Effects of Acupressure on Nurses' Psychological Distress, Depression, Job Stress, Occupational Burnout, and Resilience

NCT06946888 | Completed Results

• 1 other identifier: KSVGH24-CT6-13
• Study Type: interventional
• Target: 160
• Locations: 1 country
• Sites: 1

Brief Summary

This measurement aims to understand the effect of self-acupressure on the Shenmen Point (神門) and (內關) points on the hand on emotional distress, anxiety, depression, stress, work fatigue and adaptability of clinical nurses. The main questions it aims to answer are: Whether acupressure can reduce emotional distress, anxiety, depression, stress and work fatigue in nursing staff. Participants will: 1\. Enforcement measures:

1. 1.Acupressure group: Perform self-acupressure twice a day, each time for about 2 minutes, and record the acupressure records every day for 2 consecutive weeks.
2. 2.Original method group: followed the original self-coping method. 2. After the intervention began, participants completed study questionnaires weekly for two months.

Conditions

Psychological Distress; Anxiety; Depression; Nurses; Acupressure

Keywords

Nurses; Acupressure; Occupational stress; Burnout, professional; Resilience, psychological; Anxiety; Depression; Psychological distress

Outcome Measures

Primary Outcomes (2)

• Depressive Symptoms

  Depressive symptoms were assessed using the Taiwanese Depression Scale, which has demonstrated strong psychometric properties in Taiwanese populations. The TDS consists of 18 items rated on a 4-point Likert scale: 0 = none or seldom (less than one day per week), 1 = sometimes (one to two days per week), 2 = often (three to four days per week), and 3 = almost always (five to seven days per week). Total scores range from 0 to 54, with higher scores indicating greater severity of depressive symptoms. The results from Lee et al. (2000) demonstrated that the TDS had excellent reliability and validity. The Cronbach's alpha coefficient was 0.90, and the area under the receiver operating characteristic (ROC) curve was 0.92. The TDS also showed good concurrent validity, with a sensitivity of 0.89 and specificity of 0.92 at a cutoff score of 19. In the present study, the TDS demonstrated excellent internal consistency, with a Cronbach's alpha of .94.

  At baseline(weeks 0) and once weekly for 8 weeks(weeks 1-8)

• Psychological Distress

  Psychological distress was measured using the Brief Symptom Rating Scale-5 (BSRS-5), a validated screening tool for general psychological distress. The BSRS-5 assesses the subjective severity of the following symptoms: (1) anxiety, (2) depression, (3) hostility, (4) low self-esteem, and (5) insomnia. Each symptom was scored on a 5-point Likert scale, ranging from 0 ("not at all") to 4 ("extremely"), with a total score ranging from 0 to 20 points. Higher scores indicate more severe psychological distress. Studies have shown that a total score of 3-4 is the optimal threshold for identifying clinically relevant distress based on receiver operating characteristic (ROC) curve analysis. The BSRS-5 showed high accuracy (AUC = 0.92) and good sensitivity (0.83) and specificity (0.86). Therefore, this study used a BSRS-5 total score ≥4 as one of the inclusion criteria to ensure that participants with at least mild psychological distress were included in the study.

  At baseline(weeks 0) and once weekly for 8 weeks(weeks 1-8)

Secondary Outcomes (5)

• Resilience

  At baseline(weeks 0) and once weekly for 8 weeks(weeks 1-8)

• Anxiety

  At baseline(weeks 0) and once weekly for 8 weeks(weeks 1-8)

• Job Stress

  At baseline(weeks 0) and once weekly for 8 weeks(weeks 1-8)

• Occupational Burnout

  At baseline(weeks 0) and once weekly for 8 weeks(weeks 1-8)

• Emotional Distress

  At baseline(weeks 0) and once weekly for 8 weeks(weeks 1-8)

Study Arms (2)

Control group

NO INTERVENTION

Care continued in the original manner without any intervention.

Intervention group (Acupressure)

EXPERIMENTAL

Participants perform self-acupressure on the Shenmen and Neiguan points twice daily for 2 weeks.

Behavioral: Acupressure

Interventions

Acupressure BEHAVIORAL

Participants in this group will receive instruction on how to perform self-acupressure targeting two specific acupoints on the hands: Shenmen and Neiguan. The acupressure protocol includes pressing each acupoint approximately 15 times (about 30 seconds), with a total of four acupoints per session (both hands), for approximately 2 minutes per session. Pressure should be applied until a sensation of soreness, numbness, fullness, or slight pain is felt (equivalent to about 3 kg of pressure). Participants are asked to perform self-acupressure twice daily (once in the afternoon and once before bedtime, adjustable based on personal schedule) for a total of 2 weeks. They will record their practice using a daily log and continue to complete psychological and emotional outcome questionnaires weekly over a 2-month follow-up period.

Intervention group (Acupressure)

Eligibility Criteria

• Age: 20 Years+
• Sex: all
• Healthy Volunteers: Yes
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• Clinical nurses aged 20 years or older from a designated medical center.
• Nurses who score ≥3 on the emotional distress thermometer or ≥4 on the Brief Symptom Rating Scale (BSRS-5) based on self-reported questionnaires.
• Able and willing to complete the required study questionnaires during the 2-month study period.

