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Effects of Acupressure on Anxiety: A Systematic Review and Meta-Analysis
Abstract
To evaluate the evidence from randomised controlled trials (RCTs) and quantify the effects of acupressure on anxiety among adults.
RCTs published between January 1997 and February 2014, comparing acupressure with sham control, were identified from the databases Science Citation Index/Social Sciences Citation Index, Scopus, PubMed and PsycINFO. Meta-analysis of eligible studies was performed and the magnitude of the overall effect size was calculated for the anxiety outcome. Revised STRICTA (the Standards for Reporting Interventions in Clinical Trials of Acupuncture) criteria were used to appraise the acupressure procedures, and the Cochrane risk of bias tool was used to assess the methodological quality of the studies.
Of 39 potentially relevant studies, seven RCTs met the inclusion criteria for review while five studies met the criteria for meta-analysis. All studies reported the positive effect of acupressure on relieving anxiety from the anticipation of surgery or treatment. EX-HN3 (Yintang), HT7 (Shenmen) were the commonest points selected and two studies used bilateral points. The acupressure procedure was generally well reported and studies had a low risk of bias. The combined results of the five trials showed a greater overall reduction in anxiety in the acupressure group than in the sham controls (standardised mean differences (SMD)=-1.11; 95% CI -1.61 to -0.61; p<0.0001 heterogeneity: I(2)=75%; χ(2)=16.17; p=0.003; r=0.485).
Acupressure seems to be effective in providing immediate relief of pretreatment anxiety among adults, and has a medium effect size. However, conflicting results were found for the improvements on physiological indicators. More rigorous reporting, including allocation concealment procedure, is needed to strengthen the results.
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... The acupoint Yintang (EX-HN 3) is between the eyebrows [5][6][7]. It is known to have a mentally stabilizing effect in TCM [8,9]. In a systematic review of the effects of acupressure on anxiety, acupuncture and acupressure showed promising results for anxiety relief. ...
... In a systematic review of the effects of acupressure on anxiety, acupuncture and acupressure showed promising results for anxiety relief. EX-HN 3 was one of the most commonly used acupoints [8,9]. Yintang is used to improve mental clarity, concentration and cognitive function, soothe emotions and relieve stress, anxiety and agitation [5][6][7][8][9]. ...
... EX-HN 3 was one of the most commonly used acupoints [8,9]. Yintang is used to improve mental clarity, concentration and cognitive function, soothe emotions and relieve stress, anxiety and agitation [5][6][7][8][9]. ...
This editorial briefly describes possible relationships and similarities between chess and acupuncture. Although the methods of chess and acupuncture could not be more different, possible joint effects on the brain can be hypothesized. However, the effectiveness of these joint effects has yet to be proven in scientific studies. Both chess and acupuncture can be used to improve physical and mental well-being. According to the author, the Yintang point could play a key role here.
... With meridians connecting every organ, applying pressure to specific acupoints along the meridians reduces preoperative anxiety [12]. Acupoint activation has also been found to be empirically capable of increasing sympathetic nerve activity [12,13] and alleviating anxiety in adult patients in different treatment settings [14]. In their study on the efficacy of acupressure on Shenmen and other acupoints in reducing the anxiety and physical discomfort of patients with cancer undergoing bone marrow biopsy and aspiration, Rizi et al. found that the anxiety level of the experimental subjects was lower than that of the control subjects (1.5 ± 0.5, p = 0.018) [15]. ...
... In addition to routine care, the intervention group received acupressure treatment which involved two acupoints, Neiguan (PC6) [13] and Shenmen (HT7) [14,15]. These acupoints are related to the heart and the pericardium and are commonly used in treating anxiety and insomnia in traditional Chinese medicine. ...
... Acupressure has been reported to alleviate preoperative or pretreatment anxiety [7,12,14,34]. Khoram et al. [12] found that acupressure on the Shenmen and other acupoints was effective in reducing anxiety in patients undergoing heart surgery. Similarly, Valiee et al. [34] reported the positive influence of acupressure in reducing anxiety in patients undergoing abdominal surgery as they found acupressure on the Yingtang and Shenmen acupoints to be effective in stabilizing heart and breathing rates. ...
Objectives:
This study aimed to assess the effectiveness of practicing acupressure on the Shenmen and Neiguan acupoints with a view to reduce anxiety and improve the comfort and physical health of patients undergoing thoracoscopic surgery.
Methods:
A total of 100 hospitalized patients undergoing thoracoscopic surgery were assigned randomly into the experimental (n = 49) and control groups (n = 51). Subjects in the experimental group received routine care plus acupressure on the Shenmen and Neiguan acupoints, while those in the control group received regular routine care. The data were collected using demographic information, physical and surgical data, the Visual Analog Scale (VAS)-A, the State-Trait Anxiety Inventory Y Form (STAI-Y1), and Shortened General Comfort Questionnaire scores. The linear mixed model was used to examine the influences of acupressure on VAS-A and STAI-Y1 scores at different time points before and after the surgery to observe group-by-time interactions.
Results:
The mean age of the subjects was 60.97 years. All subjects had mild-to-moderate anxiety after surgery and showed a statistically significant decline in regression coefficients on the first and second days after the intervention (β = -11.61, p = 0.002; β = -18.71, p < 0.001). Similarly, for STAI-YI scores, the data showed a significant difference in the pre-test and post-test interactions between the two groups (β = 4.72, p = 0.031). Conversely, acupressure did not have a statistically significant difference on comfort (F = 2.953, p = 0.057). Compared with the control subjects, the experimental subjects used less morphine and developed side effects less frequently (p < 0.01). They were also able to get out of bed after surgery 163.79 min earlier (p < 0.05).
Conclusions:
Acupressure is a simple and easy-to-practice treatment. Acupressure on the Shenmen and Neiguan acupoints reduces anxiety and improves recovery in patients after undergoing thoracoscopic surgery.
... This trial used three bilateral acupuncture points: Shenmen (HT7), Neiguan (PC6), and Hegu (LI4). These points have been demonstrated to reduce physiological stress, nausea, vomiting, and abdominal pain or discomfort [10,13,15,[17][18][19][20][21][22][23]. Shenmen is known as a source point of the heart meridian, is recognized for its therapeutic effects in calming the mind and protecting the heart [18,19,24]. ...
... These points have been demonstrated to reduce physiological stress, nausea, vomiting, and abdominal pain or discomfort [10,13,15,[17][18][19][20][21][22][23]. Shenmen is known as a source point of the heart meridian, is recognized for its therapeutic effects in calming the mind and protecting the heart [18,19,24]. In traditional Chinese medicine, Neiguan is considered the "inner gate" and is reputed to harmonize the stomach and regulate the energy flow of internal organs. ...
Background
Oesophagogastroduodenoscopy (OGDS) is the most common diagnostic procedure for upper gastrointestinal diseases. It often causes discomfort and anxiety, which are only mitigated by systemic sedation. However, sedation poses additional risks of adverse cardiopulmonary events, increased medical costs, and prolonged recovery. Transcutaneous electrical nerve stimulation of acupuncture points (Acu-TENS) is a non-invasive and innovative approach that induces analgesic effect during endoscopy. This trial is the first to be reported in English that explores the potential of Acu-TENS to increase patient tolerance during non-sedated elective diagnostic OGDS.
Methods
A double-blinded randomized controlled trial involving 348 subjects was conducted at a tertiary hospital to evaluate the success rate of OGDS with Acu-TENS. Subjects aged 18–75 years scheduled for their first elective diagnostic OGDS were randomized into the intervention (Acu-TENS) and placebo arms. OGDS success was assessed based on subjects’ satisfaction ratings on a Likert scale and procedure’s technical adequacy. Secondary measures included subjects’ willingness to undergo future OGDS under similar conditions, procedure duration, and the endoscopist’s perceived ease of the procedure.
Results
OGDS success rates were significantly higher with Acu-TENS (77.8%) than with the placebo (68.0%; odds ratio [OR] 1.64, 95% confidence interval [CI] 1.01–2.66, p = 0.043). Subjects who received Acu-TENS expressed higher willingness for future OGDS (78.9%) than those who received the placebo (68.6%; OR 1.71, 95% CI 1.04–2.79, p = 0.031). Procedure duration were significantly shorter in the intervention arm (6.0 min) than in the placebo arm (10.0 min; p = 0.002). No adverse effects were reported, and endoscopists perceived similar procedure ease in both arms.
Conclusions
Acu-TENS improved OGDS success and enhanced patients’ experiences during non-sedated OGDS. It demonstrated safety with no side effects and reduced the procedure completion time. It could be used as an adjunct in non-sedated diagnostic OGDS.
... [17] In studies, acupressure has been used in various patient populations to treat a variety of symptoms and the study results have indicated that acupressure can help reduce stress, pain, and anxiety. [18][19][20][21] The studies have supported the promising role of acupressure in the management of fatigue in cancer patients. [22][23][24] In light of this information, this meta-analysis study was conducted to determine how acupressure affects the management of fatigue in cancer patients. ...
... [13,14] Results of the studies have indicated that acupressure can help reduce stress, pain, and anxiety. [18][19][20][21] There are studies showing that acupressure is not effective in managing fatigue in cancer patients. [26,31] On the contrary, there are studies reporting that acupressure is effective in managing fatigue in cancer patients. ...
Objectives
This meta-analysis study was conducted to determine how acupressure affects fatigue in cancer patients.
Materials and Methods
Randomised controlled clinical trials were conducted using the keywords ‘acupressure and fatigue’ on Google Scholar, PubMed, and ISI Web of Sciences databases. Cochran’s Q test statistics and I ² test statistics were used to test the presence of heterogeneity. The random-effect meta-analysis model was used according to the results of the test for heterogeneity. Hedge’s g test statistics were used to determine the joint effect between acupressure and control groups in the meta-analysis study.
Results
In this meta-analysis study, 409 patients from the acupressure group and 403 patients from the control group were included. When calculating the average standardised difference value of the acupressure versus the control group, it was determined that acupressure decreased the fatigue score in a statistically significant way.
Conclusion
Acupressure is an effective approach to alleviate cancer-related fatigue.
... 18 Acupressure therapy is the practice of the direct application of pressure by body parts, non-piercing devices or pressure bands to stimulate acupoints. 20,21 It is a non-invasive alternative that shares common characteristics and mechanisms with traditional needle acupuncture. The therapeutic effect is delivered by stimulating acupoints with sustained pressure to induce sensations such as soreness, numbness, and distention without penetrating the skin. ...
... 24 Several earlier studies have revealed the efficacy of acupressure therapy for symptom relief in insomnia, premenstrual syndrome, dysmenorrhoea, during and after labour, reduction of nausea and vomiting, and reducing fatigue prior to and post-treatment. 20,[25][26][27][28] Findings from these studies also suggested that acupressure therapy can significantly reduce anxiety scores. For example, one study evaluated the effects of acupressure on six meridian acupoints to reduce the stress, fatigue and anxiety of shift-work nurses, demonstrating that stress (p=0.043), ...
p> Background : Anxiety disorders are highly prevalent and are considered the most common psychiatric condition globally. Acupressure is a non-invasive alternative to acupuncture and has demonstrated effectiveness in managing psychosomatic disorders. However, due to high disparities within existing clinical research, it is difficult to recommend the optimum acupressure practice for anxiety management. This manuscript details the protocol for scoping the available evidence, mapping key concepts, and identifying gaps for future research.
Methods : This protocol is designed following the preferred reporting items for systemic reviews and meta-analyses extension for scoping reviews (PRISMA-ScR) and the Joanna Briggs institute (JBI) manual for evidence synthesis guidelines. Six electronic databases (MEDLINE, CINAHL, AMED, PsycINFO, dentistry and oral science source, and Scopus) and two other search engines (Google and Google Scholar) will be searched for all relevant primary and secondary studies, grey literature, and other sources concerning the type of acupressure interventions and the effectiveness of acupressure on anxiety. The sources retrieved will be independently assessed by two reviewers utilising the eligibility criteria defined by the population concept and context (PCC) framework. A PRISMA-ScR flowchart will be applied to track the number of identified, included, and excluded sources. Extracted data and variables will be presented in a data extraction table. Narrative explanations will accompany the synthesised results.
Conclusions: The review’s findings can assist in identifying priorities for future research and provide recommendations for optimal protocols for clinical implementation.</p
... Further, acupoint stimulation heightens endorphin and serotonin production, thus alleviating anxiety. 46 We obtained similar findings to Au et al., 7 who reviewed five studies and found that acupressure could relieve anxiety in anticipation of surgery or treatment. The present systematic review discovered numerous differences in intervention methods, including in the selected acupoints (single or multiple points), treatment durations (once to 4 weeks), and application approaches (pressing or massaging with the fingers or using items such as herb seeds, plastic beads, or magnetic balls). ...
... One previous meta-analysis investigated studies published in English only. 7 By contrast, we included five studies published in Chinese [41][42][43][44][45] and employed the updated RoB 2 to for critical assessment. The framework of RoB 2 is based on only one result for an intervention effect from each RCT. ...
Objectives: The research aim was to perform a systematic review and meta-analysis evaluating the ability of acupressure to reduce anxiety. Design: Randomized controlled trials were obtained through a search of electronic medical databases (four in English and one in Chinese) from inception to October 5, 2020. Two authors searched the databases, evaluated studies' methodological quality, and performed data extraction independently. The final studies for analysis were identified after discussion with the third author. Results: We obtained 27 studies for our systematic review and meta-analysis. Eight studies had a low overall risk of bias, and 13 had some bias concerns with methodological quality. According to the results, acupressure significantly reduced patient anxiety (standardized mean difference = 1.152; 95% confidence interval: 0.847-1.459, p < 0.001), and the study heterogeneity was high (Q = 299.74, p < 0.001, I2 = 91.333%). Two studies reported acupressure-associated adverse events. We also performed a sensitivity analysis by omitting one outlier study, which had the largest effect size; however, high heterogeneity remained (I2 = 87.816%). A subgroup analysis revealed significant differences between participant types (Q = 46.573, p < 0.001), levels of methodological quality (Q = 6.228, p = 0.044), and massage equipment (Q = 4.642, p = 0.031). Conclusions: Our meta-analysis suggests that acupressure can alleviate anxiety. Acupressure was more effective for inpatients and preoperative patients when finger massage was applied. In individuals with anxiety and a stable hemodynamic status, acupressure could be a promising treatment option. However, the substantial heterogeneity across studies means that any inference from the results should be performed cautiously.
... Acupressure is a current method used in the management of stress, it has a calming and soothing effect [8]. It is known that an increase in plasma cortisol levels is effective in the development of anxiety. ...
... Additionally, no side effects of acupressure have been reported. It is non-invasive, easy to apply, can be performed by the individual, and is inexpensive [8]. In the literature, it was reported that acupressure is frequently applied onto the HT7 point and Yintang point (EX-HN3); it reduces stress during bone marrow biopsy in cancer patients [10], preoperative anxiety [11], and stress in hemodialysis patients [12]. ...
Background: Hyperactive heart fire syndrome is characterized by anxiety, insomnia, dream-disturbed sleep, tongue ulcers, heat in the hands, and palpitations. However, syndrome differentiation is often subjective due to a lack of objective, quantifiable variables.
Objectives: To identify changes in heart rate variability (HRV) and psychometric analysis in patients with hyperactive heart fire syndrome.
Methods: Healthy controls (n = 33) were compared to patients with hyperactive heart fire syndrome (n = 48) from the Integrative University Clinic of the State University of Ecatepec Valley (CIU-UNEVE). Physiological outcome measures included heart rate
(HR), the standard deviation of the normal-to-normal heartbeat intervals (SDNN), low (LF) and high frequency (HF) power, and the LF/HF ratio. Psychometric outcome measures included the Athens Insomnia Scale (AIS) and the Hamilton Anxiety Rating Scale (HARS).
