An integrative review of acupressure interventions for older people: A focus on sleep quality, depression, anxiety, and agitation

Abstract

Objectives: This integrative review aimed to synthesize studies that investigated the effects of acupressure on sleep quality, depression, anxiety, and agitation in older people, and to describe the acupressure procedures and techniques applied in the included studies.Methods: A literature search was conducted using electronic databases including CINAHL, Cochrane Library, EMBASE, and MEDLINE. The inclusion criteria for the review were studies examining the effect of acupressure in older people aged 60 years and above, measured the outcomes for sleep quality, depression, anxiety or agitation, applied body acupressure, and published in English language. The exclusion criteria were studies using auricular acupoints only, and articles published in any language other than English. Methodological quality of studies was assessed using the critical appraised tools developed by the Joanna Briggs Institute. The information about study design, findings, and description of acupressure intervention were extracted, summarized, and synthesized.Results: A total of 255 articles were identified from the search and as well one article from cross-references. From there, a total of 19 studies were included in this review. Nine studies consistently showed positive effects of acupressure on sleep quality, and four studies consistently showed that acupressure reduced depression.The outcomes of acupressure on anxiety and agitation showed inconsistent findings, in which three studies measured anxiety and five studies measured agitation. There was also variation of acupressure techniques applied in the reviewed studies.Conclusion: This review found some emerging evidences that acupressure can be beneficial for older people who suffer from sleep problems and depression. Use of specific acupressure points, with standardized acupressure treatment protocols, may improve sleep quality and possibly psychological wellbeing of older people. Future research with well-designed mixed method studies are required to produce stronger evidence, as well as in-depth understanding of acupressure intervention in aged care context.

Acupressure to improve sleep quality of older people in residential aged care: a randomised controlled trial protocol

“…Therefore, selecting the major acupoint on the heart meridian (HT7) and additional acupoints that are linked to other internal organs (PC6 and SP6) may enhance sleep quality. The acupoints-namely, Shenmen (HT7), Neiguan (PC6), and Sanyinjiao (SP6)-have commonly been used to improve sleep quality [19,20,32,33].…”

“…The acupressure intervention runs for 4 weeks, with 12min session to be given three times per week. The acupressure intervention protocol has been developed on the basis of TCM concepts, research evidence [22,23,38,39], and systematic and integrative reviews on acupressure studies [19,20,32]. One of the supervisors is a qualified acupressure practitioner.…”

“…Acupressure, application of fingers or thumb pressure on acupuncture points, is a CAM modality which has potential to improve sleep quality [19][20][21]. Previous research and reviews have shown that acupressure improved sleep quality with no reported adverse effects [19][20][21][22][23][24]. In addition, acupressure may have potential to reduce the frequency and amount sleep medications used [23,25].…”

“…There is also some evidence that acupressure may improve depression [19], anxiety [26] and QoL [21]. However, some studies have methodological limitations as well as variation in acupressure techniques and the selection of acupoints [19,20,26]. Future well-designed studies, using standardised treatment protocols, are required to provide evidence of acupressure's usefulness in clinical practice.…”

“…However, the acceptability and effectiveness of acupressure on sleep improvement remains unclear in the Australia aged care context. The majority of the acupressure studies were carried out in Asian countries (in Taiwan, China, and Hong Kong), and the participants were Chinese who might have had beliefs in traditional Chinese medicine (TCM) [19,20]. There is a paucity of studies evaluating the outcomes of acupressure in Western countries, including Australia [19,20].…”