Psychological DistressNCT06946888

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

A study testing Acupressure in people with Psychological Distress and Anxiety, run by Kaohsiung Veterans General Hospital. at 1 site in Taiwan.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record

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Trial 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. Read more about this study

Who is it for?: Ages 20 years and olderHealthy volunteers can take part
Conditions the study is for: Psychological Distress, Anxiety, Depression
What is being tested?: Acupressure
Type of treatment: Lifestyle or therapy programme
Could I receive a placebo?: No, everyone receives an active treatment
How many people: 160 participants
Where: 1 siteTaiwan
Study dates: 20 Jun 2024to 31 Dec 2024
Phase: Interventional
Are there results?: Yes, posted in the registrySummary in the doctors' view

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

Ages 20 years and older
All sexes
Healthy volunteers accepted
Adult, Older adult

Who may be able to join

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.

Who cannot join

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.

Trial locations and contacts

1 site in 1 country.

Taiwan1 site

Kaohsiung Veterans General Hospital
Kaohsiung City, Zuoying District, 813414

Other trials in Taiwan

About this study

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

Whether acupressure can reduce emotional distress, anxiety, depression, stress and work fatigue in nursing staff.

Participants will:

Enforcement measures:
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.
Original method group: followed the original self-coping method. 2. After the intervention began, participants completed study questionnaires weekly for two months.

Read the detailed description

Purpose of the Study: The goal of this study is to understand emotional distress, anxiety, depression, stress, workplace fatigue, and resilience among clinical nurses, as well as the factors related to these conditions. Investigators also want to evaluate the effects of different coping methods-either by self-pressing specific acupuncture points (Shenmen and Neiguan on the hand) or using usual ways of managing stress and anxiety.
About the Acupressure Points:

Shenmen Point (神門): Shenmen, located on the inner wrist, is a key point on the Heart Meridian. It's often used in traditional Chinese medicine to calm the mind, ease anxiety, help with sleep problems, headaches, and emotional fatigue.
Neiguan Point (內關): Neiguan is located on the inner forearm. Pressing this point can help relieve stress, reduce bloating, calm palpitations, and improve sleep. It's often used when feeling tense or anxious.
Usual Coping Methods: If participants are assigned to this group, participants will simply continue handling stress and anxiety the way you normally do.

Who Can Join the Study: Participants can join this study if:

A clinical nurse aged 20 or older.
Participants screening results show a distress score of 3 or above, or a mood thermometer score of 4 or above.
Participants are willing and able to fill out questionnaires at specific times over the next two months. Participants cannot join this study if:
Participated in a similar study within the last month.
Currently work in administrative or non-patient care units (like the supply center).
Are currently pregnant.

Study Procedures: If participants agree to participate and sign the consent form, researchers will ask participants to fill out several questionnaires. These will cover basic info, emotional distress, mood, depression, anxiety, work stress, fatigue, and resilience. It takes about 10-20 minutes to complete. If participants distress score is 3 or higher, or your mood score is 4 or higher, participants will be randomly assigned to one of two groups:

Acupressure Group: Participants will learn how to press the Shenmen and Neiguan acupoints on their hands and press them twice a day (about 2 minutes each time) for 2 weeks. participants will also keep a simple daily log of your acupressure practice.
Usual Care Group: Participants will continue with usual ways of coping and fill out a short daily emotional self-assessment form. Investigators will check in with participants every week using the same set of questionnaires to track changes for two months. In total, participants will be asked to fill out the survey 9 times.

Possible Side Effects and How to Handle Them:

From the Acupressure: When pressing the Shenmen or Neiguan points, participants might feel a sensation like soreness, tingling, pressure, or slight pain-this is normal and usually tolerable. There's no research showing any harmful side effects from pressing these points. If it ever feels too uncomfortable, participants can adjust the pressure.
From Participation: The risks of participating in this study were similar to participants' normal, everyday experiences. Participants were free to stop at any time if they felt sick or uncomfortable during the study. Participants can also contact the program's emergency contacts.

