patients who meet the criteria for inclusion in the study is planned to be the group in which sujok therapy was applied (37 people), the group that was administered placebo (37 people) and the control group (37 people) in which routine applications were made.

The researcher attended the Sujok Therapy Training given by the International Sujok Association between 08-28.11.2022. The content of the training consists of theoretical and practical information including the history of Su Jok, its mechanism of action, areas of use, basic information about Su Jok points.

Group application steps to be applied water jok therapy; The right foot in men and the left foot in women will be preferred, and the outer and inner surface of the foot will be massaged with a massage stick for an average of 3 minutes, then the middle of the area between the 3rd and 4th toes and the wrist line on the outer surface of the foot, which represents the kidney area in the macro system. The pain point will be determined with a diagnostic metal rod in the thoracic 12th spine and the area representing the lumbar 3rd spine region, and it will be fixed with the help of a Mexican bean seed patch in the appropriate size for the painful spot, and it will be ensured to remain in the area for at least 8 hours. It also plans insect (micro system) work simultaneously with the macro system, and the pain point is detected with a diagnostic metal rod in the lower 2/3 part of the 3rd node (the area representing the kidney region in the insect system) on the outer surface of the toes, and the appropriate size for the painful point is located in Mexico. bean seed will be fixed with the help of a plaster and it will be ensured that it remains in the area for at least 8 hours.

Group administration steps to be administered placebo; It is planned that all the application steps will be the same as the group in which water jok therapy was applied, but instead of Mexican bean seeds, the use of red plastic number bean, which is used to improve the counting skill, is planned.