Results: Compared to controls, hyperactive heart fire patients had higher HR (9.6 ± 2.62%), LF (22 ± 4.21%) and LF/HF ratio (23 ± 3.14%), and lower SDNN (21 ± 2.33%) and HF (18 ± 4.61%). Patients showed increased anxiety, both with somatic (33 ± 11.2%) and psychic symptoms (39 ± 10.5%) with more difficulty falling asleep (47 ± 9.9%) and diurnal impact of sleep (31 ± 9.6%).
Conclusion: Hyperactive heart fire patients may have a sympathovagal imbalance due to a reduced parasympathetic tone and/or adominant sympathetic tone, which may be at the origin of the observed symptoms of insomnia and anxiety.
... Acupressure is a current method used in the management of stress, it has a calming and soothing effect [8]. It is known that an increase in plasma cortisol levels is effective in the development of anxiety. ...
... Additionally, no side effects of acupressure have been reported. It is non-invasive, easy to apply, can be performed by the individual, and is inexpensive [8]. In the literature, it was reported that acupressure is frequently applied onto the HT7 point and Yintang point (EX-HN3); it reduces stress during bone marrow biopsy in cancer patients [10], preoperative anxiety [11], and stress in hemodialysis patients [12]. ...
Background: Nursing students experience clinical stress frequently and severely. The
application of acupressure is reported to be effective in stress management.
Objectives: This study was conducted to determine the effects of acupressure on
reducing the stress of nursing students in clinical practice.
Methods: This study was carried out using a single-blind randomized controlled
experimental design. The experimental and control groups were randomly determined by
using a previously prepared randomization checklist. A Participant Information Form, VAS,
and the State Anxiety Inventory were applied to all students before practice. Acupressure
was performed on the HT7 point and Yintang point (EX-HN3), respectively, every five
minutes for a total of 30 minutes in the experimental group.
Results: The level of stress experienced by the students in the experimental group before
the intervention according to VAS was 6.95 ± 1.57, and it was determined as 2.82 ± 1.94
after the third application (p < 0.05). The mean clinical stress score before the application
was 46.54 ± 3.81, and after the 3rd week of application, it was 25.15 ± 5.26 (p < 0.05). It
was observed that the students' stress levels decreased in all measurements made after
the acupressure intervention.
Conclusion: This study determined that acupressure effectively reduces the stress levels
of nursing students, and it may be applied in clinical stress management.
... 16 Prior research focused on the use of acupressure in patients being treated for anxiety and depression associated with a surgical intervention or other treatment. 17,18 Whether auricular acupressure (AA) can effectively reduce depression and anxiety in older adults in LTC institutions needs to be confirmed with empirical-based studies. ...
... A systematic review and metaanalysis that combined five trials showed a significant reduction in anxiety by acupressure. 17 Acupressure can be effective with a short duration of treatment, is easy to use, and requires no special equipment. In addition, our results support the proposed functions of the auricular Shenmen point for treating depression and anxiety in other studies. ...
The current study was a single-blind clinical trial that evaluated the effect of auricular acupressure on older adults' depression and anxiety. Forty-seven older adults in long-term care institutions were randomly divided into two groups using block randomization. In the experimental group, patches with magnetic beads were pasted onto the auricular Shenmen acupoints for 14 days. In the control group, blank patches were used. Among the older adults in the study institutions, 82.09% scored ≥5 points on the Geriatric Depression Scale (GDS). Significant differences in GDS scores were observed between the two groups after both 7 and 14 days of treatment (p < 0.05). There was no significant difference (p < 0.05) in anxiety scores between the two groups at 7 days, but there was a significant difference after 14 days of the intervention (p < 0.05). Our results suggest that acupressure can reduce depression and anxiety among older adults in long-term care institutions.
... However, the exact underlying mechanism of acupressure is still not fully understood. The rationale behind acupuncture is the stimulation of the body's selfregulation process, which involves the release of neurochemicals such as serotonin, known to regulate mood and reduce pain and emotional distress, including anxiety [20]. Acupressure is an accessible and non-invasive intervention that offers a cost-effective alternative to acupuncture. ...
Background: Inserting a chest tube is a life-saving procedure for patients with chest trauma, but it is often associated with significant pain. To alleviate this discomfort, non-pharmacological methods such as acupressure can be employed. Therefore, this study aimed to determine the effect of acupressure on pain during chest tube removal in patients with thoracic trauma. Methods: This quasi-experimental study involved the selection of 204 patients with chest tubes following chest trauma in Zahedan in 2022. The through patients were selected purposefully and Non-random allocation divided into two intervention and control groups of 102 people. The intervention group received acupressure treatment, while the control group did not. Pain levels of the patients were measured using a pain intensity scale on both the day of chest tube insertion and the day of removal. The data were analyzed using statistical test such as independent-t, paired-t and chi-square statistical tests within the SPSS 26 software. Results: The normality of the main variable was assessed using the Kolmogorov-Smirnov (KS) test. The significance level for the pain variable was found to be less than 0.05 (P<0.001), indicating a non-normal distribution. Therefore, the Mann-Whitney U test was utilized for data analysis. The results of the Mann-Whitney test revealed that before the intervention, the mean pain scores were 9.46±0.69 in the intervention group and 9.47±0.65 in the control group. After the intervention, the mean pain scores were 7.11±0.98 in the intervention group and 9.39±0.90 in the control group. Based on the Mann-Whitney U value obtained from the comparison of the two groups before and after the intervention, it can be concluded that the intervention had a significant effect on reducing pain (Table 2). Conclusion: The insertion and removal of chest tube after trauma can be an extremely painful experiences for individuals. Considering the crucial role of nurses, non-pharmacological methods such as acupressure can be used to alleviate their pain. Acupressure is a cost-effective, accessible, and readily available approach that can be utilized in this context.
... Применяли несколько техник введения игл, которые обеспечивали возбуждающие, тормозные, гармонизирующие методики воздействия, в зависимости от синдромального акупунктурного и клинического диагнозов [20, с. 6]. Наиболее часто при тревожном расстройстве воздействие производилось на биологически активные точки, такие как CV (6,12,17), LI (4), ST (36), GB (34). Количество вводимых игл варьировало от 5 до 15. ...
Цель. Оценить эффективность индивидуальной комплексной программы медицинской реабилитации пациентов, перенесших коронавирусную инфекцию, осложненную психоневрологическими расстройствами, с применением физических факторов и иглорефлексотерапии. Материалы и методы. В исследовании приняли участие 166 пациентов в возрас- те от 18 до 75 лет (средний возраст – 46,4±1,82 года), перенесших COVID-19 с ней- ропсихологическими проявлениями постковидного синдрома. В зависимости от проводимой программы медицинской реабилитации пациенты были разделены на 4 группы. В основную группу входили 46 пациентов, которые получали комплексное реабилитационное лечение: процедуры рефлексотерапии и занятия ЛФК с элементами традиционных восточных гимнастик (с элементами йоги) и малогрупповой психотерапии. В контрольную группу были включены 38 пациентов, которые самостоя- тельно в домашних условиях ежедневно занимались лечебной физкультурой в виде 10–15-минутного комплекса утренней гимнастики и 30–40-минутной вечерней пешей прогулки. К сравнительной группе 1 были отнесены 40 пациентов, получавших процедуры массажа и физиотерапии. В сравнительную группу 2 вошли 42 пациента, программа реабилитации которых содержала только процедуры рефлексотерапии. Критериями эффективности проведенных реабилитационных мероприятий были: оценка клинических проявлений (частота цефалгии, астении, артериальной гипертензии, миалгий, вестибуломозжечковых и тревожно-депрессивных расстройств, когнитивных нарушений, диссомнии, аносмии, диспепсии), выраженность одышки по шкале Medical Research Council, показатели пульсоксиметрии, тест с шестиминутной ходьбой, физическая активность по шкале Борга, выраженность болевого синдрома по визуальной аналоговой шкале, состояние психоэмоционального статуса по Госпитальной шкале тревоги и депрессии, результаты Европейского опросника качества жизни EQ-5 (European Quality of Life Questionaire). Результаты. В ходе реабилитационных мероприятий состояние пациентов улучши-лось во всех группах, однако в различной степени. Наиболее выраженная положи- тельная динамика наблюдалась в основной группе пациентов. Заключение. Наиболее эффективной оказалась программа, включавшая иглорефлексотерапию и занятия лечебной физкультурой с элементами традиционных вос- точных гимнастик, что подтверждается более выраженной динамикой купирования основных клинических симптомов постковидного синдрома, улучшением психоэмоционального статуса и показателей физической работоспособности у пациентов.
Purpose. To assess the effectiveness of an individual comprehensive medical rehabilitation program for patients who have recovered from COVID-19 and are experiencing neuropsychological manifestations of post-COVID syndrome, using physical modalities and acupuncture reflexology. Materials and methods. The study involved 166 patients aged 18 to 75 years (average age 46.4±1.82 years) who had recovered from COVID-19 with neuropsychological manifestations of post-COVID syndrome. Depending on the conducted medical rehabilitation program, the patients were divided into four groups, homogeneous in terms of age, gender, and clinical-functional condition. The main group consisted of 46 patients who received comprehensive rehabilitation treatment, including reflexotherapy procedures, therapeutic exercise with elements of traditional Oriental gymnastics (including yoga), and small-group psychotherapy. The control group consisted of 38 patients who independently engaged in physical therapy at home. Comparative Group 1 consisted of 40 patients who received massage and physiotherapy procedures. Comparative Group 2 comprised 42 patients whose rehabilitation program included only reflexology procedures. The criteria for evaluating the effectiveness of the rehabilitation measures were as follows: assessment of clinical symptoms (frequency of cephalgia, asthenia, arterial hypertension, myalgia, vestibular-cerebellar disorders, anxiety and depressive disorders, cognitive impairments, insomnia, anosmia, dyspepsia); severity of dyspnea measured using the "Medical Research Council" scale; pulse oximetry readings; Six-Minute Walk Test results and physical activity assessed using the Borg Scale; severity of pain syndrome assessed using the Visual Analog Scale for Pain; evaluation of the psychosocial status using the Hospital Anxiety and Depression Scale; results of the European Quality of Life Questionnaire EQ-5 (European Quality of Life Questionnaire). Results. After the rehabilitation interventions, the condition of patients improved in all groups, albeit to varying degrees. The most pronounced positive dynamics were observed in the main group of patients. Conclusions. The most effective rehabilitation program was one that included acupuncture and physiotherapy, as evidenced by a more pronounced improvement in the control of the main clinical symptoms of post-COVID syndrome, improvement in the psycho-emotional status and indicators of physical performance in patients.
... The review of Dehghanmehr found that acupressure at P6, GB21, and LIV3 could be used to relieve the anxiety of patients undergoing hemodialysis [25]. A systematic review and meta-analysis of five studies concluded that acupressure could be effective in relieving pretreatment anxiety of adults with a medium effect size [26]. ...
... While the commonly applied method involves Western medicine, its efficacy frequently falls short. [13] In addition, acupressure, [14] acupuncture, [15,16] and the combination of traditional Chinese and Western medicine exhibit noticeable therapeutic efficacy as Medicine alternative treatments. [13] However, considering the psychological root of GAD, exclusive reliance on medicinal interventions addresses only the outward manifestations of the disease. ...
Personal quantification plays a crucial role in preserving individual mental health. However, in previous research, its effectiveness in alleviating generalized anxiety disorder (GAD) has not been conclusively established. This study explores the impact of personal quantification on GAD among PhD students. The research data was obtained through questionnaires distributed to 308 PhD students across universities in China. Among these students, 118 anxiety-free participants were excluded, yielding valuable data from 190 students with GADs. We employed Python programming language and SPSS software for the empirical analysis. The results illustrated that personal quantification significantly and negatively impacted GAD (β = −0.148, P = .002), concurrently producing a significantly positive effect on self-efficacy (β = 0.359, P < .001). Further analysis showed that through 5000 sampling iterations and a 95% confidence level, self-efficacy significantly reduced certain symptoms of GAD (β = −0.1183; P = .026; 95% Cl: −0.2222 to −0.0144). Moreover, when the coefficient of self-efficacy was significantly negative, the impact of personal quantification on GAD remained statistically significant (β = −0.1056; P = .033; 95% Cl: −0.2025 to −0.0087). The findings indicated that personal quantification has a significant role in alleviating GAD among PhD students, which is partly mediated through self-efficacy. This study contributes valuable insights to the nonpharmacological alleviation of GAD in Chinese PhD students.
... The etiology and pathogenesis of anxiety disorder are complex, believed to involve a variety of factors including genetics, neurobiochemistry, neuroimaging, sex hormones, constitution and other reasons (55)(56)(57). Contemporary studies propose that the pathogenesis of anxiety disorder primarily encompasses neurotransmitter hypothesis and neuroendocrine dysfunction hypothesis, specifically the serotonin system, the hypothalamicpituitary-adrenal (HPA) axis (58), and hypothalamic-pituitarygonadal (HPG) axis activity (59). ...
Background
From the end of 2019 to December 2023, the world grappled with the COVID-19 pandemic. The scope and ultimate repercussions of the pandemic on global health and well-being remained uncertain, ushering in a wave of fear, anxiety, and worry. This resulted in many individuals succumbing to fear and despair. Acupoint massage emerged as a safe and effective alternative therapy for anxiety relief. However, its efficacy was yet to be extensively backed by evidence-based medicine. This study aimed to enhance the clinical effectiveness of acupoint massage and extend its benefits to a wider population. It undertakes a systematic review of the existing randomized controlled trials (RCTs) assessing the impact of acupoint massage on anxiety treatment, discussing its potential benefits and implications. This research aims to furnish robust evidence supporting anxiety treatment strategies for patients afflicted with COVID-19 disease and spark new approaches to anxiety management.
Objectives
This study evaluates the evidence derived from randomised controlled trials (RCTs), quantifies the impact of acupressure on anxiety manifestations within the general population, and proposes viable supplementary intervention strategies for managing COVID-19 related anxiety.
Materials and methods
This review included RCTs published between February 2014 and July 2023, that compared the effects of acupressure with sham control in alleviating anxiety symptomatology as the outcome measure. The studies were sourced from the multiple databases, including CINAHL, EBM Reviews, Embase, Medline, PsycINFO, Scopus and Web of Science. A meta-analysis was performed on the eligible studies, and an overall effect size was computed specifically for the anxiety outcome. The Cochrane Collaboration Bias Risk Assessment Tool (RevMan V5.4) was employed to assess bias risk, data integration, meta-analysis, and subgroup analysis. The mean difference, standard mean deviation, and binary data were used to represent continuous outcomes.
Results
Of 1,110 studies of potential relevance, 39 met the criteria for inclusion in the meta-analysis. The majority of the studies reported a positive effect of acupressure in assuaging anticipatory anxiety about treatment. Eighteen studies were evaluated using the STAI scale. The acupressure procedures were thoroughly documented, and studies exhibited a low risk of bias. The cumulative results of the 18 trials showcased a more substantial reduction in anxiety in the acupressure group compared to controls (SMD = −5.39, 95% CI −5.61 to −5.17, p < 0.01). A subsequent subgroup analysis, based on different interventions in the control group, demonstrated improvement in anxiety levels with sham acupressure in improving changes in anxiety levels (SMD −1.61, 95% CI: −2.34 to −0.87, p < 0.0001), and blank controls (SMD −0.92, 95% CI: −2.37 to 0.53, p = 0.22).
Conclusion
In the clinical research of traditional Chinese medicine treatment of anxiety, acupressure demonstrated effectiveness in providing instant relief from anxiety related to multiple diseases with a medium effect size. Considering the increasing incidence of anxiety caused by long COVID, the widespread application of acupressure appears feasible. However, the results were inconsistent regarding improvements on physiological indicators, calling for more stringent reporting procedures, including allocation concealment, to solidify the findings.
... A systematic review indicated a moderate positive eff ect of acupressure on quality of life among older adults (Chen et al., 2019). Th ere is some evidence indicating that acupressure could reduce depression (Sok, 2016;Tse & Au, 2010), anxiety (Au et al., 2015), and psychological distress among older adults (Chen et al., 2019). None of these studies were conducted in Australia. ...