Expected Benefits: Past research and traditional practice have shown that pressing the Shenmen and Neiguan points can help reduce anxiety, stress, insomnia, and related symptoms. While the researchers cannot guarantee that this study will help individual participants, it may help healthcare professionals understand ways to better support caregivers and could benefit others in the future.
The researcher's requirements for participants during the study:

Please do not participate in other similar clinical studies while participating in this clinical study.
Please fill in the daily log on time and truthfully.
Provide accurate information in the questionnaire.

Participants' privacy is protected:

Researchers will only collect information necessary for this study. All personal data and survey responses of participants will remain confidential. The researcher will not use the participant's name or personal identification, but will assign a code to the participant so that the participant's identity remains anonymous in all records.

Conditions: Psychological Distress, Anxiety, Depression, Nurses, Acupressure
Being tested: Acupressure
Keywords: Nurses, Acupressure, Occupational stress, Burnout, professional, Resilience, psychological, Anxiety, Depression, Psychological distress
Medical subject headings: Anxiety Disorders, Depression, Occupational Stress, Burnout, Professional

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

AcupressureBehavioural
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.

Study groups in NCT06946888
Study group	Role	What they receive
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. Receives: Behavioral: Acupressure

What is being measured

The primary outcome is the main question the study is designed to answer.

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

Secondary outcomes (5)

Resilience
This scale assesses an individual's ability to adapt and recover from stress and adversity. Each item is rated on a 5-point Likert scale, ranging from 1 ("strongly disagree") to 5 ("strongly agree"), with a total score ranging from 10 to 50, with higher scores indicating greater resilience.
Initial validation studies demonstrated strong psychometric properties, including good model fit in confirmatory factor analysis (GFI = 0.973) and excellent internal consistency (Cronbach's α = .91).
All instruments used in this study were authorized by their original developers and have been psychometrically validated in previous studies. All scales demonstrated good to excellent internal consistency, with Cronbach's α values ranging from 0.84 to 0.95.
Measured: At baseline(weeks 0) and once weekly for 8 weeks(weeks 1-8)
Anxiety
Anxiety levels were assessed using the state subscale of the State-Trait Anxiety Inventory (STAI-S). Studies have confirmed the multidimensional factor structure of the Chinese version of the scale and demonstrated good psychometric properties, including adequate convergent and discriminant validity. In this sample, the STAI-S demonstrated excellent internal consistency (Cronbach's α = .95). The STAI-S consists of 20 items that assess anxiety-related feelings, thoughts, and behaviors at the time of assessment. Each item is rated on a 4-point Likert scale ranging from 1 ("not at all") to 4 ("very much"). Items 1, 2, 5, 8, 10, 11, 15, 16, 19, and 20 are reverse-scored. The total score ranges from 20 to 80, with scores between 20 and 39 indicating mild anxiety, 40 to 59 indicating moderate anxiety, and 60 to 80 indicating severe anxiety.
Measured: At baseline(weeks 0) and once weekly for 8 weeks(weeks 1-8)
Job Stress
Perceived job stress was measured using the 14-item Work Pressure Inventory developed by Huang et al. (2017), which has demonstrated good internal consistency. The scale comprises three dimensions: low self-development, workload, and job characteristics. Each item is rated on a 5-point Likert scale ranging from 1 ("strongly disagree") to 5 ("strongly agree"), with total scores ranging from 14 to 70. Higher scores indicate greater perceived occupational stress. In the original validation study, the Cronbach's α coefficients for the three subscales were 0.81, 0.73, and 0.77, respectively. In the present study, the Work Pressure Inventory showed good overall internal consistency (Cronbach's α = .84).
Measured: At baseline(weeks 0) and once weekly for 8 weeks(weeks 1-8)
Occupational Burnout
Occupational burnout was assessed using the Chinese version of the Copenhagen Burnout Inventory (CBI), which has demonstrated good psychometric properties in Taiwanese populations. The scale consists of four subscales: personal burnout, work-related burnout, client-related burnout, and overcommitment to work. Each item is rated on a five-point frequency scale: "always" (100), "often" (75), "sometimes" (50), "rarely" (25), and "never" (0). Subscale scores are calculated as the average of the items within each domain, ranging from 0 to 100, with higher scores indicating more severe occupational burnout. The original validation study reported Cronbach's α values above 0.84 across all subscales. In the present study, the scale demonstrated excellent internal consistency (Cronbach's α = .95).
Measured: At baseline(weeks 0) and once weekly for 8 weeks(weeks 1-8)
Emotional Distress
Emotional distress was measured using the Distress Thermometer (DT), a single self-report screening instrument with a score range of 0 (no distress) to 10 (extreme distress), with higher scores indicating greater emotional distress. The DT demonstrated good psychometric properties in validation studies, with sensitivities ranging from 0.50 to 1.00 (median = 0.83) and specificities ranging from 0.36 to 0.98 (median = 0.68).
This study used a DT cutoff score of ≥3 as the inclusion criterion. Other studies have shown that the optimal DT cutoff score varies across settings, typically ranging from 3 to 5, while thresholds of ≥4 or ≥5 are commonly used in clinical practice. The use of a score of ≥3 in this study was intended to maximize sensitivity and minimize the risk of underidentifying caregivers considered at high risk for psychological distress.
Measured: At baseline(weeks 0) and once weekly for 8 weeks(weeks 1-8)