You may not qualify if:

• Nurses who refuse to participate after being informed about the study or are unable to comply with the study protocol.
• Nurses working in non-patient-care units (e.g., administrative departments or supply centers).
• Pregnant nurses.

Sponsors & Collaborators

• Kaohsiung Veterans General Hospital.: lead

Study Sites (1)

Kaohsiung Veterans General Hospital

Kaohsiung City, Zuoying District, 813414, Taiwan

Location

Related Publications (19)

• Zhou XQ, Han YF, Xu MX. Effects of different intervention methods on psychological anxiety, stress, and fatigue among healthcare workers during COVID-19 pandemic: a systematic review and meta-analysis. Eur Rev Med Pharmacol Sci. 2024 Feb;28(4):1614-1623. doi: 10.26355/eurrev_202402_35491.

  PMID: 38436194 BACKGROUND

• Yang X, Liu Q, Wu X. Meta-Analysis of the Clinical Efficacy of Auricular Acupressure on Patients with Depression. Alpha Psychiatry. 2025 Feb 28;26(1):38776. doi: 10.31083/AP38776. eCollection 2025 Feb.

  PMID: 40110387 BACKGROUND

• Wu X, Tu M, Yu Z, Cao Z, Qu S, Chen N, Jin J, Xiong S, Yang J, Pei S, Xu M, Wang J, Shi Y, Gao L, Xie J, Li X, Fang J, Shao X. The efficacy and cerebral mechanism of intradermal acupuncture for major depressive disorder: a multicenter randomized controlled trial. Neuropsychopharmacology. 2025 Jun;50(7):1075-1083. doi: 10.1038/s41386-024-02036-5. Epub 2024 Dec 8.

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• Peng Z, Zheng Y, Yang Z, Zhang H, Li Z, Xu M, Cui S, Lin R. Acupressure: a possible therapeutic strategy for anxiety related to COVID-19: a meta-analysis of randomized controlled trials. Front Med (Lausanne). 2024 Mar 21;11:1341072. doi: 10.3389/fmed.2024.1341072. eCollection 2024.

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• Pachi A, Sikaras C, Melas D, Alikanioti S, Soultanis N, Ivanidou M, Ilias I, Tselebis A. Stress, Anxiety and Depressive Symptoms, Burnout and Insomnia Among Greek Nurses One Year After the End of the Pandemic: A Moderated Chain Mediation Model. J Clin Med. 2025 Feb 10;14(4):1145. doi: 10.3390/jcm14041145.

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• Li J, Zhang K, Zhao T, Huang W, Hou R, Wang S, Zhao M, Guo Y. Acupressure for depression: A systematic review and meta-analysis. Asian J Psychiatr. 2024 Feb;92:103884. doi: 10.1016/j.ajp.2023.103884. Epub 2023 Dec 23.

  PMID: 38171225 BACKGROUND

• Hong WK, Kim YJ, Lee YR, Jeong HI, Kim KH, Ko SG. Effectiveness of electroacupuncture on anxiety: a systematic review and meta-analysis of randomized controlled trials. Front Psychol. 2023 Dec 19;14:1196177. doi: 10.3389/fpsyg.2023.1196177. eCollection 2023.

  PMID: 38173848 BACKGROUND

• Elliott D. Comparison of three instruments for measuring patient anxiety in a coronary care unit. Intensive Crit Care Nurs. 1993 Sep;9(3):195-200. doi: 10.1016/0964-3397(93)90027-u.

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• Donovan KA, Grassi L, McGinty HL, Jacobsen PB. Validation of the distress thermometer worldwide: state of the science. Psychooncology. 2014 Mar;23(3):241-50. doi: 10.1002/pon.3430. Epub 2013 Nov 11.

  PMID: 25160838 BACKGROUND

• Dincer B, Inangil D. The effect of Emotional Freedom Techniques on nurses' stress, anxiety, and burnout levels during the COVID-19 pandemic: A randomized controlled trial. Explore (NY). 2021 Mar-Apr;17(2):109-114. doi: 10.1016/j.explore.2020.11.012. Epub 2020 Dec 3.

  PMID: 33293201 BACKGROUND

• Bal SK, Gun M. The effects of acupressure on pain, anxiety and vital signs in patients undergoing coronary angiography: A randomized and sham-controlled trial. Explore (NY). 2024 Jan-Feb;20(1):101-109. doi: 10.1016/j.explore.2023.07.001. Epub 2023 Jul 4.

  PMID: 37429762 BACKGROUND

• Amiri S, Mahmood N, Javaid SF, Khan MA. The Effect of Lifestyle Interventions on Anxiety, Depression and Stress: A Systematic Review and Meta-Analysis of Randomized Clinical Trials. Healthcare (Basel). 2024 Nov 13;12(22):2263. doi: 10.3390/healthcare12222263.

  PMID: 39595461 BACKGROUND

• Alghamdi R, Bahari G. Shift Work, Psychological Health Disorders, and Job Security Among Nurses: A Cross-Sectional Study. Healthcare (Basel). 2025 Jan 22;13(3):221. doi: 10.3390/healthcare13030221.