The current study explored participants' experiences and perceptions of receiving acupressure within an Australian aged care context. Participants were older adults living in three residential aged care facilities who had received an acupressure intervention. Data were collected using semi-structured interviews and analyzed using a thematic approach. Twelve participants (10 females and two males) were interviewed. Four major themes emerged: Having Better Sleep , Feeling Calm and Relaxed , Promoting Well-Being and Functional Status , and Acceptability of Acupressure . Participants' perception of the acupressure was positive, as participants found acupressure to be beneficial for the improvement of sleep, mood, and general well-being. Participants' overall perception supports the acceptability of acupressure and suggests acupressure may be beneficial for improving sleep, relaxation, and well-being in older adults. [ Journal of Gerontological Nursing, 50 (1), 30–36.]
... This non-invasive form of acupuncture involves applying gentle pressure to specific reflex points on various parts of the body, such as the ears, head and neck, and abdomen. Stimulation of these reflex points regulates the function of the sympathetic and parasympathetic nervous systems, thereby Fig. 3 The comparison of mean test anxiety levels before and after the intervention in the study groups improving overall bodily function and promoting a sense of comfort [40,41]. Additionally, acupressure activates C tactile fibers, which elicit the "limbic touch" response, triggering hormonal and emotional reactions [20]. ...
Background
Test anxiety is a prevalent issue among students, including those in the medical field. The present study aims to examine the impact of auricular acupressure on reducing test anxiety specifically among medical students.
Methods
In this single-blind randomized parallel-group trial, a total of 114 medical students from Kermanshah, Iran, were allocated into two groups: intervention and control. Each group consisted of 57 students. The data collection instruments included a demographic information form and the Sarason Anxiety Inventory. In the intervention group, bilateral auricular acupressure was administered on the Shen Men point for a duration of 10 min. On the other hand, the control group received bilateral auricular acupressure on the Sham point, located in the earlobe, as a placebo, also for 10 min.
Results
The mean test anxiety scores in the Shen Men acupressure group exhibited a significant reduction from 18.4 ± 5.3 before the intervention to 13.3 ± 4.8 after the intervention (P = 0.001). Conversely, in the Sham acupressure group, the mean test anxiety scores showed no significant change, with values of 16.36 ± 6.4 before the intervention and 16.4 ± 6.1 after the intervention (P = 0.963). Prior to the intervention, the majority of participants in both the intervention group (87.7%) and control group (86.0%) exhibited moderate to severe levels of test anxiety. Following acupressure, a significant improvement was observed in the intervention group, with 52.6% of participants experiencing a reduction to mild anxiety levels (P = 0.001); however, no notable change in anxiety levels was observed in the control group. Furthermore, a statistically significant difference in anxiety intensity after the intervention was found between the two groups (P = 0.001).
Conclusion
Shen Men auricular acupressure demonstrates efficacy in reducing test anxiety among medical students. However, to validate its effectiveness, further research using objective measures is warranted.
... On the one hand, acupressure's effectiveness is often proposed to be closely related to the specific points that are pressed (for review, see e.g. Au et al., 2015). Moreover, the ability to discriminate between more than two simultaneous tactile stimuli is limited, for example, by the distance that needs to separate two tactile stimuli to be distinguishable (see e.g. ...
Acupressure mats are promoted as stress management tools for easy and effective self‐application, promising reduced stress and increased well‐being. However, the scientific evidence for these effects is based on few experimental studies and lacks the examination of acupressure mats as a solitary relaxation tool. Our study aimed to examine which changes in stress and well‐being can be expected from the use of acupressure mats by healthy young people on the subjective and psychophysiological level. Unexperienced participants practiced relaxation for three weeks either with an acupressure mat or without any tools (active control group [CG]). As a results, subjective well‐being and stress decreased, while sleep quality and concentration endurance increased across groups. Blood pressure (BP), heart rate (HR), pain threshold and pain tolerance did not change significantly from pre‐ to post‐training measurements. Most importantly, no significant differences were found between groups, indicating that training with an acupressure mat yielded no superior effects compared with an active control condition in healthy young students. As a conclusion, taking time to relax has some but limited beneficial effects on the subjective levels independent of the specific method for healthy students. Potential beneficial effects of acupressure mats might be bound to specific impairments, such as tension pain.
... The synthesis of 24 randomised controlled trials involving 2537 participants across six types of elective surgeries demonstrated that acupressure can statistically significantly reduce preoperative anxiety when compared to placebo (apply pressure on sham acupoints) and usual care, which is consistent with previous reviews that found a large effect size for acupressure amongst community-dwelling adults, outpatients and inpatients (including preoperative patients) (Au et al., 2015;Chen et al., 2022). Based on the nine included randomised controlled trials, acupressure may also statistically significantly lower preoperative heart rate, and systolic and diastolic blood pressure, in line with the results of a past review amongst patients with hypertension . ...
Background:
Preoperative anxiety is prevalent amongst adults with elective surgery and is associated with multiple detrimental perioperative physiological effects. Increasing studies support the effectiveness of acupressure in managing preoperative anxiety. However, the magnitude of acupressure's positive association with preoperative anxiety is still unclear due to a lack of rigorous evidence synthesis.
Objective:
To estimate the efficacy of acupressure on preoperative anxiety and physiological parameters amongst adults scheduled for elective surgery.
Design:
Systematic review and meta-analysis.
Data sources:
Search terms were combined for acupressure and preoperative anxiety in PubMed, Cochrane Library, EMBASE, CINAHL, China National Knowledge Infrastructure, and WanFang Data Knowledge Service Platform to search for eligible randomised controlled trials from the inception of each database through September 2022.
Methods:
Pairs of researchers independently screened and extracted data from included studies. The risk of bias was assessed using the Cochrane risk of bias tool Version 2.0. Meanwhile, random-effects meta-analysis of overall effects and prespecified subgroup (i.e., surgery types, intervention providers, and acupressure stimulation tools) was conducted using Review Manager Software 5.4.1. Meta-regression was performed to explore study-level variables that may contribute to heterogeneity using STATA 16.
Results:
Of 24 eligible randomised controlled trials, there were a total of 2537 participants from 5 countries contributed to this synthesis. When comparing acupressure with usual care or placebo, acupressure showed a large effect size for preoperative anxiety (SMD = -1.30; 95%CI = -1.54 to -1.06; p < 0.001; I2 = 86%). The significant mean reduction of heart rate, and systolic and diastolic blood pressure was -4.58 BPM (95%CI = -6.70 to -2.46; I2 = 89%), -6.05 mmHg (95%CI = -8.73 to -3.37; p < 0.001; I2 = 88%), and -3.18 mmHg (95%CI = -5.09 to -1.27; p = 0.001; I2 = 78%), respectively. Exploratory subgroup analyses showed significant differences in surgery types and acupressure stimulation tools, whilst the intervention providers (i.e., healthcare professionals and self-administered) showed no statistically significant difference for acupressure therapy. None of the predefined participants and study-level characteristics moderated preoperative anxiety through meta-regression.
Conclusion:
Acupressure appears efficacious as a therapy for improving preoperative anxiety and physiological parameters amongst adults with elective surgery. Self-administered acupressure, which is effective with a large effect, may be considered as an evidence-based approach to managing preoperative anxiety. Hence, this review aids in the development of acupressure in different types of elective surgeries and the improvement of the rigour of acupressure therapy.
... Similar to needle acupuncture, acupressure harmonizes the circulation of physiological energy called qi, promotes health, and helps to prevent disease. It is a non-pharmacological therapy for managing a variety of symptoms, including pain conditions [2,3], nausea and vomiting [4,5], and some mental health conditions such as anxiety [6]. The fact that this treatment can be selfadministered is one of the reasons it is becoming more popular [7], since it enhances the user's self-efficacy [8] and allows the patient to actively participate in the treatment process without increasing costs. ...
Background:
Anxiety is an important problem in children in dental clinics. Acupressure may be a useful tool to assist in dental procedures in anxious children.
Objectives:
This pilot study was performed to examine the effects of acupressure on dental anxiety in children undergoing restorative procedures.
Methods:
Fourteen children aged 7-10 years and with at least one primary molar with caries on the dentine were included in the study. The participants also needed to score at least one point on the modified Venham Picture Test (VPTm) for the determination of anxiety. The children were randomly allocated to two groups: group A - non-documented points for the reduction of anxiety and induction of relaxation; group B - documented points (EX-HN3, Shen Men of auricular acupuncture). The anxiety scale was administered on three occasions: prior to the application of acupressure; immediately after sitting in the dental chair to undergo restorative treatment; and after removal of acupressure at the end of the restorative procedure. Heart rate (HR) was measured when each child sat in the dental chair, after the removal of carious tissue, and after the removal of acupressure.
Results:
After the procedure, HR (as an indicator of anxiety) was statistically significantly lower in group B than group A (p = 0.02). However, there was no significant difference between the groups regarding anxiety before and during the restorative procedure (VPTm and HR: p > 0.05).
Conclusion:
The children who received acupressure on documented points for the reduction of anxiety had a significantly lower HR after the restorative procedure. No significant between-group difference was found regarding anxiety measured using a psychometric evaluation (VPTm).
... Seperti yang kita tahu bahwa totok wajah memliki manfaat yang banyak seperti Memperlancar peredaran darah area wajah dan kepala, mengurangi nyeri/ sakit kepala dan migrain, mengurangi ketegangan otot wajah, menghilangkan kecemasan dan stress (Ayuningtyas, 2019;Handayani, 2014;Sharin, 2015). Acupressure efektif dalam memberikan bantuan langsung dari kecemasan (Au et al., 2015). Acupressure secara signifikan dapat menurunkan stres, kelelahan, dan kecemasan (Cho et al., 2021). ...
ABSTRAK Gangguan kecemasan adalah kondisi yang paling sering terjadi pada remaja, diikuti oleh gangguan perilaku, gangguan mood, dan gangguan penggunaan zat. Permaslahan yang muncul pada remaja/ siswi adalah kecemasan, nyeri (kepala, diminore), belum pernah mendapatkan informasi terkait acupressure untuk kesehatan. Acupressure telah terbukti efektif untuk menghilangkan berbagai rasa sakit pada untuk mengurangi dismenore (gangguan menstruasi), nyeri persalinan, nyeri punggung bawah, sakit kepala kronis, dan nyeri traumatis lainnya. Kegiatan ini bertujuan untuk mengatasi berbagai masalah yang sering terjadi pada remaja seperti kecemasan, nyeri. Metode kegiatan ini dengan ceramah, tanya jawab, diskusi dan praktik terapi Acupressure untuk kesehatan dalam hal ini difokuskan dengan totok wajah. Khalayak sasaran yang dipilih adalah Siswi SMAN 1 Rancah Ciamis Jawa Barat dan tempat yang dipilih adalah Universitas Harapan Bangsa. Hasil kegiatannya yang diikuti oleh 26 peserta diawali dengan pretest, pemberian informasi, edukasi dan praktik lalu peserta diberikan posttest untuk megukur pengetahuannya. terjadi peningkatan pengetahuan dan keterampilan tentang menerapkan terapi acupressure (totok wajah) untuk kesehatan. Diharapkan siswi/ remaja dapat mentransferkan informasi tentang terapi acupressure untuk kesehatan (totok wajah). Sedangkan untuk pikah sekolah dapat mengupayakan adanya seminar/ workshop atau bisa juga mengundang pakar terutama terkait dengan kesehatan para remaja/ sisiwa dan siswi. Kata Kunci: Terapi, Acupressure, Kesehatan ABTRACT Anxiety disorders are the most common condition in adolescents, followed by behavior disorders, mood disorders, and substance use disorders. The problems that arise in adolescents/students are anxiety, pain (headache, dysmenorrhea), they have never received information related to acupressure for health. Acupressure has been shown to be effective in relieving a variety of pains to reduce dysmenorrhea (menstrual disturbances), labor pains, low back pain, chronic headaches, and other traumatic pains. This activity aims to overcome various problems that often occur in adolescents such as anxiety, pain. The method of this activity is lectures, questions and answers, discussions and the practice of Acupressure therapy for health in this case focused on full-blooded faces. The target audience chosen were students of SMAN 1 Rancah Ciamis, West Java and the chosen place was Harapan Bangsa University. The results of the activity, which was attended by 26 participants, began with a pretest, providing information, education and practice, then participants were given a posttest to measure their knowledge. there is an increase in knowledge and skills about applying acupressure therapy (acupressure) for health. It is expected that students/teenagers can transfer information about acupressure therapy for health (full-faced). Meanwhile, for school marriages, they can seek seminars/workshops or invite experts, especially those related to the health of teenagers/students and students. Keywords: Therapy, Acupressure, Health
... For instance, Chen et al. (2022) conducted a systematic review and meta-analysis of 27 studies and found that acupressure significantly reduced patient anxiety (p , .001). Au et al. (2015) performed a meta-analysis of five RCTs that showed a greater overall reduction of anxiety in acupressure treatments than in sham controls. Gach and Henning (2004) include conditions such as anxiety, depression, addiction, anger, grief, guilt, shame, jealousy, trauma, and self-doubt in their popular book on acupressure for emotional self-healing. ...
Integrando la estimulación manual de los puntos de acupuntura a la psicoterapia: una revisión sistemática con recomendaciones clínicas
La integración a la psicoterapia de los protocolos con estimulación de los puntos de acupuntura con un suave tapping, un modo de acupresión, está surgiendo ampliamente en la práctica clínica. Una premisa subyacente es que el procedimiento genera señales activadoras y desactivadoras que, en tiempo real, impactan las zonas del cerebro excitadas por el foco de atención del cliente. Esto posibilita que el terapeuta pueda velozmente facilitar cambios cognitivos y neurológicos por cambiar la redacción y las imágenes que acompañan al tapping. El abordaje ha sido controversial, con entusiastas promotores y obstinantes críticos. Un total de 309 artículos revisados por homólogos, de revistas en inglés, se han enfocado en este desarrollo. El objetivo de este artículo es poner estos informes en contexto usando un modelo basado en la “jerarquía de evidencia”. En una jerarquía de evidencia, juicios sobre la eficacia de un abordaje clínico se forman en base a la fortaleza relativa de los tipos de estudios que apoyan el método. La jerarquía de evidencia para las psicoterapias que usan el tapping sobre los puntos de acupuntura incluye 28 revisiones sistemáticas o meta análisis, 125 pruebas clínicas, 25 casos de estudio, 26 informes describiendo observaciones sistemáticas, 17 pruebas clínicas de método mixto con un componente de tapping y 88 artículos abordando procedimientos clínicos, teoría, mecanismos, o cuestiones parecidas. Se remarca la consistencia en resultados positivos posterior al tapping de selectos puntos de acupuntura para un rango de condiciones, y los puntos débiles en los diseños de los estudios se discuten. Se consideran los mecanismos de acción y se presentan sugerencias para integrar protocolos de acupoint tapping a la práctica clínica. El artículo concluye en que, aunque se necesita más investigación, la base creciente de evidencia que documenta la efectividad, velocidad y durabilidad del abordaje es promisoria.
... [11,36,37] Other studies have indicated that specific peptides with analgesic properties are released during acupressure, which reduce the activity of sympathoadrenal system that is activated while feeling anxious, for example, during labor. [38,39] Moreover, Rebecca et al. stated that hydrotherapy as a nonpharmacological method during labor decreased anxiety and affects neuroendocrine responses that modify psychophysiological processes. They said, "it seems reasonable to speculate that decreased contraction frequency and improved uterine profusion could facilitate a return to normal contraction synchrony, intensity and frequency, thereby decreasing pain and dysfunction." ...
Background:
Natural delivery is distressing, and the mother's anxiety in this condition can have negative impacts on the fetus, mother, and the delivery process. Hence, many women tend to use pharmacological or nonpharmacological methods for reduction of labor stress and anxiety. The aim was to assess the effect of supportive care and acupressure during labor on the mother's anxiety level and arterial oxygen pressure of the umbilical cord of infants.