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

20 Jun 202431 Dec 2024

First posted27 Apr 2025
Study start20 Jun 2024
Primary completion31 Dec 2024
Study completion31 Dec 2024

Resources

Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
Posted resultsParticipant flow, outcome measures and adverse events reported by the sponsor.
Publications (19)Papers the sponsor has linked to this study.
Other trials for Psychological DistressStudies of the same condition, open and under way.
What the trial phases meanHow a treatment moves from first tests in people to approval.

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design

Study type: Interventional
Phase: Phase N/A
Primary purpose: Treatment
Allocation: Randomised
Intervention model: Parallel groups
Model description: 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.
Masking: Single blind
Who is masked: Outcomes assessor
Enrolment: 160 participants (actual)

IDs, dates and publications

ClinicalTrials.gov ID: NCT06946888
Sponsor's protocol ID: KSVGH24-CT6-13
Status last verified: Sep 2025
First submitted: 21 Apr 2025
Last updated: 6 Oct 2025
Results posted: Yes, on ClinicalTrials.gov
Data monitoring committee: No
FDA-regulated drug: No
FDA-regulated device: No
Individual data sharing: No

Publications

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.
PubMed 38436194
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.
PubMed 40110387
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.
PubMed 39648209
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.
PubMed 38576710
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.
PubMed 40004676
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.
PubMed 38171225
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.
PubMed 38173848
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.
PubMed 8400749
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.
PubMed 25160838
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.
PubMed 33293201
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.
PubMed 37429762
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.
PubMed 39595461
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.
PubMed 39942410
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.
PubMed 39297814
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.
PubMed 35060955

Want to know more?

The sponsor has not listed a contact. The official record may have more details.

Talk to your doctor first and take this page with you. Only the study team can confirm whether you can join.

Questions to ask the study team

What is the study trying to find out?
What would I need to do, and how often would I visit?
Could I receive a placebo instead of the treatment?
What are the possible risks and benefits for me?
Will it cost me anything? Are travel or time paid for?
Can I keep seeing my own doctor during the study?
What happens when the study ends?

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Study at a glance

From the registry record, last updated by the sponsor on 6 Oct 2025. Recruitment status is as the sponsor reported it: confirm with the study team.

