2.1. Patients and Study Protocol
allergy, psychiatric, visual or hearing impairments
CENTRAL NERVOUS SYSTEM DISORDERS, ALLERGY, DISEASES, DISORDERS
This study was approved by the Institutional Review Board of Kung Tien General Hospital, Taichung (KTGH No: 11054). We used purposive sampling to enroll 37 patients on HD from the Dialysis Center of Kung Tien General Hospital. This study enrolled individuals aged 20 and above with a minimum six-month history of hemodialysis that consisted of three sessions per week, each lasting four hours. Participants could not be receiving current oxygen therapy, had to be able to chew solid food, exhibit clear consciousness and literacy, and have no visual or hearing impairments. Voluntary participation was subject to signing an informed consent form. Individuals with oral diseases or removable dentures, central nervous system disorders, a history of chemotherapy or radiation therapy, psychiatric disorders, difficulty cooperating with the study, or a known allergy to chewing gum were excluded.All participants were randomly divided into the chewing gum group, who received sugar-free gum before or after dialysis (