Materials and methods:
This performed on 150 pregnant women were randomly assigned to two interventions and a control group in the delivery ward of the selected educational center of Shiraz University of Medical Sciences (Shoushtari Hospital) in Iran. Mothers' anxiety scores before (beginning of the active stage of labor) and after intervention (the end of the first stage of labor) were measured using Spielberger's questionnaire. Then, infants' cord blood samples for arterial blood gas and hematologic analyses were sent to the hospital's laboratory. After all, the data with SPSS version 16 and using Pearson's correlation coefficient, one-way ANOVA, were analyzed.
Results:
The mean of anxiety score in the control group was 21.1% and in the supportive group and the acupressure group, respectively, decreased by 37.5% and 34.8%, respectively (P < 0.001). The mean of PO2 was also reported in the maternal supportive, acupressure, and control groups, 40.4 ± 8.8, 27.4 ± 2.8, and 18.1 ± 3.7, respectively. Additionally, a significant correlation was found between mothers' anxiety scores after the intervention and the mean of PO2 (P = 0.014).
Conclusion:
The supportive care and acupressure at BL32 acupoint reduced mothers' anxiety and consequently improved fetal oxygenation. Therefore, these methods are recommended to be used during labor for improving birth outcomes.
... It has also been used to treat primary anxiety and depression, and its efficacy has been proven. [34,[52][53][54][55][56] The purpose of this study is to explore whether AM is also effective and safe for the treatment of CRPD. If this study proves that AM is effective and safe for cancer patients, it will benefit clinicians and patients and help them overcome cancer with a good mental state. ...
Introduction:
Cancer-related psychological disorders (CRPD) with high incidence are often underdiagnosed and undertreated. Although, some studies suggested that acupuncture and moxibustion (AM) are effective and safe for CRPD, lacking strong evidence, for instance, the relevant systematic review, meta-analysis, and randomized control trial (RCT) of a large sample, multicenter, makes the effects and safety remain uncertain. The aim of protocol is to evaluating the RCTs of AM for CRPD to verify the association of AM with the improvement of CRPD.
Methods and analysis:
Eight electric databases (4 English databases and 4 Chinese databases) will be searched from inception to Mar. 2022. There will be no restrictions on the category of the language. The RCTs of AM for CRPD unlimited to any type of cancer will be included. Depression and anxiety scores will be the primary outcome indicators. Two researchers will independently complete study selection, evaluate the risk of bias, and extract the data. The RevMan 5.2 software will be used to conduct data synthesis using the random-effects model. The weighted mean differences or standardized mean differences with 95% CIs will be used to present the results of measurement data, and the risk ratios with 95% CIs will be used to express the counting data. Additionally, we will use the Grading of Recommendations Assessment, Development, and Evaluation to assess evidence quality.
Main results:
The results of the meta-analysis will be presented with tables and figures.
Ethics and dissemination:
The results of this meta-analysis and meta-regression will be disseminated via publication in peer-reviewed journals and will be published at relevant conferences. The data to be used will not contain individual patient data; therefore, there is no need to worry about patient privacy.
Prospero registration number:
CRD42020177219.
... 23 There have been reports that acupressure can be effective in relieving pain, reducing anxiety, and controlling vital signs, but further studies with detailed findings are needed to confirm this statement. 24 There are several points in acupressure, including Sanyinjiao and Zusanli. SP6 or Sanyinjiao, 3 cm above the inner ankle of the foot behind the posterior edge of the tibia, is one of the most important and commonly used points. ...
Background:
Pain is the most crucial reason to seek treatment, and acupressure is one of the most common ways to relieve pain; therefore, this study was conducted with the aim to investigate the effectiveness of acupressure on the reduction of pain and stability of physiological indexes in addicted men.
Methods:
The present single-blind, randomized, clinical trial was performed on 90 participants who were hospitalized in an addiction treatment camp in Masjed-e-Soleyman, Iran. The participants were divided into acupressure group (n = 45) and control group (n = 45) through allocating permutation blocks method. The acupressure group received acupressure on SP6 and ST36 points for 3 consecutive sessions and each session for 10 minutes. The data collection tools used included a demographic information questionnaire, the Short-Form McGill Pain Questionnaire (SF-MPQ), and a physiological index registration form, tympanic thermometer, sphygmomanometer, pulse oximetry device, and digital watch. Repeated measures ANOVA was used to analyze the data. P ≤ 0.05 was considered statically significant.
Findings:
There was a statistically significant decrease in the sensory dimension of pain in the acupressure group compared to the control group in all 3 sessions (P ≤ 0.001; P ≤ 0.001; P = 0.001, respectively). There was no statistically significant difference in the overall pain score (P ≥ 0.005), emotional pain dimension (P ≥ 0.005), and physiological indexes of pain (P ≥ 0.005) between the two groups after the intervention.
Conclusion:
Acupressure is a non-invasive and cost-effective method that reduces the sensory dimension of painý, and its application does not require special tools; ýthus, the use of such a safe and secure method for relieving pain is recommended.
... 64 Similarly in a systematic review and meta-analysis on the effect of acupressure on anxiety, it was found that Acupuncture was effective in relieving anxiety from the anticipation of surgery or treatment. 65 Systematic desensitization or exposure therapy is a technique where the patient is exposed to progressively more anxiety-provoking stimuli and taught relaxation techniques. This involves three sets of activities. ...
The dental fear and anxiety (DFA) is a common phenomenon around the world. From children to the adults, most of the people become frightened when they face any dental discomfort and they need to visit a dentist and go through a treatment procedure in a dental set up. This narrative review tends to identify the causes behind DFA, its consequences and management of DFA from different studies which were conducted previously. This study is a narrative review of DFA. This study is mainly based on the secondary data from different articles and journals which were available online. After the proper screening from 154 titles, the final review included 68 articles. Based on different studies, it is found that DFA in quiet common in the people of all ages. The studies had found that dental fear and anxiety most often results from a traumatic past dental experience. Friendly dental office environment is an effective way in reducing dental fear and anxiety. Psychotherapeutic management is also important is managing DFA like behavior-management techniques, relaxation techniques, distraction, guided imagery, hypnotherapy, acupuncture, systematic desensitization or exposure therapy, positive reinforcement, cognitive restructuring and pharmacological management. The techniques for managing DFA can be the effective solution for reducing stress and make the treatment process more comfortable.
... Furthermore, the benefits of acupressure in psychological well-being have also been observed. While emerging evidence shows that acupressure has encouraging and promising effects on depression [15,16], there has been no systematic review and meta-analysis of its effectiveness for this condition. The present study aimed to synthesize findings of randomized clinical trials (RCTs) and quantify the effectiveness of acupressure for the treatment of depression in adults. ...
Background:
Depression is recognized as a major public health problem with a substantial impact on individuals and society. Complementary therapies such as acupressure may be considered a safe and cost-effective treatment for people with depression. An increasing body of research has been undertaken to assess the effectiveness of acupressure in various populations with depression, but the evidence thus far is inconclusive.
Aim:
To examine the efficacy of acupressure on depression.
Methods:
A systematic literature search was performed on PubMed, PsycINFO, Scopus, Embase, MEDLINE, and China National Knowledge (CNKI). Randomized clinical trials (RCTs) or single-group trials in which acupressure was compared with control methods or baseline in people with depression were included. Data were synthesized using a random-effects or a fixed-effects model to analyze the impacts of acupressure treatment on depression and anxiety in people with depression. The primary outcome measures were set for depression symptoms. Subgroups were created, and meta-regression analyses were performed to explore which factors are relevant to the greater or lesser effects of treating symptoms.
Results:
A total of 14 RCTs (1439 participants) were identified. Analysis of the between-group showed that acupressure was effective in reducing depression [Standardized mean differences (SMDs) = -0.58, 95%CI: -0.85 to -0.32, P < 0.0001] and anxiety (SMD = -0.67, 95%CI: -0.99 to -0.36, P < 0.0001) in participants with mild-to-moderate primary and secondary depression. Subgroup analyses suggested that acupressure significantly reduced depressive symptoms compared with different controlled conditions and in participants with different ages, clinical conditions, and duration of intervention. Adverse events, including hypotension, dizziness, palpitation, and headache, were reported in one study.
Conclusion:
The evidence of acupressure for mild-to-moderate depressive symptoms was significant. Importantly, the findings should be interpreted with caution due to study limitations. Future research with a well-designed mixed method is required to consolidate the conclusion and provide an in-depth understanding of potential mechanisms underlying the effects.
... It has been proven to be effective in many medical and psychological disorders. In recent years, acupressure has been receiving more attention for anxiety management, and many randomized controlled trials 4-13 and reviews [14][15][16] have shown promising evidence for anxiety relief (Table 1). According to the Oxford grading of evidence, all reported studies strongly support the favorable effect. ...
Anxiety is highly reported during the COVID-19 pandemic. The use of acupressure for anxiety is a common practice in integrative medicine, and previous literature has shown that acupressure can be an effective and feasible alternative treatment for decreasing anxiety. Given the social distancing requirements during the COVID-19 pandemic, it appears reasonable to assume that acupressure may be especially suited to treat anxiety under these circumstances. However, there has been relatively little reported use of acupressure for anxiety during the pandemic. This viewpoint aims to highlight the possible role of acupressure as a self-administered therapeutic approach for anxiety amidst the COVID-19 pandemic and to outline key areas for future research.
... [16][17][18] And some RCTs and systematic reviews have found that acupuncture are effectiveness and safety for depression and anxiety. [19][20][21][22][23][24][25][26] The mechanism of acupuncture for anxiety may be the balance of prefrontal cortex (PFC) activity [27] and endogenous melatonin secretion. [28] The mechanism of acupuncture for depression is associated with the restoration of hippocampus Cornu Ammonis1(CA1) synaptic plasticity, [29] increasing of adreno-cortico-tropic-hormone (ACTH) and neuropeptide Y, [30][31][32] and reducing of the expression of 3 cytokines, interleukin-6, nerve growth factor, and tissue inhibitor metalloproteinase. ...
Background:
Insomnia with high incidence is usually accompanied by many other diseases, especially mental disorders with the under-diagnosis and under-treatment. Some studies demonstrated that acupuncture may be effective for emotional disorders accompanied by insomnia. The systematic review protocol is designed to guiding analysis the effectiveness and safety of acupuncture for emotional disorders in patients with insomnia.
Methods:
Seven databases, Cochrane central register of controlled trials, Medline, Embase, China National Knowledge Infrastructure, Chinese Biomedical Literature database, VIP database and Wanfang database, will be searched from initial to December 2020. Randomized controlled trials (RCTs) of acupuncture for insomnia with emotional disorders (depression and anxiety) outcomes, which were reported in Chinese or English, will be included. The primary outcome is the change of degree of anxiety and depression. Study selection, data extraction and assessment of the risk of bias will be performed independently by 2 or more reviewers. Available data will be synthesized and statistically analyzed in RevMan V.5.3. The model of fixed effects will be used for the pooled data when the heterogeneity tests show little or no statistical heterogeneity (I2 < 50%). The random-effects model will be taken with heterogeneous data (50% ≤ I2 < 75%).
Results:
The effect of acupuncture on emotional disorders in patients with insomnia will be assessed on Hamilton anxiety Scale, Hamilton anxiety Scale, Pittsburgh Sleep Quality Index, Insomnia Severity Index, Self-rating Anxiety Scale, Self-rating Depressive Scale and the number of participants secede and the number of patients reported adverse events.
Conclusion:
the emotional disorders interaction with insomnia and the increase of risk on disease evolving and insomnia-related burden, it is so momentous to know that the role of insomnia treatment on comorbidities. We should concern about the management of emotional disorders when treat insomnia, and acupuncture treatment anxiety and depression caused by insomnia may be effective.
Ethics and dissemination:
Ethics approval is not be needed because the data will not contain individual patient data, and there are no concerns about privacy. The results of this meta-analysis will be disseminated through publication in a peer-reviewed academic journal or relevant conference.
Inplasy registration number:
INPLASY2020100115.
... A recent systematic review showed that acupressure has good results in relieving anxiety. [27] Another systematic review revealed that there is good evidence to encourage the treatment of anxiety disorders with acupuncture, because it produces effective results and has fewer side effects than traditional therapies. [28] Studies on data mining also summarizes the commonly used acupoints for anxiety treatment, as shown in Figure 2. [29] Therefore, we intend to systematically review the clinical trials of acupuncture and related interventions for anxiety in COVID-19 patients. ...
Background:
Traditional Chinese medicine plays an irreplaceable role in the treatment and prevention of epidemic diseases in China. Acupuncture is an important part of Chinese medicine. During the coronavirus disease 2019 (COVID-19) epidemic, acupuncture and related interventions are used to treat COVID-19 patients in China. The systematic review aims to evaluate the efficacy and safety of acupuncture and relevant interventions for anxiety in COVID-19.
Methods:
We will search for randomized control and observational studies of acupuncture and related interventions for anxiety in COVID-19 in the 6 databases from inception to 31 October 2020. There is no language restriction. Two independent reviewers will screen and collect all trials, data extraction and evaluate the risk of bias of the researches. We will perform a meta-analysis if appropriate.
Results:
Our findings will evaluate the feasibility of acupuncture and related interventions as adjunctive therapy for anxiety in COVID-19 patients, which will be disseminated in a relevant conference and published in a peer-reviewed publication.
Conclusion:
Our research will appraise the overall quality and evidence of whether acupuncture and related interventions are effective therapies for anxiety in COVID-19.
... Two trained authors (YTC&JP) screened the titles, abstracts, and fulltexts independently. A total of 21 of the 11336 articles were included [7,12,13,[17][18][19][20][21][22][23][24][25][26][27][28][29][30][31][32][33][34] (Figure 1, Table 2). All studies meeting the eligibility criteria were appraised independently by three authors (YTC, JP, and LJS) through quality assessment tools (Table 3). ...
Background. Psychological symptoms such as depression and anxiety are quite common among stroke survivors and have great negative impacts on patients. Objective. To develop a care bundle through reviewing and integrating care strategies for psychological symptoms after stroke and then improve the bundle by Delphi study. Methods. A structured search of the literature was performed to identify studies evaluating interventions for stroke patients with psychological symptoms such as depression and anxiety. Two trained researchers screened papers through the titles, abstracts, and full-texts independently. All studies complying with the eligibility criteria were appraised using quality assessment tools. Related interventions with evaluated evidence levels formed the preliminary bundle. Afterward, the Delphi study was carried out to improve the bundle, and the experts were contacted by e-mail. Ten clinical experts specialized in stroke and psychological rehabilitation were recruited. The reliability of experts was represented by the effective response rate and authority coefficient (Cr). The consensus was deemed to be reached when the mean score for item importance is all equal or above 3.50 and the coefficient of variation (CV) is all equal or below 0.20. The Kendall coefficient W test was adopted to evaluate the consensus on agreement among the experts as well. Data analysis was performed using SPSS V.22.0. Results. Through a systematic evidence summary and two-round Delphi study, the items that were given high scores and got consensus by experts were chosen for the bundle. The iDAME bundle consisted of five interventions eventually: maintaining Interaction, tailored Diet, Acupressure, mindfulness Meditation, and physical Exercise. Conclusion. The development of an evidence-based and consensus-based iDAME bundle which integrated western and traditional Chinese medicine intervention was described. Evidence summary made the bundle become scientific, while the Delphi study made it more maneuverable. Based on these results, the bundle would be potentially implemented in stroke patients for their psychological symptoms.
1. Introduction
Psychological symptoms are quite common among stroke survivors, such as depression, anxiety, apathy, and bipolar disorder [1]. An updated systematic review and meta-analysis found that the prevalence of poststroke depression was 31%∼33% [2], and 55% of patients might have depressive symptoms within 15 years after stroke [3]. The prevalence of anxiety within 10 years after stroke was 17%∼24%, and 57% of stroke patients might experience anxiety symptoms during this period [4]. It indicates that the adverse psychological symptoms of stroke patients occur in the long term and are persistent. Furthermore, psychological symptoms after stroke have great negative impacts on patients, such as self-efficacy reduction, rehabilitation stagnation, and much more heavy economic burden from the extended LOS (i.e., length of hospital stay) [5, 6].