Official title: Effects of Acupressure on Nurses' Psychological Distress, Anxiety, Depression, Job Stress, Occupational Burnout, and Resilience
ClinicalTrials.gov ID: NCT06946888
Acronym / sponsor ID: KSVGH24-CT6-13
Conditions: Psychological Distress, Anxiety, Depression, Nurses, Acupressure
Keywords: Nurses, Acupressure, Occupational stress, Burnout, professional, Resilience, psychological, Anxiety, Depression, Psychological distress
Study type: Interventional
Recruitment status: Completed
Enrolment: 160 participants (actual)
Lead sponsor: Kaohsiung Veterans General Hospital.University, hospital or other
Study start: 20 Jun 2024 (actual)
Primary completion: 31 Dec 2024 (actual)
Study completion: 31 Dec 2024 (actual)
First posted: 27 Apr 2025 (actual)
Results: Posted 6 Oct 2025

Clinical summary

The research question as the sponsor registered it. This describes what the study plans to test, not what it found.

Whether acupressure can reduce emotional distress, anxiety, depression, stress and work fatigue in nursing staff.

Participants will:

Enforcement measures:
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.
Original method group: followed the original self-coping method. 2. After the intervention began, participants completed study questionnaires weekly for two months.

Detailed description

Purpose of the Study: The goal of this study is to understand emotional distress, anxiety, depression, stress, workplace fatigue, and resilience among clinical nurses, as well as the factors related to these conditions. Investigators also want to evaluate the effects of different coping methods-either by self-pressing specific acupuncture points (Shenmen and Neiguan on the hand) or using usual ways of managing stress and anxiety.
About the Acupressure Points:

Shenmen Point (神門): Shenmen, located on the inner wrist, is a key point on the Heart Meridian. It's often used in traditional Chinese medicine to calm the mind, ease anxiety, help with sleep problems, headaches, and emotional fatigue.
Neiguan Point (內關): Neiguan is located on the inner forearm. Pressing this point can help relieve stress, reduce bloating, calm palpitations, and improve sleep. It's often used when feeling tense or anxious.
Usual Coping Methods: If participants are assigned to this group, participants will simply continue handling stress and anxiety the way you normally do.

Who Can Join the Study: Participants can join this study if:

A clinical nurse aged 20 or older.
Participants screening results show a distress score of 3 or above, or a mood thermometer score of 4 or above.
Participants are willing and able to fill out questionnaires at specific times over the next two months. Participants cannot join this study if:
Participated in a similar study within the last month.
Currently work in administrative or non-patient care units (like the supply center).
Are currently pregnant.

Study Procedures: If participants agree to participate and sign the consent form, researchers will ask participants to fill out several questionnaires. These will cover basic info, emotional distress, mood, depression, anxiety, work stress, fatigue, and resilience. It takes about 10-20 minutes to complete. If participants distress score is 3 or higher, or your mood score is 4 or higher, participants will be randomly assigned to one of two groups:

Acupressure Group: Participants will learn how to press the Shenmen and Neiguan acupoints on their hands and press them twice a day (about 2 minutes each time) for 2 weeks. participants will also keep a simple daily log of your acupressure practice.
Usual Care Group: Participants will continue with usual ways of coping and fill out a short daily emotional self-assessment form. Investigators will check in with participants every week using the same set of questionnaires to track changes for two months. In total, participants will be asked to fill out the survey 9 times.

Possible Side Effects and How to Handle Them:

From the Acupressure: When pressing the Shenmen or Neiguan points, participants might feel a sensation like soreness, tingling, pressure, or slight pain-this is normal and usually tolerable. There's no research showing any harmful side effects from pressing these points. If it ever feels too uncomfortable, participants can adjust the pressure.
From Participation: The risks of participating in this study were similar to participants' normal, everyday experiences. Participants were free to stop at any time if they felt sick or uncomfortable during the study. Participants can also contact the program's emergency contacts.

Expected Benefits: Past research and traditional practice have shown that pressing the Shenmen and Neiguan points can help reduce anxiety, stress, insomnia, and related symptoms. While the researchers cannot guarantee that this study will help individual participants, it may help healthcare professionals understand ways to better support caregivers and could benefit others in the future.
The researcher's requirements for participants during the study:

Please do not participate in other similar clinical studies while participating in this clinical study.
Please fill in the daily log on time and truthfully.
Provide accurate information in the questionnaire.