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• Turkili S, Karaman A, Cam Yanik T, Altun Ugras G, Yuksel S, Turkili S, Tasdelen B. The Effects of Acupressure on Preoperative Anxiety, Postoperative Pain, and Nausea and Vomiting in Otolaryngology Patients. J Perianesth Nurs. 2025 Apr;40(2):385-392. doi: 10.1016/j.jopan.2024.05.027. Epub 2024 Sep 19.

  PMID: 39297814 BACKGROUND

• Zeiher W, Sego E, Trimmer D, Bowers C. Posttraumatic Stress Disorder in Nurses During a Pandemic: Implications for Nurse Leaders. J Nurs Adm. 2022 Feb 1;52(2):E3-E8. doi: 10.1097/NNA.0000000000001112.

  PMID: 35060955 RESULT

• Lin J, Chen T, He J, Chung RC, Ma H, Tsang H. Impacts of acupressure treatment on depression: A systematic review and meta-analysis. World J Psychiatry. 2022 Jan 19;12(1):169-186. doi: 10.5498/wjp.v12.i1.169. eCollection 2022 Jan 19.

  PMID: 35111587 RESULT

• Liang R, Tang L, Li L, Zhao N, Yu X, Li J, Wang Q, Cun H, Gao X, Yang W. The effect of pressing needle therapy on depression, anxiety, and sleep for patients in convalescence from COVID-19. Front Neurol. 2024 Dec 18;15:1481557. doi: 10.3389/fneur.2024.1481557. eCollection 2024.

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• Katsiroumpa A, Moisoglou I, Papathanasiou IV, Malliarou M, Sarafis P, Gallos P, Konstantakopoulou O, Rizos F, Galanis P. Resilience and Social Support Protect Nurses from Anxiety and Depressive Symptoms: Evidence from a Cross-Sectional Study in the Post-COVID-19 Era. Healthcare (Basel). 2025 Mar 7;13(6):582. doi: 10.3390/healthcare13060582.

  PMID: 40150432 RESULT

Related Links

• Effects and safety of auricular acupressure on depression and anxiety in isolated COVID-19 patients: A single-blind randomized controlled trial.
• A survey on the current status of resilience among healthcare professionals and the development of a resilience scale: A sample from a hospital in southern Taiwan.
• Epidemiological survey of depressive disorder in Kaohsiung Metropolis: Development of a culture-relevant Taiwanese Depression Screening Questionnaire.
• Using the BSRS-5 to predict suicidal ideation among community residents.
• Development and validation of the Chinese version of the Copenhagen Burnout Inventory.

MeSH Terms

Conditions

Anxiety Disorders; Depression; Occupational Stress; Burnout, Professional

Interventions

Acupressure

Condition Hierarchy (Ancestors)

Mental Disorders; Behavioral Symptoms; Behavior; Occupational Diseases; Stress, Psychological; Burnout, Psychological

Intervention Hierarchy (Ancestors)

Therapy, Soft Tissue; Musculoskeletal Manipulations; Complementary Therapies; Therapeutics; Physical Therapy Modalities; Rehabilitation

Limitations and Caveats

1. The data are all self-administered questionnaires, which are affected by recall bias and social expectations. 2. The intervention period is only two weeks, and the intervention period or stimulation frequency can be extended. 3. Other acupoints related to emotional stability are not included, nor are they combined with common auxiliary methods. 4. Multiple workplace factors can be incorporated into the analysis to enhance external validity and reference for practical application.

Results Point of Contact

• Title: Li-Ying Lin
• Organization: Kaohsiung Veterans General Hospital

llylin@vghks.gov.tw

07-3422121

Study Officials

• Li-Ying Lin, PhD

  supervise

  PRINCIPAL INVESTIGATOR

Publication Agreements

• PI is Sponsor Employee: Yes

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: SINGLE
• Who Masked: OUTCOMES ASSESSOR
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Nursing Supervisor

Model Details: This is a single-center, randomized, single-blind, parallel-controlled trial. Eligible clinical nurses will be randomly assigned (1:1) to an intervention group or a control group. The intervention group will receive self-acupressure instructions on Shenmen and Neiguan points twice a day for two weeks, and record each treatment process. The control group will continue to use their usual stress and emotional distress coping strategies without any intervention. Both groups will be required to complete a validated questionnaire covering emotional distress, mood, anxiety, depression, stress, fatigue and resilience. Assessments will be conducted weekly for two months (including pre-test (baseline week 0) and follow-up for two months (weeks 1-8), a total of 9 times) to evaluate the effectiveness of self-acupressure compared with usual care.

Study Record Dates

• First Submitted: April 21, 2025
• First Posted: April 27, 2025
• Study Start: June 20, 2024
• Primary Completion: December 31, 2024
• Study Completion: December 31, 2024
• Last Updated: October 6, 2025
• Results First Posted: October 6, 2025

Record last verified: 2025-09

Data Sharing

• IPD Sharing: Will not share

Locations

TW (1)