At present, the management of psychological symptoms after stroke can be subdivided into pharmaceutical and nonpharmaceutical management. Common drugs used in clinical treatment include selective serotonin reuptake inhibitor (SSRI), serotonin-norepinephrine reuptake inhibitor (SNRI), a noradrenergic and specific serotonergic antidepressant (NaSSA), tricyclic antidepressants (TCAs), Wuling capsule (traditional Chinese medicine), and Shugan Jieyu capsule (traditional Chinese medicine) [7]. Though pharmaceutical treatments have a significant effect, most of them are accompanied by serious gastrointestinal reactions, liver or neurological damage, and other side effects. Current nonpharmaceutical management mainly includes physical therapy, psychotherapy, and traditional Chinese medicine treatment technology. Repetitive transcranial magnetic stimulation (rTMS) and transcranial direct current stimulation (tDCS) were applied to the treatment of psychological symptoms after stroke. A meta-analysis by Shen et al. analyzed a total of 1764 stroke patients in 22 randomized controlled trials and found that rTMS was effective for poststroke depression [8]. Bucur and Papagno demonstrated the efficacy and safety of tDCS and rTMS in stroke patients with psychological symptoms [9]. Exercise therapy such as muscle strengthening, mobilization exercise, and aerobic treadmill training was also confirmed that could provide positive contributions to mood improving after stroke through some clinical trials [10, 11]. Cognitive behavior therapy (CBT), behavioral activation therapy (BAT), problem-solving therapy (PST), mindfulness-based intervention (MBI), interpersonal therapy (IPT), and motivational interviewing (MI) are effective psychotherapies for mood disorders after stroke, suitable for patients of poor medication compliance and adverse drug reactions [7]. The effectiveness of traditional Chinese medicine treatment technology (e.g., acupuncture, moxibustion, and acupressure) and other adjuvant treatments such as music therapy, meditation, relaxation exercise, and mind-body exercise (e.g., Taichi, Qigong, and yoga) are also demonstrated and have the potential for clinical promotion [7, 12, 13]. However, the contributing factors of psychological symptoms are complex and various, and comprehensive interventions should be worked out. The existing combinations of interventions are empirical and lack of evidence-based. Hence, a synthesis of the existing literature to develop a care bundle for stroke patients with psychological symptoms is required.
A care bundle is a set of evidence-based or self-evident good-practice-based interventions for a defined patient population and care setting [14]. It is a concept proposed by the Institute for Healthcare Improvement (IHI), which refers to combining and integrating evidence-based treatments and nursing measures into a set of intervention program, so as to achieve the goal of treating clinical diseases and improve the quality of care and patients’ outcomes [15]. The combination of multiple intervention measures is often more efficient and beneficial than the single performed alone.
In this study, we present the development of a poststroke psychological symptom care bundle called iDAME. iDAME is the abbreviation of maintaining Interaction, tailored Diet, Acupressure, mindfulness Meditation, and physical Exercise. These five interventions were obtained through evidence summary and two-round Delphi. The formation of the whole bundle is evidence-based; it not only combines the best available evidence but also attaches the importance to the individual clinical experience. The best evidence, practical experience, and patient’s actual condition are comprehensively considered in medical decision making to achieve the transition from evidence to practice effectively.
2. Materials and Methods
2.1. Evidence Summary
2.1.1. Literature Search
According to the 6S evidence resource pyramid model [16], related practical guidelines, evidence summaries, expert consensus, systematic reviews, and clinical trials for the management of poststroke psychological symptoms were retrieved.
To obtain empirical studies on the management of poststroke psychological symptoms, a comprehensive search of multiple databases from January 2010 to May 2019 was conducted, including SinoMed, Wan Fang Database, Chinese National Knowledge Infrastructure (CNKI), PubMed, EMBASE, CINAHL, Web of Science, JBI, and Cochrane (Table 1). In addition, the relevant clinical practice guideline websites were also searched, such as the Scottish Intercollegiate Guidelines Network (SIGN), the National Institute for Health and Care Excellence (NICE), the Registered Nurses’ Association of Ontario, Canada (RNAO), American Heart Association/American Stroke Association (AHA/ASA), Neurocritical Care Society (NCS), European Stroke Organisation (ESO), Royal College of Physicians (RCP), National Stroke Foundation (NSF), and Royal Dutch Society for Physical Therapy (KNGF) using the search terms “stroke,” “cerebrovascular accident,” “psychological disorder,” “psychological symptom,” “mental problem,” “emotional problem,” and “mood stress.” Reference lists of relevant articles were cross-checked and pertinent journals were hand searched for articles. The inclusion criteria were (1) studies written in English and Chinese and (2) studies that involved psychological symptoms in the context of the poststroke period and addressed any aspect of care. The exclusion criteria were (1) duplicates, review articles, and unpublished manuscripts and (2) studies that did not report poststroke psychological symptoms in their findings.
JBI
#1 Stroke or hemiplegia or “cerebrovascular disease” or “cerebral arterial thrombosis” or “Ischemic stroke”
#2 depression or anxiety
#3 yr = “2010-Current”
#1 and #2 and #3
Cochrane
#1 Stroke or strokes or hemiplegia or “brain infarction” or “cerebrovascular disease” or CVD or “cerebrovascular attack” or “cerebrovascular accident” or “cerebrovascular accidents” or CVA or “brain vascular accident” or “brain vascular accidents” or “acute cerebrovascular accident” or “cerebrovascular apoplexy” or “cerebrovascular stroke” or “cerebrovascular strokes” or “acute stroke” or “acute strokes” or “cerebral strokes” or “cerebral stroke” or “cerebral arterial thrombosis” or “Ischemic stroke”
#2 Psychological or Psychology or “psychological disorders” or “psychological disorder” or “psychological stress” or “psychological health” or “Psychological symptom” or “Psychological symptoms” or “psychological problem” or “psychological problems” or mental or “mental health” or “mental symptoms” or “mental symptom” or “mental disorder” or “mental disorders” or “mental problem” or “mental problems” or “mental stress” or emotional or emotion or “emotional stress” or “emotional symptoms” or “emotional symptom” or “emotional disorder” or “emotional disorders” or “emotional problem” or “emotional problems” or “emotional health” or mood or “mood disorders” or “mood disorder” or “mood health” or “mood stress” or “mood symptom” or “mood symptoms” or “mood problem” or “mood problems” or affectivity or affective or “affective disorder” or “affective disorders” or “affective health” or “affective stress” or “affective problem” or “affective problems” or “affective symptom” or “affective symptoms” or depression or “depression symptom” or “depression symptoms” or “depression disorder” or “depression disorders” or anxiety or “anxiety symptom” or “anxiety symptoms” or “anxiety disorder” or “anxiety disorders”
#3 “Randomized controlled trial ” or ”Randomized controlled trials” or RCT or RCTs or “systematic review” or “systematic reviews” or meta-analysis or guideline or guidelines or consensus
#4 2010-current
#1 and #2 and #3 and #4
Pubmed
#1 Stroke[Title/Abstract] OR strokes[Title/Abstract] OR hemiplegia[Title/Abstract] OR “brain infarction” [Title/Abstract] OR “cerebrovascular disease” [Title/Abstract] OR CVD[Title/Abstract] OR “cerebrovascular attack” [Title/Abstract] OR “cerebrovascular accident” [Title/Abstract] OR “cerebrovascular accidents” [Title/Abstract] OR CVA[Title/Abstract] OR “brain vascular accident” [Title/Abstract] OR “brain vascular accidents” [Title/Abstract] OR “acute cerebrovascular accident”[Title/Abstract] OR “cerebrovascular apoplexy”[Title/Abstract] OR “cerebrovascular stroke” [Title/Abstract] OR “cerebrovascular strokes” [Title/Abstract] OR “acute stroke” [Title/Abstract] OR “acute strokes” [Title/Abstract] OR “cerebral strokes” [Title/Abstract] OR “cerebral stroke” [Title/Abstract] OR “cerebral arterial thrombosis” [Title/Abstract] OR “Ischemic stroke” [Title/Abstract]
#2 Psychological[Title/Abstract] OR Psychology[Title/Abstract] OR “psychological disorders” [Title/Abstract] OR “psychological disorder” [Title/Abstract] OR “psychological stress” [Title/Abstract] OR “psychological health”[Title/Abstract] OR “Psychological symptom” [Title/Abstract] OR “Psychological symptoms” [Title/Abstract] OR “psychological problem” [Title/Abstract] OR “psychological problems” [Title/Abstract] OR mental[Title/Abstract] OR “mental health” [Title/Abstract] OR “mental symptoms” [Title/Abstract] OR “mental symptom” [Title/Abstract] OR “mental disorder” [Title/Abstract] OR “mental disorders” [Title/Abstract] OR “mental problem” [Title/Abstract] OR “mental problems “ [Title/Abstract] OR “mental stress” [Title/Abstract] OR emotional[Title/Abstract] OR emotion[Title/Abstract] OR “emotional stress” [Title/Abstract] OR “emotional symptoms” [Title/Abstract] OR “emotional symptom” [Title/Abstract] OR “emotional disorder” [Title/Abstract] OR “emotional disorders” [Title/Abstract] OR “emotional problem” [Title/Abstract] OR “emotional problems” [Title/Abstract] OR “emotional health” [Title/Abstract] OR mood[Title/Abstract] OR “mood disorders” [Title/Abstract] OR “mood disorder” [Title/Abstract] OR “mood health” [Title/Abstract] OR “mood stress” [Title/Abstract] OR “mood symptom” [Title/Abstract] OR “mood symptoms” [Title/Abstract] OR “mood problem” [Title/Abstract] OR “mood problems” [Title/Abstract] OR affectivity[Title/Abstract] OR affective[Title/Abstract] OR “affective disorder” [Title/Abstract] OR “affective disorders” [Title/Abstract] OR “affective health” [Title/Abstract] OR “affective stress” [Title/Abstract] OR “affective problem” [Title/Abstract] OR “affective problems” [Title/Abstract] OR “affective symptom” [Title/Abstract] OR “affective symptoms” [Title/Abstract] OR depression[Title/Abstract] OR “depression symptom” [Title/Abstract] OR “depression symptoms” [Title/Abstract] OR “depression disorder” [Title/Abstract] OR “depression disorders” [Title/Abstract] OR anxiety[Title/Abstract] OR “anxiety symptom” [Title/Abstract] OR “anxiety symptoms” [Title/Abstract] OR “anxiety disorder” [Title/Abstract] OR “anxiety disorders” [Title/Abstract]
#3 ”Randomized controlled trial ” [Title/Abstract] OR “Randomized controlled trials” [Title/Abstract] OR RCT[Title/Abstract] OR RCTs[Title/Abstract] OR “systematic review” [Title/Abstract] OR “systematic reviews” [Title/Abstract] OR meta-analysis[Title/Abstract] OR guideline[Title/Abstract] OR guidelines[Title/Abstract] OR consensus[Title/Abstract])
#4 Publication date from 2010/01/01
#1 and #2 and #3 and #4
Web of science
#1 TITLE : Stroke or strokes or hemiplegia or “brain infarction” or “cerebrovascular disease” or CVD or “cerebrovascular attack” or “cerebrovascular accident” or “cerebrovascular accidents” or CVA or “brain vascular accident” or “brain vascular accidents” or “acute cerebrovascular accident” or “cerebrovascular apoplexy” or “cerebrovascular stroke” or “cerebrovascular strokes” or “acute stroke” or “acute strokes” or “cerebral strokes” or “cerebral stroke” or “cerebral arterial thrombosis” or “Ischemic stroke”
#2 TITLE : Psychological or Psychology or “psychological disorders” or “psychological disorder” or “psychological stress” or “psychological health” or “Psychological symptom” or “Psychological symptoms” or “psychological problem” or “psychological problems” or mental or “mental health” or “mental symptoms” or “mental symptom” or “mental disorder” or “mental disorders” or “mental problem” or “mental problems” or “mental stress” or emotional or emotion or “emotional stress” or “emotional symptoms” or “emotional symptom” or “emotional disorder” or “emotional disorders” or “emotional problem” or “emotional problems” or “emotional health” or mood or “mood disorders” or “mood disorder” or “mood health” or “mood stress” or “mood symptom” or “mood symptoms” or “mood problem” or “mood problems” or affectivity or affective or “affective disorder” or “affective disorders” or “affective health” or “affective stress” or “affective problem” or “affective problems” or “affective symptom” or “affective symptoms” or depression or “depression symptom” or “depression symptoms” or “depression disorder” or “depression disorders” or anxiety or “anxiety symptom” or “anxiety symptoms” or “anxiety disorder” or “anxiety disorders”
#3 TITLE: “Randomized controlled trial ” or ”Randomized controlled trials” or RCT or RCTs or “systematic review” or “systematic reviews” or meta-analysis or guideline or guidelines or consensus
#4 Timespan: 2010-2019. Indexes: SCI-EXPANDED, SSCI, A&HCI, CPCI-S, CPCI-SSH, ESCI, CCR-EXPANDED, IC
#1 and #2 and #3 and #4
Embase
#1 Stroke or hemiplegia or “cerebrovascular disease” or “cerebral arterial thrombosis” or “Ischemic stroke”
#2 depression or anxiety
#3 yr = “2010”
#1 and #2 and #3
CINAHL
#1 TI ( Stroke or strokes or hemiplegia or “brain infarction” or “cerebrovascular disease” or CVD or “cerebrovascular attack” or “cerebrovascular accident” or “cerebrovascular accidents” or CVA or “brain vascular accident” or “brain vascular accidents” or “acute cerebrovascular accident” or “cerebrovascular apoplexy” or “cerebrovascular stroke” or “cerebrovascular strokes” or “acute stroke” or “acute strokes” or “cerebral strokes” or “cerebral stroke” or “cerebral arterial thrombosis” or “Ischemic stroke”
#2 TI ( Psychological or Psychology or “psychological disorders” or “psychological disorder” or “psychological stress” or “psychological health” or “Psychological symptom” or “Psychological symptoms” or “psychological problem” or “psychological problems” or mental or “mental health” or “mental symptoms” or “mental symptom” or “mental disorder” or “mental disorders” or “mental problem” or “mental problems” or “mental stress” or emotional or emotion or “emotional stress” or “emotional symptoms” or “emotional symptom” or “emotional disorder” or “emotional disorders” or “emotional problem” or “emotional problems” or “emotional health” or mood or “mood disorders” or “mood disorder” or “mood health” or “mood stress” or “mood symptom” or “mood symptoms” or “mood problem” or “mood problems” or affectivity or affective or “affective disorder” or “affective disorders” or “affective health” or “affective stress” or “affective problem” or “affective problems” or “affective symptom” or “affective symptoms” or depression or “depression symptom” or “depression symptoms” or “depression disorder” or “depression disorders” or anxiety or “anxiety symptom” or “anxiety symptoms” or “anxiety disorder” or “anxiety disorders”
#3 AB (“Randomized controlled trial” or ”Randomized controlled trials” or RCT or RCTs or “systematic review” or “systematic reviews” or meta-analysis or guideline or guidelines or consensus)
#4 2010–2019
#1 and #2 and #3 and #4
Background
Diarrhea-predominant irritable bowel syndrome (IBS-D) significantly impacts patients’ quality of life, with existing treatments offering limited relief. Self-administered acupressure presents a potential non-invasive, cost-effective treatment option that could alleviate symptoms and enhance health outcomes in these patients.
Aim
This randomized controlled trial aimed to evaluate the effect of active acupressure compared to sham acupressure on primary and secondary outcomes among IBS-D patients.
Method
The study included 63 patients with IBS-D, recruited from Alexandria Main University Hospital, Egypt. Participants were randomized into either an active acupressure group or a sham acupressure group. Both groups underwent two days of training, followed by four weeks of intervention. The active group applied pressure to specific therapeutic acupoints, while the sham group used non-therapeutic points. Outcomes were assessed at baseline, week 2, and week 4.