Participants' privacy is protected:

Study design

Primary purpose: Treatment
Allocation: Randomised
Intervention model: Parallel groups
Masking: Single blind (outcomes assessor)
Number of arms: 2
Model description: 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.

Arm	Type	Receives
Control group	No intervention	–Care continued in the original manner without any intervention.
Intervention group (Acupressure)	Experimental	Behavioral: AcupressureParticipants perform self-acupressure on the Shenmen and Neiguan points twice daily for 2 weeks.

Who may qualify

Ages: 20 years and older
Sex: All
Healthy volunteers: Accepted
Age groups: Adult, Older adult

Key inclusion criteria (3 listed)

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.

Key exclusion criteria (3 listed)

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.

Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.

Interventions

Intervention	Type	Arms
AcupressureParticipants 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.	Behavioural	Intervention group (Acupressure)

Primary outcome

Depressive Symptoms
Time frame: At baseline(weeks 0) and once weekly for 8 weeks(weeks 1-8)
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.
Psychological Distress
Time frame: At baseline(weeks 0) and once weekly for 8 weeks(weeks 1-8)
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.

5 secondary outcomes

Resilience
Time frame: At baseline(weeks 0) and once weekly for 8 weeks(weeks 1-8)
Anxiety
Time frame: At baseline(weeks 0) and once weekly for 8 weeks(weeks 1-8)
Job Stress
Time frame: At baseline(weeks 0) and once weekly for 8 weeks(weeks 1-8)
Occupational Burnout
Time frame: At baseline(weeks 0) and once weekly for 8 weeks(weeks 1-8)
Emotional Distress
Time frame: At baseline(weeks 0) and once weekly for 8 weeks(weeks 1-8)

Results and safety

Results posted to the registry on 6 Oct 2025, as reported by the sponsor. Figures are copied from the record, not re-analysed. Full results on ClinicalTrials.gov.

Participant flow

Group	Started	Completed
Control Group	80	80
Intervention Group (Acupressure)	80	80

Primary outcome: Depressive Symptoms

Time frame: At baseline(weeks 0) and once weekly for 8 weeks(weeks 1-8). Mean (Standard Deviation). Unit: score on a scale

Measure	Control Group n = 80	Intervention Group (Acupressure) n = 80
Tracking Week 1	11.76 (7.20)	11.55 (6.76)
Tracking Week 2	11.70 (7.51)	10.84 (8.12)
Tracking Week 3	12.05 (8.22)	10.86 (7.51)
Tracking Week 4	13.35 (8.39)	10.59 (9.02)
Tracking Week 5	12.54 (8.84)	10.95 (8.98)
Tracking Week 6	12.66 (9.63)	10.93 (9.22)
Tracking Week 7	12.05 (9.24)	10.16 (8.19)
Tracking Week 8	12.31 (10.64)	10.51 (8.62)

Control Group vs Intervention Group (Acupressure): p = 0.837, Generalized Estimating Equations, GEE
Control Group vs Intervention Group (Acupressure): p = 0.428, Generalized Estimating Equations, GEE
Control Group vs Intervention Group (Acupressure): p = 0.269, Generalized Estimating Equations, GEE

Population analysed: After the pre-test questionnaire assessment (baseline week 0), the subjects (control group/intervention group) will be followed up with a weekly questionnaire survey for eight weeks (weeks 1 to 8) after the start of the program. The depression questionnaire will obtain data for a total of nine weeks (baseline week 0 and follow-up weeks 1 to 8) and conduct data analysis.

