An Integrative Review of Acupressure Interventions for Older people: A focus on sleep quality, depression, anxiety and agitation.

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 were 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, summarised and synthesized. RESULTS: A total of 225 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 standardised 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.