Results
The active acupressure group showed a significant reduction in symptom severity, improved stool consistency, and frequency, and greater adequate symptom relief by week 4 compared to the sham group. Psychological outcomes, including anxiety and depression, also improved significantly in the active group. Additionally, the active group reported reduced use of rescue medications.
Conclusion
Active acupressure is an effective nursing intervention for alleviating symptoms of IBS-D, particularly when applied consistently over time. It improves both physical and psychological outcomes, offering a valuable non-pharmacological treatment option.
Implications
Nurses can integrate self-administered acupressure into IBS-D care plans, teaching patients this technique to manage symptoms independently, thus enhancing their quality of life (QOL) and reducing reliance on conventional medications. This intervention aligns with holistic nursing care and offers a cost-effective, patient-friendly solution for managing IBS-D.
Trial registration
This study was prospectively registered as a randomized controlled trial in https://clinicaltrials.gov/ Registration Date: January 7, 2023, Registration Number: NCT05702255.
Coping with cancer presents a multitude of challenges that encompass every aspect of a patient's life. These challenges not only strain the body but also weigh heavily on the mind, often culminating in profound psychological distress for cancer patients. The cumulative burden of these experiences can heighten the risk of developing psychiatric disorders, exacerbating the already daunting landscape of cancer care. Therefore, this study reviewed the available research with the aim of investigating the effects of traditional Chinese medicine on psychological conditions in elderly cancer patients. In this scoping review, we applied specific criteria to select studies that focused on elderly patients with cancer. We performed an extensive search across electronic databases, including Embase, Science Direct, PubMed, Google Scholar, Scopus, Cochrane Library and Web of Science. In our investigation, we identified a total of 3870 articles related to the topic under review. Following a meticulous screening process that involved evaluating titles, abstracts, and full texts, we ultimately selected five articles deemed relevant for inclusion in this review. Among these articles, three were randomised studies, while the remaining two were review articles. The outcomes of our analysis revealed that herbal decoctions, nutritional counselling, Tai Chi and acupressure, can effectively improve various psychological outcomes in elderly cancer patients. These interventions reduce fatigue, depression, anxiety, and stress, while also enhancing sleep quality and overall mental health. The present study highlights the importance of traditional Chinese medicine in addressing the needs of elderly patients with cancer. As a result, it is recommended that further extensive research be conducted to comprehensively assess the efficacy and safety of traditional Chinese medicine in managing cancer in the elderly.
Background: Normal labor is stressful, and the intense pain and anxiety can have an adverse effect on the mother, the fetus, and the delivery procedure. This study aimed to determine how acupressure applied to multiple acupoints during normal labor affected labor pain and anxiety in primiparous women. Method: This study was a double-blinded randomized controlled trial that involved 43 primiparous women aging 20-30 years who were referred for normal labor. Subjects were randomly allocated to one of two groups: acupressure or control. Acupressure was administered to the Large Intestine 4 (LI4), Heart 7 (He-7), and Spleen 6 (SP6) acupoints in the acupressure group, whereas sham acupressure was administered to the control group. The study assessed the mothers' anxiety levels using the Spielberger Inventory questionnaire and measured their pain levels using the visual analog scale before and after the intervention. In addition, pulse rate and blood pressure were also measured. Result: In the acupressure group, both the anxiety score and pain level showed a substantial improvement (p < 0.001), but in the control group, only the anxiety score showed a significant improvement (p < 0.001). After the intervention, the difference in anxiety and pain scores between the two groups is statistically significant (p < 0.001). Furthermore, neither group's blood pressure nor pulse rate showed any significant changes (p < 0.05). Conclusion: According to the study's findings, acupressure targeting LI4, He-7, and SP6 acupoints was effective in relieving anxiety and pain during labor. Compared with the sham acupressure group, the acupressure group showed a greater decrease in both anxiety and pain levels. As such, acupressure may be recommended as an effective, affordable, and accessible technique for managing pain and anxiety during labor. This study has been registered in the database of clinical trials under the identifier Clinicaltrials.gov NCT05411289.
Background and objectives:
Burns often cause severe pain, especially during dressing changes. This study aimed to investigate the effect of acupressure on pain during dressing changes in burn patients.
Methods:
This randomized clinical trial was conducted on 76 burn patients. The eligible patients were randomly assigned to the intervention and control groups after obtaining informed consent. Eligible patients were randomly assigned to the intervention and control groups by blocking. The study was conducted over two days using the same method. Before entering the dressing room, acupressure was performed in the intervention group for 10 min in acupressure points and the control group in other points. Pain intensity was measured in two groups 30 min before entering the dressing room and 15 and 30 min after leaving the dressing room using VAS. Finally, the data were analyzed using SPSS software 25th edition.
Results:
Pain scores were similar for the two groups before the dressing change. The results of this study revealed a significant decrease in the patient's pain intensity mean in the test group following acupressure compared to the control group on day one which remained on day two (P < 0.05).
Conclusion:
Considering the experience of severe pain in burn patients, acupressure is recommended as a complementary method along with modern medicine to reduce these patients' pains.
Aim:
This randomised sham-controlled trial aimed to analyse the effects of acupressure on pain, anxiety, and vital signs in patients who underwent coronary angiography.
Materials and methods:
After undergoing coronary angiography, 105 patients were randomised into acupressure (n = 35), sham acupressure (n = 35), and control groups (n = 35). Patients in the acupressure group received acupressure on the heart meridian 7 (HT7), large intestine meridian 4 (LI4), and pericardium meridian (PC6) acupoints 30 min after admission to the clinic, for a period of 16 min, whereas those in the sham group received acupressure on locations 1-1.5 cm away from these points. The control group received standard treatment. The patient information form, Spielberger's state anxiety inventory, visual analogue scale, and vital signs follow-up form were used for data collection.
Findings:
Consecutive measurements revealed that anxiety levels in the acupressure group were lower than that in the sham and control groups (p < 0.05). In addition, compared to the sham and control groups, the pain scores in the acupressure group decreased significantly after acupressure (p < 0.01). Although there was no significant difference between the pain scores of the sham group before and after acupressure intervention (p > 0.05), the scores of the control group increased significantly over time (p < 0.01). Finally, the vital signs decreased significantly in the acupressure and sham groups after intervention (p < 0.01), but increased significantly in the control group (p < 0.01).
Conclusion:
The findings of this trial indicated that acupressure is an effective method for reducing anxiety, pain, and vital signs.
PurposeLaser acupuncture, a non-invasive variant of acupuncture, has been proven effective in the medical and dental fields. Hence, the present study aims to determine the effect of low-level laser therapy on the LI4 point, using a laser acupuncture pen, in reducing children’s pain during local anesthetic (LA) administration.Methods
Children in the age range of 8–12 years, in need of LA administration, were randomly assigned to two groups: Group I: laser acupuncture, Group II: control. For all the children, baseline simplified Modified Child Dental Anxiety Scale-Faces version (MCDAS(f)) was recorded, followed by laser acupuncture or standard care. Following the conventional protocol, LA was administered. The procedural pain was assessed using the Faces, Legs, Activity, Cry and Consolability scale (FLACC) and Faces Pain Scale-Revised (FPS-R). All the variations in pulse rate were recorded from baseline to the completion of LA administration. After the procedure, simplified MCDAS(f) was recorded one more time. The data were tabulated and analyzed statistically.ResultsA significant reduction in anxiety after LA administration, as observed in MCDAS(f) score, was noticed only in the laser acupuncture group. The pain scores, as reported in FPS-R, were low in children randomized to the laser group compared to the control. The FLACC pain scores also showed low values in the experimental group.Conclusion
Based on the study findings, within the limitations, low-level laser therapy using a laser acupuncture pen can reduce the pain perception of children undergoing LA administration and alleviate dental anxiety.
Practical acupuncture methods are described for reducing anxiety and burnout for staff working during the COVID pandemic.
The aim of this study was to evaluate the effect of acupressure on anxiety and pain of patients undergoing coronary angiography procedures. This study was conducted in a cardiology clinic of the training and research hospital in of a province of southeast Turkey. A randomized control group design was used. Eighty patients who were undergoing coronary angiography were randomly enrolled in intervention and control groups. The intervention protocol included 11 minutes of acupressure that applied to Hegu, Shenmen, and Yintang acupoints. No intervention was applied to the control group. Spielberger's state-trait anxiety inventory and the visual analog scale were used as data-collecting tools. Data were analyzed using t test in independent groups and χ2 test. The mean score of state anxiety of the intervention group was 41.50 ± 3.88, and was statistically significantly lower than the score of the control group after acupressure (P = .000). VASP2 and VASP3 pain intensity of the intervention group was statistically significantly lower than that of the control group after the coronary angiography procedure (P = .000). Acupressure is an effective technique for reducing the pain severity and anxiety among patients undergoing coronary angiography.
The present work consists of the study of Traditional Chinese Medicine (TCM), with the objective of reporting the use of acupuncture as an alternative in the treatment of anxiety contextualizing it with public health, through a literature review in which articles from the last ten years were selected in reliable websites. Acupuncture and proved effective in all selected articles, avoiding the prolonged use of medications that may cause dependence, this practice allows the pharmaceutical professional to apply his area of activity to the patient so that they can use such therapy in their treatment.
Currently, acupressure is widely accepted as a non-pharmacological therapy for managing pain, nausea and vomiting, and mental health conditions. Since acupressure can be self-administered, clinicians and researchers’ interest in information and communication technologies (ICTs) for disseminating acupressure to manage symptoms has increased. This mini review was conducted to examine clinical studies of acupressure using ICTs, with a particular focus on self-acupressure. Through a search of MEDLINE, EMBASE, and CENTRAL, all studies of self-acupressure using ICTs published before December 31, 2021 were collected. Twelve studies met the inclusion criteria. More than half of the studies published since 2020 (4/7, 54.14%) were described as being related to COVID-19. As target conditions, musculoskeletal injuries or pain, cancer-related symptoms, dysmenorrhea, mental health issues, and obesity were considered. The most frequently used acupoints were LI4, LR3, and Shenmen. Moreover, smartphone applications were the most commonly used ICT method to support self-acupressure. In addition to the basic information of self-acupressure, other tools such as timers, reminders, and schedule checkers to facilitate its implementations have been incorporated into the smartphone applications. Recently, there have been some attempts to combine acupressure and ICTs. Although these studies mainly focus on musculoskeletal pain or injuries, recent studies related to mental health have emerged in relation to COVID-19. However, few studies have been conducted to date, making it difficult to fully grasp the trends in this field. Therefore, more studies are needed to evaluate the feasibility and efficacy of combining self-acupressure and ICTs in more diverse clinical areas.
Background and purpose
Touch for health (TFH) based kinesiology is a complementary therapy with foundations in a natural health training developed utilising techniques from chiropractic, osteopathy and acupressure therapies. Although popular, the impact of the therapy is poorly understood. The aim of this study was to understand outcomes of TFH-based kinesiology interventions that clients perceive as important in their lives.
Materials and methods
A qualitative phenomenological approach was chosen to capture rich descriptive data. Thirteen individuals were recruited from TFH-based kinesiology practices. Focus groups included semi-structured questions, photo-elicitation and a wellness word activity to prompt discussion on impacts of interventions. Audio-recordings were transcribed, coded and grouped to develop themes. Comparisons were made and linked with the wellness model, theory of planned behaviour and mindfulness-based interventions.
Results
Three interrelated themes emerged: impact on awareness, experience of effects and impact on action. TFH-based kinesiology was perceived to enhance self-awareness and feelings of wellbeing, promote self-care and support new actions to manage stress and complement conventional healthcare. The use of a mind-body approach with feedback from muscle testing and less need for dialogue were valued. Photo-elicitation generated rich narratives recounting experiences after interventions. Impacts aligned with the wellness model and resembled outcomes of mindfulness-based interventions.
Conclusion
This study provides an insight into experiences and impacts of TFH-based kinesiology. Interventions were seen to facilitate self-awareness, experiences of wellbeing and promote self-care. Findings contribute towards a knowledge-base to foster dialogue and inform TFH-based kinesiologists, health professionals, consumers and research of TFH-based kinesiology and comparative therapies.
Because of its “drug-free” analgesic effect, acupuncture has re-sparked the interest of western medical practitioners. Although western anesthesia practices rapidly replaced acupuncture-induced surgical analgesia in China, acupuncture is still widely accepted as an effective complementary, alternative treatment for pain, especially chronic pain. To counter a nationwide opioid epidemic fostered by opioid overuse and misuse, acupuncture has increasingly been integrated into a multimodal analgesic intervention approach. After almost a half-decade of using this multiple intervention strategy, additional benefits of perioperative acupuncture have been confirmed or “rediscovered” as a result of well-conducted basic research and clinical trials. These beneficial effects include maintaining hemodynamic stability, protecting vital organs, decreasing intraoperative anesthetic usage, and decreasing postoperative complications and support the belief that there is a role for acupuncture in current modern anesthesia practice. Recent perioperative medicine has implemented protocols for perioperative care that reduce surgical stress, promote organ recovery, decrease adverse outcomes, and decrease the length of hospital stay without an increased rate of readmission. While multimodal analgesic management is heavily emphasized, acupuncture in perioperative usage should be considered. This article will discuss the role of acupuncture in perioperative medicine from the past to the present as well as future use in managing surgical patients.
This study investigated the effects of acupressure on sleep quality, anxiety, depression, and quality of life among older people in Australia. Acupressure improved overall subjective sleep quality and anxiety but no differences in depression and quality of life. Future studies with larger sample sizes are required to generate good evidence.
Introduction
Application of stereotaxy frame for gamma knife under local anesthesia creates anxiety and phobia in many patients. Vasovagal syncopal attacks and events of bradycardia are not infrequently seen. We tried to analyse the various factors affecting these events and set standards and safety recommendations for the procedure.
Materials and methods
This prospective study was carried out in Gamma Knife Centre, AIIMS, New Delhi over a 6 month period between June, 2021- November, 2021. All patients coming to Gamma knife for various etiologies were asked to fill Hamilton Anxiety Rating Scale (HAM-A) before frame application. Baseline pulse rate was evaluated and with every pin application pulse rate was recorded. A VAS (visual analogue scale) for pain was also administered after the procedure. Twenty percent fall in pulse rate were considered as significant bradycardia. Intraprocedural syncopal events were also recorded.
Results
A total of 141 patients were studied of which 6% patients had intraprocedural syncopal attacks requiring medical treatment while 32% patients had bradycardia. Having previous surgery, having breakfast before the procedure, duration of pin application, quantity of local anaesthetia, primary diagnosis, sex of patients were not found to alter the syncope or bradycardia events. Patients who were found anxious (score > 18 on HAM-A) had a significantly higher risk of having a procedural event. Previous history of syncope was also associated with 1.7 times more chances of developing Intraprocedural bradycardia.
Conclusions
Frame application for gamma-knife is a relatively safe procedure however procedure rooms should be equipped with emergency drugs and fluids for management of syncope. A Simple anxiety questionnaire can predict ‘at risk’ patients’ for procedural events
Objectives
This study aims to identify and analyze the scientific evidence on the effectiveness of massage therapy toward fatigue on cancer patients.
Methods
We used a PRISMA checklist to systematically review articles from the following databases: PubMed, Scopus, ProQuest, Science Direct, EBSCO, and Wiley Online Library, published from 2009 to 2018. We structured the research questions with the PICO elements. Although 2747 articles were obtained, only seven articles met the inclusion criteria. Each article was analyzed critically using CASP checklists.
Results
Among the seven shortlisted articles, one was a retrospective study, and six were intervention studies (four RCTs, one quasi-experiment, and one pre-posttest without control).
Conclusion
All of the studies found similar results that suggest massage therapy as one of the effective interventions in reducing fatigue in cancer patients.
Purpose:
More than 86% patients experience moderate to severe pain after thoracoscopic surgery. A combination of diverse nonpharmacological pain relief methods is a developing trend for pain management. The purpose of this study was to explore the effect of acupressure in reducing pain after thoracoscopic surgery.