Primary outcome: Psychological Distress

Time frame: At baseline(weeks 0) and once weekly for 8 weeks(weeks 1-8). Mean (Standard Deviation). Unit: score on a scale

Measure	Control Group n = 80	Intervention Group (Acupressure) n = 80
Tracking Week 1	5.65 (3.42)	5.54 (3.32)
Tracking Week 2	5.54 (3.12)	5.31 (3.56)
Tracking Week 3	5.05 (3.03)	4.6 (3.23)
Tracking Week 4	5.53 (3.67)	4.66 (3.44)
Tracking Week 5	5.28 (3.81)	4.81 (3.42)
Tracking Week 6	4.99 (3.80)	4.48 (3.39)
Tracking Week 7	5.09 (3.85)	4.55 (3.26)
Tracking Week 8	5.05 (4.15)	4.40 (3.18)

Control Group vs Intervention Group (Acupressure): p = 0.63, Generalized Estimating Equations, GEE
Control Group vs Intervention Group (Acupressure): p = 0.608, Generalized Estimating Equations, GEE
Control Group vs Intervention Group (Acupressure): p = 0.244, Generalized Estimating Equations, GEE

Population analysed: After the pre-test questionnaire assessment (baseline week 0), the subjects (control group/intervention group) will be followed up with weekly questionnaires for eight weeks (weeks 1 to 8) after the start of the program, of which the Mood Thermometer (Brief Symptoms Rating Scale, BSRS-5) questionnaire will obtain data for a total of nine weeks (baseline week 0 and follow-up weeks 1 to 8) and conduct data analysis.

5 secondary outcomes are reported in the full results.

Adverse events

Time frame: From enrollment until end of follow-up, up to 8 weeks.. Other adverse events reported at 0% frequency or more

Group	Serious adverse events	Other adverse events	Deaths
Control Group	0 of 80 (0%)	0 of 80 (0%)	0 of 80
Intervention Group (Acupressure)	0 of 80 (0%)	0 of 80 (0%)	0 of 80

Limitations and caveats (from the sponsor): 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.

Loading the posted results from ClinicalTrials.gov…

Research links

Official record on ClinicalTrials.govLast updated by the sponsor 6 Oct 2025.
Posted resultsParticipant flow, baseline, all outcome measures and adverse events.
Background: PubMed 38436194Zhou 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.
Background: PubMed 40110387Yang 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.
Background: PubMed 39648209Wu 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.
Background: PubMed 38576710Peng 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.
Background: PubMed 40004676Pachi 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.
Background: PubMed 38171225Li 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.
Background: PubMed 38173848Hong 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.
Background: PubMed 8400749Elliott 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.
Background: PubMed 25160838Donovan 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.
Background: PubMed 33293201Dincer 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.
Background: PubMed 37429762Bal 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.
Background: PubMed 39595461Amiri 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.
Effects and safety of auricular acupressure on depression and anxiety in isolated COVID-19 patients: A single-blind randomized controlled trial.Link provided by the sponsor.
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.Link provided by the sponsor.
Epidemiological survey of depressive disorder in Kaohsiung Metropolis: Development of a culture-relevant Taiwanese Depression Screening Questionnaire.Link provided by the sponsor.
Using the BSRS-5 to predict suicidal ideation among community residents.Link provided by the sponsor.
Development and validation of the Chinese version of the Copenhagen Burnout Inventory.Link provided by the sponsor.
Individual participant dataSharing planned: No

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Referral and contact

AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.

Li-Ying Lin, PhD principal investigator

supervise

1 site in 1 country: see every site and its status.

Questions about this trial

What is this clinical trial studying?

A study testing Acupressure in people with Psychological Distress and Anxiety, run by Kaohsiung Veterans General Hospital. at 1 site in Taiwan.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 3 inclusion and 3 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: finished, as of the sponsor's last update on 6 Oct 2025. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in Taiwan. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

Yes. Results are posted in the registry (first posted 6 Oct 2025). A summary is in the For doctors view, and the full results are on ClinicalTrials.gov.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Depressive Symptoms (time frame: At baseline(weeks 0) and once weekly for 8 weeks(weeks 1-8)). The study lists 2 primary outcomes in all. It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT06946888, which also lists 19 linked publications.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 6 Oct 2025.