Self-administered acupressure for caregivers of older family members : a randomized controlled trial

Abstract

OBJECTIVE: To test whether self-administered acupressure reduces stress and stress-related symptoms in caregivers of older family members. DESIGN: In this randomized, assessor-blind, controlled trial, 207 participants were randomized (1:1) to an acupressure intervention or a wait-list control group. SETTING: Community centers in Hong Kong, China. PARTICIPANTS: Primary caregivers of an older family member who screened positive for caregiver stress with symptoms of fatigue, insomnia, or depression. INTERVENTION: The 8-week intervention comprised four training sessions on self-administered acupressure, two follow-up sessions for learning reinforcement, and daily self-practice of self-administered acupressure. MEASUREMENTS: The primary outcome was caregiver stress (Caregiver Burden Inventory). Secondary outcomes included fatigue (Piper Fatigue Scale), insomnia (Pittsburgh Sleep Quality Index), depression (Patient Health Questionnaire), and health-related quality of life (QoL) (12-item Short-Form Health Survey version 2). An intention-to-treat analysis was adopted. RESULTS: Of 207 participants, 201 completed the study. Caregiver stress in the intervention group was significantly lower than that in the control group after 8 weeks (difference = −8.12; 95% confidence interval [CI] = −13.20 to −3.04; P =.002) and at 12-week follow-up (difference = −8.52; 95% CI = −13.91 to −3.12; P =.002). The intervention group, relative to the control group, also had significantly improved secondary outcomes of fatigue (difference = −0.84; 95% CI = −1.59 to −0.08; P =.031), insomnia (difference = −1.34; 95% CI = −2.40 to −0.27; P =.014), depression (difference = −1.76; 95% CI = −3.30 to −0.23; P =.025), and physical health-related QoL (difference = 3.08; 95% CI = 0.28-5.88; P =.032) after 8 weeks. CONCLUSION: Self-administered acupressure intervention significantly relieves self-reported caregiver stress and co-occurring symptoms in those caring for older family members. Further studies are needed to measure the symptoms objectively and to examine the clinical importance of the observed improvement in caregiver stress.