Design:
A Randomized controlled study with purpose sampling was used for this study. Patients who underwent thoracoscopic surgery at a medical center in central Taiwan were enrolled. Study data was collected from September 2020 to April 2021 after the approval of the institutional review board. A total of 100 participants were randomized into two groups (49 and 51 in the experimental and control groups, respectively).
Methods:
Participants in the experimental group received acupressure at the Neiguan (PC6) and Shenmen (HT7) acupoints thrice a day for 2 days, whereas those in the control group received routine treatment and did not receive acupressure. The measurement included questionnaires for the collection of general information, physiological information, and disease rating scale. The Visual Analogue Scale-Pain (VAS-P) was used to measure the severity of pain. SPSS statistical software was used for data analysis. Independent sample t-test and chi-squared test were used for descriptive statistics, and paired t-test and linear mixed model were used to examine the effect of acupressure in alleviating pain.
Findings:
After acupressure intervention, the pain score of the experimental group was lower than that of the control group, and this difference was significant β = 17.76, p < 0.001 on day 1 after intervention; β = 19.80, p < 0.001 on day 2 after intervention. The postoperative pain score in the experimental group on day 2 after intervention was significantly lower than that in the control group (t = 2.039, p = 0.044). After the subjects received acupressure, pain index significantly decreased after considering the interaction between time and group (p < 0.001). Regardless of the type of surgery, there were significant differences in pain index when the interaction between time and group was considered (p < 0.001).
Conclusions:
This study provided an experimental basis that acupressure can help in pain management in patients after thoracoscopic surgery, and the pain relief results become more significant as the duration of intervention increases.
Clinical relevance:
Acupressure is effective in relieving postoperative pain in any type of thoracoscopic surgery. Nurses can use acupressure to help control pain in patients after thoracoscopic surgery.
This review aims to evaluate the effectiveness of acupressure as a treatment method for osteoarthritis. Fourteen electronic databases were searched from the date of inception until 16 March 2021, for eligible studies. Studies comparing acupressure with sham acupuncture, no intervention or conventional intervention were eligible for inclusion. The risk of bias of the included studies was assessed using the Cochrane Collaboration’s Risk of Bias Assessment tool Version 2.0. A total of eight trials were included in this review, focusing on the seven trials investigating knee osteoarthritis. The risk of bias is judged as low in only two trials and concerning in the remaining six trials. The meta-analysis showed that acupressure has equivalent effects in reducing pain (p = 0.12), relieving stiffness (p = 0.38), and improving physical function (p = 0.12), as compared to sham acupressure. Pooled results also showed similar results where acupressure has an equivalent effect in reducing pain (p = 0.09), and relieving stiffness (p = 0.68), but showed a favorable effect in improving physical function of joints (MD –6.30, CI 95%: −11.69 to −0.92, p = 0.02), as compared to no intervention. For acupressure complementing conventional intervention, pooled results showed superior effects for easing pain compared to conventional intervention alone (MD −3.72, 95% CI: −4.84 to −2.61, p < 0.00001). Overall, the studies included in this review have concerning quality and suffer from small sample sizes, and the findings of this review should be interpreted with caution. More clinical trials with proper methodology are needed to confirm the effectiveness of acupressure for osteoarthritis.
Preoperative anxiety is a common reaction exhibited by up to 80% of patients who are scheduled for surgical procedures and characterized by psychological and physical changes which may affect their perioperative period. Our aim is to report the most up-to-date evidence on preoperative anxiety in brain surgery patients through a systematic analysis of the studies produced in the last decades. We performed a systematic review of literature by searching PubMed, Embase, and Cochrane Library databases. Data were extracted using the Population, Intervention, Comparison, Outcome framework and critically analyzed. PRISMA guidelines were applied, and the risk of bias of the included studies was assessed using the Risk of bias (RoB) 2 and ROBINS tools, as was the methodological quality, following GRADE criteria. We included 27 articles, accounting for 2558 patients in twelve different countries. The prevalence of preoperative anxiety ranged from 17 up to 89%, higher in female patients. Preoperative anxiety was associated with lower quality of life and cognitive performance, higher need for information, poorer memory and attention, longer hospitalization, depressive symptoms, and increase of physical disability; no correlation with survival rate was found. Seven randomized controlled trials attested the efficacy of acupuncture, music therapy, virtual reality, and pharmacological support in lowering anxiety levels. Preoperative anxiety is a common phenomenon that could negatively affect the perioperative period of brain surgery patients: this is something that should not be neglected to achieve better care through early prevention and optimal management.
Anxiety during the preoperative period is a common problem experienced by women who will deliver by cesarean section. The use of nonpharmacological methods to control anxiety in pregnant women has been shown to be more appropriate. This double-blind randomized controlled experimental study was conducted to assess the effect of acupressure on acute anxiety developing before cesarean section under spinal anesthesia. In the present study, 82 pregnant women scheduled for surgery were randomly assigned to the acupressure and control groups including 40 and 42 persons, respectively. Acupressure was applied to HE-7 acupuncture points in the participants in the acupressure (intervention) group for 10 minutes before the surgery. The participants in the control group were subjected to the hospital protocol. Anxiety levels of the participating women were assessed twice preoperatively using the State-Trait Anxiety Inventory. Anxiety scores of the participants in the acupressure group before the procedure (49.13 ± 6.22) were higher than were those of the participants in the control group (41.71 ± 3.26); however, after the procedure, the anxiety scores decreased statistically significantly in the acupressure group (38.30 ± 4.45) compared with the control group (52.48 ± 7.30) (P < .001). Acupressure reduced the preoperative acute anxiety suffered by the participating pregnant women.
Preoperative anxiety, as an emotional reaction, is common among patients undergoing surgery. The purpose of this study was to examine the effect of acupressure on preoperative anxiety before abdominal surgery. The 70 subjects of this clinical trial were randomly assigned into the acupressure group (n=35), which received acupressure at the true points, or the placebo group (n=35), which received acupressure at sham (false) points. Preoperative anxiety and vital signs before and after the intervention were measured in both groups. The findings demonstrated a reduction in the level of preoperative anxiety for both groups (P<.001). Furthermore, they showed a statistically significant difference between the mean of vital signs before and after the intervention in the acupressure group (P<.001) and only statistically significant results for cardiovascular (P=.016) and respiratory rates (P=.007) in the placebo group. Overall, findings revealed that acupressure at true points (third eye and Shen men) can reduce higher preoperative anxiety of patients before abdominal surgery and that it has had a more clinically beneficial effect than sham points.
Shiatsu, similar to acupressure, uses finger pressure, manipulations and stretches, along Traditional Chinese Medicine meridians. Shiatsu is popular in Europe, but lacks reviews on its evidence-base.
Acupressure and Shiatsu clinical trials were identified using the MeSH term 'acupressure' in: EBM reviews; AMED; BNI; CINAHL; EMBASE; MEDLINE; PsycARTICLES; Science Direct; Blackwell Synergy; Ingenta Select; Wiley Interscience; Index to Theses and ZETOC. References of articles were checked. Inclusion criteria were Shiatsu or acupressure administered manually/bodily, published after January 1990. Two reviewers performed independent study selection and evaluation of study design and reporting, using standardised checklists (CONSORT, TREND, CASP and STRICTA).
Searches identified 1714 publications. Final inclusions were 9 Shiatsu and 71 acupressure studies. A quarter were graded A (highest quality). Shiatsu studies comprised 1 RCT, three controlled non-randomised, one within-subjects, one observational and 3 uncontrolled studies investigating mental and physical health issues. Evidence was of insufficient quantity and quality. Acupressure studies included 2 meta-analyses, 6 systematic reviews and 39 RCTs. Strongest evidence was for pain (particularly dysmenorrhoea, lower back and labour), post-operative nausea and vomiting. Additionally quality evidence found improvements in sleep in institutionalised elderly. Variable/poor quality evidence existed for renal disease symptoms, dementia, stress, anxiety and respiratory conditions. Appraisal tools may be inappropriate for some study designs. Potential biases included focus on UK/USA databases, limited grey literature, and exclusion of qualitative and pre-1989 studies.
Evidence is improving in quantity, quality and reporting, but more research is needed, particularly for Shiatsu, where evidence is poor. Acupressure may be beneficial for pain, nausea and vomiting and sleep.
Acupressure is a noninvasive strategy used to manage various symptoms.
The purpose of this article was to review randomized controlled trials that investigated the efficacy of acupressure for the management of symptoms.
A literature search was conducted in the Cumulative Index to Nursing and Allied Health Literature, Medline, and PubMed using the key words acupressure, clinical trial, human, and/or randomized. Randomized clinical trials published between January 1, 2000 and January 31, 2010, which used acupressure as the sole intervention for one group, were included when they were written in English and when there were four or more studies of the efficacy of acupressure for that particular symptom.
Forty-three studies were included in this review. Investigators in 16 of 23 studies concluded acupressure was effective, primarily for the management of nausea and vomiting in patients during pregnancy and during chemotherapy. Investigators in nine of 10 studies concluded that acupressure was effective for pain in patients with dysmenorrhea, during labor and after trauma. Investigators of four studies concluded that acupressure was effective in the management of dyspnea and investigators in six studies concluded that acupressure was effective in improving fatigue and reducing insomnia in a variety of populations. However, evaluation of the randomized controlled trial reports indicated a significant likelihood of bias.
Acupressure may be a useful strategy for the management of multiple symptoms in a variety of patient populations, but rigorous trials are needed. Inclusion of acupressure as an intervention may improve patient outcomes.
David Moher and colleagues introduce PRISMA, an update of the QUOROM guidelines for reporting systematic reviews and meta-analyses
To investigate the efficacy and acceptability of antidepressants in the treatment of generalized anxiety disorder.
All randomized controlled trials assessing the use of antidepressants in generalized anxiety disorder up to may 2002 were included. Non randomized trials and those that included patients with both generalized anxiety disorder and another Axis I co-morbidity were excluded. Relative risks, weighted mean difference and number needed to treat were estimated. People who died or dropped out were regarded as having had no improvement.
Antidepressants (imipramine, venlafaxine and paroxetine) were found to be superior to placebo in treating generalized anxiety disorder. The calculated number needed to treat for antidepressants in generalized anxiety disorder was 5.15. Dropout rates did not differ between antidepressants and placebo.
The available evidence suggests that antidepressants would probably be a reasonable treatment for generalized anxiety disorder patients in the clinical context.
Scientific interest in acupuncture has led numerous investigators to conduct clinical trials to test the efficacy of acupuncture for various conditions, but the mechanisms underlying acupuncture are poorly understood.
The author conducted a PubMed search to obtain a fair sample of acupuncture clinical trials published in English in 2005. Each article was reviewed for a physiologic rationale, as well as study objectives and outcomes, experimental and control interventions, country of origin, funding sources and journal type.
Seventy-nine acupuncture clinical trials were identified. Twenty-six studies (33%) offered no physiologic rationale. Fifty-three studies (67%) posited a physiologic basis for acupuncture: 33 (62% of 53) proposed neurochemical mechanisms, 2 (4%) segmental nervous system effects, 6 (11%) autonomic nervous system regulation, 3 (6%) local effects, 5 (9%) effects on brain function and 5 (9%) other effects. No rationale was proposed for stroke; otherwise having a rationale was not associated with objective, positive or negative findings, means of intervention, country of origin, funding source or journal type. The dominant explanation for how acupuncture might work involves neurochemical responses and is not reported to be dependent on treatment objective, specific points, means or method of stimulation.
Many acupuncture trials fail to offer a meaningful rationale, but proposing a rationale can help investigators to develop and test a causal hypothesis, choose an appropriate control and rule out placebo effects. Acupuncture may stimulate self-regulatory processes independent of the treatment objective, points, means or methods used; this would account for acupuncture's reported benefits in so many disparate pathologic conditions.
We investigated whether there had been an improvement in quality of reporting for randomised controlled trials of acupuncture since the publication of the STRICTA and CONSORT statements. We conducted a before-and-after study, comparing ratings for quality of reporting following the publication of both STRICTA and CONSORT recommendations.
Ninety peer reviewed journal articles reporting the results of acupuncture trials were selected at random from a wider sample frame of 266 papers. Papers published in three distinct time periods (1994-1995, 1999-2000 and 2004-2005) were compared. Assessment criteria were developed directly from CONSORT and STRICTA checklists. Papers were independently assessed for quality of reporting by two assessors, one of whom was blind to information which could have introduced systematic bias (e.g. date of publication). We detected a statistically significant increase in the reporting of CONSORT items for papers published in each time period measured. We did not, however, find a difference between the number of STRICTA items reported in journal articles published before and 3 to 4 years following the introduction of STRICTA recommendations.
The results of this study suggest that general standards of reporting for acupuncture trials have significantly improved since the introduction of the CONSORT statement in 1996, but that quality in reporting details specific to acupuncture interventions has yet to change following the more recent introduction of STRICTA recommendations. Wider targeting and revision of the guidelines is recommended.
One of the ways to diagnose heart diseases is catheterization that most often causes stress and anxiety in patients. Acupressure is one of the effective non-pharmacological interventions to reduce patients' anxiety. The present study was aimed at investigating the effect of acupressure on the level of anxiety in patients undergoing coronary angiography. Method: The study was a double-blind clinical trial in which 70 patients who had referred to Kashan's Shahid Beheshti Hospital and undergone coronary angiography were studied. The participants were randomly assigned to an acupressure group and a pseudo points group. For the experimental group, acupressure was applied in correct third eye and shenmen points while the control group patients received acupressure in 1.5 cm away from the main points. Anxiety was measured through VAS anxiety questionnaire (0-10) and the dysrhythmia through a checklist. In the both groups, VAS anxiety and dysrhythmia in angiography blade were measured right away after the participants entered the angiography ward and before they were injected medication in three phases. Data analysis was carried out through independent t-test, paired t-test, covariance analysis, and chi square test. Results: There was a significant difference between the level of VAS anxiety of angiography blade and its level immediately after the patients entered the angiography ward and before they were injected medication (p<0.001). However, there was no significant difference between the two groups regarding dysrhythmia (angiography blade and immediately after entering the angiography ward, p=0.2) and (angiography blade and before injecting medication, p=0.6). Discussion and Conclusion: Acupressure had positive effect on reduction of anxiety and tachycardia. Therefore, acupressure can be utilized before conducting critical procedures.
Acupressure is a complementary treatment that uses fingers and hands to stimulate acupoints and maintains the balance of energy. The objective of this study was to review the application of acupressure in managing different pains and the effectiveness of acupressure on relieving pain in various settings. A systematic review of English articles using the databases of MEDLINE, PubMed, and Cumulative Index to Nursing and Allied Health Literature (CINAHL) was performed using the search terms of "acupressure" and "pain." Studies during which acupressure was applied as an intervention and assessed for its effectiveness on relieving pain were selected. The studies selected were those published from January 1, 1996 to December 31, 2011 that met the inclusion and exclusion criteria. The participants included patients with dysmenorrhea, labor pain, low back pain, chronic headache, and other traumatic pains. The Oxford 2011 Levels of Evidence was used to appraise the literature. Fifteen studies were extracted for reducing dysmenorrhea (menstrual distress), labor pain, low back pain, chronic headache, and other traumatic pain. These papers were further reviewed for their study design, adequacy of randomization and concealment of allocation, blinding of participants, interventions, and outcome measurements. Acupressure has been shown to be effective for relieving a variety of pains in different populations. The review begins to establish a credible evidence base for the use of acupressure in pain relief. The implication for health care providers would be incorporating acupressure into their practice as an alternative therapy to facilitate patients who suffer from pain.
Introduction: A majority of children experience significant anxiety in the preoperative period. This study aimed to investigate the effects of acupressure on preoperative anxiety reduction in school aged children. Methods: The study population included 80 subjects (aged 9-12 years) who had to undergo elective surgery. Children were randomly assigned to the acupressure (N=40) and sham groups (N=40). Anxiety in the preoperative period was measured by the State-Trait Anxiety Inventory for Children (STAIC). Acupressure was carried out by an acupressure-bead causing a constant pressure of 70 g/cm 2. In the acupressure group, the bead was fixed on the Yin Tang point (the midpoint between eyebrows) while in the sham group, it was put on a sham point outside the eyebrows line. Half an hour later, the STAIC was filled out by the children again. Results: The results revealed significant differences between anxiety values at baseline and 30 minutes after applying pressure on the sham point (P < 0.007). Conclusion: Further research is needed to decide whether acupressure could be used as an effective non-pharmacological substitutive method for preoperative anxiety reduction in children.
