Auricular Acupuncture on Fatigue, Energy and Well-Being in Intensive Care Nurses
Condition: Fatigue
MeSH terms: Fatigue
Study type: Interventional

Summary: 
      Notably, no acupuncture intervention studies have aimed at reducing the fatigue level and
      increasing the energy of the nurses working in the ICU. For this reason, this study aims to
      investigate the effects of auricular acupuncture applied to nurses working in the ICU, who
      work at a critical point in patient care in our country, work with intense work tempo,
      experience excessive stress, tension, fatigue, and are open to psychosocial problems such as
      depression and burnout, on fatigue and energy levels. This study can significantly contribute
      to the literature on managing the physical and psychosocial issues associated with fatigue
      and that similar intervention programs can be expanded in working life. This study aimed to
      determine the effect of auricular acupuncture applied to intensive care nurses on fatigue,
      energy and well-being. This was a single-blind, randomized controlled clinical study. The
      study was conducted in three groups: semi-permanent needle acupuncture (intervention), seed
      acupuncture (intervention), and a control group.
    

Detailed description: 
      A stratified randomization method was used to determine intervention, placebo and control
      groups. It was ensured that the nurses were evenly distributed to the groups according to
      their age, working year and baseline fatigue scores. A computer-generated
      (https://www.randomizer.org/) sorting was used to allocate the groups homogeneously.

      The intervention groups received five sessions of auricular acupuncture with semi-permanent
      needles and seeds once a week. Semi-permanent needles and seeds placed in nurses' ear
      acupuncture points stayed for one week. In the sessions in the following weeks,
      semi-permanent needles and seeds were replaced with new ones. Nurses were reminded to remove
      the semi-permanent needle and seed tapes 24 hours before the scheduled session. They are also
      instructed to remove it beforehand if there is any discomfort, itching or any sign of
      allergy. Placement of the semi-permanent needles and seed tapes took approximately five
      minutes per session. Before each session for the semi-permanent needle group, the ears of the
      participants were cleaned with a 70% alcohol wipe and sterile, fine-caliber, disposable
      semi-permanent needles were used. A similar application was made to the seed group and they
      were asked to apply pressure on the bands three times a day, 15 times each time.

      These were placed unilaterally on five specific points in the ear (ShenMen, sympathetic,
      liver, kidney, lung) by a certified specialist in acupuncture using the National Acupuncture
      Detoxification Association (NADA) protocol. Since the body or organs have an emotional
      component and can be adversely affected by excessive and prolonged emotions, these ear points
      were chosen to facilitate the release of negative/toxic emotions from the organs. This
      process was thought to help the treated participant return to balance and increase energy and
      well-being by giving a feeling of calm instead of stress and anxiety. Shen men (TF4) and
      Sympathetic (AH6a) points can regulate the sympathetic and parasympathetic nervous systems to
      effectively reduce patient tension and anxiety. In addition, the TF4 point reduces anxiety,
      while the AH6a point calms excessive sympathetic activity. Both of these points help increase
      parasympathetic activation by balancing the sympathetic/parasympathetic branches of the
      autonomic nervous system. Low mood and lethargy are improved by stimulating the liver (CO12).
      Kidney point (CO10) is a point that has a strengthening effect by relieving mental weakness,
      fatigue and headaches and stimulating kidney functions. Combining these ear acupuncture
      points can increase the energy and blood flow of the organs, thereby relieving the patient's
      fatigue.

      Data were collected at baseline and at the end of the intervention (week 5) using the Chalder
      Fatigue Scale, Subjective Vitality Scale, and Well-being Scale.
    

Intervention name(s): Auricular acupuncture
Intervention type(s): Other
Intervention description(s): The NADA protocol used in this study uses five specific points on the ear: Shen men, sympathetic autonomic, lung, liver, and kidney. Using this protocol, semi-permanent needles and seeds were placed unilaterally at five specific points in the ear by a specialist physician certified in acupuncture.
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Single (Outcomes Assessor)
Primary purpose: Supportive Care
Keywords: intensive care nurses; acupuncture; fatigue; well-being