This study provides a meta-analytic review of controlled trials examining cognitive behavior therapy (CBT) and pharmacotherapy for generalized anxiety disorder (GAD). Thirty-five studies, published or presented between 1974 and January 1996, were identified, and provided 61 separate treatment interventions. Both modalities of treatment offered clear efficacy to patients, and the overall effect size (ES) for CBT (ES = .70) was not statistically different from pharmacotherapy (ES = 0.60) for measures of anxiety severity. CBT was associated with significantly greater effects on depression severity, and was associated with clear maintenance of treatment gains, whereas the long-term efficacy of pharmacologic treatment was attenuated following medication discontinuation. Data concerning the efficacy of specific cognitive behavioral and pharmacologic interventions are provided, as are analyses of the influence of methodological factors (e.g., gender distribution, length of treatment) on the efficacy of treatments.
In concert with growing public interest in complementary and alternative medicine (CAM), these therapies and products have been increasingly studied over the past two decades for the treatment of sleep disorders. While systematic reviews have been conducted on acupuncture and valerian in the treatment of insomnia, to date no comprehensive review has been conducted on all major CAM treatments. We sought to address this via a rigorous systematic review of hypnotic CAM interventions, including herbal and nutritional medicine, acupuncture, acupressure, yoga, tai chi, massage, aromatherapy and homoeopathy. The electronic databases MEDLINE (PubMed), CINAHL, PsycINFO, and The Cochrane Library were accessed during late 2009 for CAM randomized controlled trials (RCTs) in the treatment of chronic insomnia. Sixty-four RCTs were identified, of which 20 studies involving eight CAM interventions met final inclusion criteria. Effect size calculations (where possible) and a quality control analysis using a modified Jadad scale were undertaken. Many RCTs lacked methodological rigor, and were commonly excluded due to small sample size or an inadequate control condition. Among the studies that met inclusion criteria, there was evidentiary support in the treatment of chronic insomnia for acupressure (d=1.42-2.12), tai chi (d=0.22-2.15), yoga (d=0.66-1.20), mixed evidence for acupuncture and L-tryptophan, and weak and unsupportive evidence for herbal medicines such as valerian. Surprisingly, studies involving several mainstream CAM therapies (e.g., homoeopathy, massage, or aromatherapy) were not located or did not meet basic inclusion criteria. If CAM interventions are to be considered as viable stand-alone or adjuvant treatments for sleep disorders, future researchers are urged to use acceptable methodology, including appropriate sample sizes and adequate controls. RCTs evaluating other untested CAM therapies such as massage, homoeopathy, or osteopathy are encouraged, as is the exploration of using CAM therapies adjuvantly with conventional therapies.
To assess the effectiveness of acupressure for the symptomatic treatment of primary dysmenorrhoea from randomised controlled trials (RCTs).
Electronic databases including English, Korean, Japanese and Chinese databases were systematically searched for RCTs investigating acupressure for primary dysmenorrhoea up to July 2008 with no language restrictions. The methodological qualities of eligible studies were assessed using the criteria described in the Assessing risk of bias of the Cochrane Handbook edited by Higgins and Altman.
Four RCTs comprising a total of 458 participants were systematically reviewed. Only one of the included trials described adequate methods of randomisation. All trials did not have clear descriptions of their method of allocation concealment. Two studies reported significant improvements in the severity of pain for acupressure compared with sham acupressure on non-acupoints. Acupressure reduced the pain and anxiety typical of dysmenorrhoea in a Taiwan study. The U.S. study using an acupressure device reported that the reduction of menstrual pain was significantly better in worst menstrual pain, menstrual pain symptom intensity and the consumption of pain medication, compared with conventional treatment. One study investigated adverse events and reported that there was no adverse event in acupressure treatment.
The available data from RCTs suggest that acupressure alleviates menstrual pain. These results were limited by the small number of trials. Well-designed RCTs with rigorous methods of randomisation, and adequately concealed allocation, are needed.
Method guidelines for systematic reviews of trials of treatments for neck and back pain.
To help review authors design, conduct and report systematic reviews of trials in this field.
In 1997, the Cochrane Back Review Group published Method Guidelines for Systematic Reviews, which was updated in 2003. Since then, new methodologic evidence has emerged and standards have changed. Coupled with the upcoming revisions to the software and methods required by The Cochrane Collaboration, it was clear that revisions were needed to the existing guidelines.
The Cochrane Back Review Group editorial and advisory boards met in June 2006 to review the relevant new methodologic evidence and determine how it should be incorporated. Based on the discussion, the guidelines were revised and circulated for comment. As sections of the new Cochrane Handbook for Systematic Reviews of Interventions were made available, the guidelines were checked for consistency. A working draft was made available to review authors in The Cochrane Library 2008, issue 3.
The final recommendations are divided into 7 categories: objectives, literature search, inclusion criteria, risk of bias assessment, data extraction, data analysis, and updating your review. Each recommendation is classified into minimum criteria (mandatory) and further guidance (optional). Instead of recommending Levels of Evidence, this update adopts the GRADE approach to determine the overall quality of the evidence for important patient-centered outcomes across studies and includes a new section on updating reviews.
Citations of previous versions of the method guidelines in published scientific articles (1997: 254 citations; 2003: 209 citations, searched February 10, 2009) suggest that others may find these guidelines useful to plan, conduct, or evaluate systematic reviews in the field of spinal disorders.
We review the published literature examining the efficacy of acupressure and acustimulation wrist bands for the relief of nausea, with special emphasis on the alleviation of nausea associated with pregnancy. We also present preliminary data from an open-label study on the efficacy of acustimulation bands for control of chemotherapy nausea. The literature supports the conclusion that Neiguan-point stimulation by acupressure and acustimulation wrist bands for nausea relief is efficacious for many patients.
An introduction to the history and basic concepts underlying acupuncture and Oriental body work was presented in the April 2000 (14:3) issue of Holistic Nursing Practice. The functioning of Yin and Yang organs and meridians are addressed in this article, along with the diagnostic frameworks of Five Elements or Phases and Eight Principle Patterns. Contemporary biomedical developments in the use of acupuncture are discussed, along with research on the endorphin system as a biomediary of acupuncture. Possible applications to nursing are discussed.
Auricular acupuncture at the relaxation point has been previously shown to be an effective treatment for anxiety in the preoperative setting. The purpose of this prospective, randomized, blinded study was to determine whether auricular acupressure can reduce stress and anxiety during ambulance transport.
Patients who required ambulance transport secondary to medical conditions were randomized to receive auricular acupressure at the relaxation point (n = 17) or at a sham point (n = 19). A visual analog scale was used to assess state anxiety as well as patient anticipation of hospital medical treatment (estimated waiting period for treatment, anticipated pain during treatment, attitude toward the physicians, and treatment outcomes). These variables were assessed at baseline and on arrival to the hospital.
Patients in the relaxation group reported significantly less anxiety than patients in the sham group on arrival to the hospital (visual analog scale mean +/- SD: 37.6 +/- 20.6 to 12.4 +/- 7.8 mm vs. 42.5 +/- 29.9 to 46.7 +/- 25.9 mm, respectively; P = 0.002). Similarly, patient perception of pain during treatment (mean visual analog scale +/- SD: 32.7 +/- 27.7 to 14.5 +/- 8.1 mm vs. 17.2 +/- 26.1 to 28.8 +/- 21.9 mm, respectively; P = 0.006) and treatment outcomes of their illnesses (mean visual analog scale +/- SD: 46.7 +/- 29.4 to 19.1 +/- 10.4 mm vs. 35.0 +/- 25.7 to 31.5 +/- 20.5 mm, respectively; P = 0.014) were significantly more positive in the relaxation group than in the sham group. No differences were found in the other variables assessed.
It was concluded that auricular acupressure is an effective treatment for anxiety in prehospital emergency settings.
In this randomized sham-controlled study we examined the anxiolytic and sedative effects of acupressure on parents in the preoperative holding area before their children's surgery. Sixty-one parents received acupressure either at the Yintang point (midpoint between the two eyebrows) or at a sham point. Anxiety (as measured by the Stait-Trait Anxiety Inventory), arterial blood pressure, and heart rate were assessed before and after the intervention and a Bispectral Index monitor was used to continuously monitor hypnotic sedation levels. Repeated-measures analysis of variance showed that parents in the acupressure group reported significantly less anxiety at 20 min post-intervention as compared with parents in the sham group (37 +/- 10 versus 45 +/- 13, P = 0.03). Bispectral Index values, heart rate, and arterial blood pressure, however, did not differ between the two study groups (P = not significant). We conclude that acupressure at the Yintang point may be used as a treatment for parental preoperative anxiety. Future studies are needed to quantify the magnitude and duration of the anxiolytic effect.
Pre-operative anxiety is associated with many unwanted effects such as increased analgesic and anaesthetic requirement, postoperative pain and prolonged hospital stay. In the present study, we investigated the effects of acupressure on pre-operative anxiety and bispectral index (BIS) values. Seventy-six adults, ASA grade I and II, undergoing elective surgery, were randomly assigned to two equal groups. Group 1 (control) received acupressure at an inappropriate site and group 2 (acupressure) received acupressure at extra 1 point. The study was conducted during the pre-operative period and the duration of the study was 40 min (acupressure was applied for 10 min and thereafter patients were observed for another 30 min). Anxiety was recorded on a visual stress scale (VSS) at the start of the study and thereafter at 10 and 40 min. BIS was recorded at 0, 2, 5, 10, 12, 15, 30 and 40 min. The VSS decreased in both groups following pressure application for 10 min: median VSS (interquartile range) were 5 (1) vs. 8 (1) in the acupressure and 7 (0) vs. 8 (1) in the control groups (p < 0.001). Both pre-operative anxiety and BIS decreased significantly during acupressure application at extra 1 point (p < 0.001). Acupressure is effective in decreasing both pre-operative anxiety and BIS; however, these effects are not sustained 30 min following release of acupressure. Further studies are needed to elucidate the duration for which acupressure is effective.
Auricular acupressure is known to decrease the level of anxiety in patients during ambulance transport. The purpose of this randomized, double-blind, sham control study was to determine whether auricular acupressure can decrease not only the level of anxiety but also the level of pain in a group of elder patients with acute hip fracture.
With the assistance of the Vienna Red Cross, 38 patients with acute hip fracture were enrolled into this study. Patients were randomized into two study groups: the true intervention group and the sham control group. Subjects in the true intervention group (n = 18) received bilateral auricular acupressure at three auricular acupressure points for hip pain. Patients in the sham group (n = 20) received bilateral auricular acupressure at sham points. Baseline demographic information, anxiety level, pain level, blood pressure, and heart rate were obtained before the administration of the appropriate acupressure intervention. The level of anxiety, level of pain, hemodynamic profiles, and level of satisfaction were reassessed once the patients arrived at the hospital.
Patients in the true intervention groups had less pain (F = 28, p = 0.0001) and anxiety (F = 4.3, p = 0.018) and lower heart rate (F = 18, p = 0.0001) on arrival at the hospital than did patients in the sham control group. As a result, the patients in the true intervention group reported higher satisfaction in the care they received during the ride to the hospital.
The authors encourage physicians, health care providers, and emergency rescuers to learn this easy, noninvasive, and inexpensive technique for its effects in decreasing anxiety and pain during emergency transportation.
The onset of depression is often triggered by breathlessness in persons with chronic obstructive pulmonary disease (COPD). It is hypothesized that these are the psychologic consequences of chronic dyspnea. Lessening dyspnea might alleviate depressive symptoms. Acupressure has been shown in other studies to produce relaxation. The aim of this study was to determine if it would lessen dyspnea and reduce depression in patients with COPD.
Subjects diagnosed with COPD were chosen from one medical center and three regional hospitals in Taipei, Taiwan. A randomized, block experimental design was used, with subjects and the data collector blinded. Using age, gender, pulmonary function, smoking, and steroid use as matching factors, 44 subjects were randomly assigned to either the true acupressure or the sham acupressure groups. The true acupressure group received a program of acupressure using appropriate acupoints that promote relaxation and relieve dyspnea. The sham acupressure group received acupressure using sham acupoints different from the meridians and ganglionic sections of the true acupressure group. Both acupressure programs lasted 4 weeks, with five sessions per week that lasted 16 minutes per session.
The Geriatric Depression Scale (GDS) and Dyspnea Visual Analogue Scale (DVAS) were administered prior to the program as a baseline, and again following the completion of the 4-week program. Oxygen saturation and other physiological indicators were measured before and after each session.
The results of this study showed that the GDS scores, DVAS scores, oxygen saturation, and physiological indicators of the true acupressure group were significantly improved, compared to those of the sham acupressure group.
These findings provide health professionals with an evidence-based intervention to use with persons with COPD. Applying this acupressure program in clinical practice, communities, and long-term care units may lessen chronic dyspnea and depression in persons with COPD.
Auricular acupuncture at the relaxation point has been shown to be effective treatment for anxiety. We hypothesized that auricular acupressure may decrease anxiety in elderly individuals who are transported by ambulance before receiving ESWL.
We enrolled 100 patients with renal calculi who were transported to the local hospital by special ambulance, accompanied by 2 paramedics. Paramedic 1 performed data collection, while paramedic 2 performed auricular acupressure in patients randomly assigned to a relaxation group and a sham treated group. Anxiety was measured using a visual analog scale score on a scale of 0 to 100 mm.
Each group consisted of 50 patients with similar demographic characteristics. The relaxation group had significantly decreased anxiety scores upon arrival at the hospital and lower anticipation of pain scores (mean+/-SD 57.6+/-21.8 to 15.4+/-9.8 and 35.7+/-29.7 to 9.5+/-4.1 mm VAS) than the sham treated group (55.5+/-25.9 to 49.8+/-28.9 and 37.7+/-24.1 to 33.8+/-25.2 mm VAS, respectively, 2-way repeated measure ANOVA each p=0.001). Estimated waiting times for treatment did not differ significantly between the 2 groups (5.0+/-2.5 and 5.5+/-2.95, respectively, repeated measures ANOVA p=0.83). The Post-Intervention Anxiety visual analog scale demonstrated the significant superiority of the true treatment group (19.5+/-5.9 and 66.8+/-27.9 mm VAS, respectively, p=0.001).
Elderly patients who received auricular acupressure at specific relaxation points while being transported to the hospital were less anxious, anticipated less pain and were more optimistic about the outcome of treatment that they will receive than the sham treated group. These data prove that this is an effective treatment for anxiety that improves the patient overall perception of ESWL.
Acupressure is a longstanding treatment in traditional Chinese medicine, and involves the stimulation of certain acupoints by pressing with the fingers or moving limbs or joints slowly to promote health or offer comfort. Acupressure treatment, which conforms to the same principles as acupuncture, is characterized by the pressing of acupuncture points and sense of chi. Chi is regarded as the universal life energy and the vital potential that is inborn in each person and which maintains that person until death. Sleep disturbance, pain and agitation are common health problems in gerontological nursing. Both pharmacological and non-pharmacological forms of treatment have been applied to deal with the problems. Studies have revealed, however, that the benefits that the elderly derive from drug use might not outweigh the adverse effects of such treatment. Non-pharmacological forms of treatment, like acupressure, though, not only caused no side effects, but also relieved the symptoms. Also, nurses, nurse's aides, or elderly people who have received training in acupressure can administer this non-pharmacological treatment independently. Therefore, this paper addresses common health problems in the elderly, such as sleep disturbance, pain, and agitation, the principles and maneuvers of acupressure, and application of acupressure in the elderly.
Out-of-hospital auricular acupressure in elder patients with hip fracture: a randomized double-blinded trial
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