A Non-Pharmacological Approach to Symptom Management in Intensive Care Patients: Acupressure

Ayşe Buket Doğan; Özlem Canbolat

doi:10.59124/guhes.1837039

A Non-Pharmacological Approach to Symptom Management in Intensive Care Patients: Acupressure

Abstract

Acupressure is a non-pharmacological method based on applying pressure to key points on the body using the hands, fingers, or devices to relieve muscle tension and promote circulation. In the intensive care unit, it can be implemented by nurses as an evidence-based, low-cost intervention that does not require invasive procedures and contributes to symptom management. By applying pressure to the appropriate points targeting specific symptoms, acupressure may lead to improvements in pain, anxiety, and sleep quality

Keywords

Ethical Statement

Ethics committee approval was deemed unnecessary for this study, given that open-access sources were utilized.

References

Alinia-Najjar, R., Bagheri-Nesami, M., Shorofi, S. A., Mousavinasab, S. N., & Saatchi, K. (2020). The effect of foot reflexology massage on burn-specific pain anxiety and sleep quality and quantity of patients hospitalized in the burn intensive care unit (ICU). Burns, 46(8), 1942–1951. https://doi.org/10.1016/j.burns.2020.04.035
Au, D. W., Tsang, H. W., Ling, P. P., Leung, C. H., Ip, P. K., & Cheung, W. M. (2015). Effects of acupressure on anxiety: A systematic review and meta-analysis. Acupuncture in Medicine, 33(5), 353–359. https://doi.org/10.1136/acupmed-2014-010720
Aygin, D., & Şen, S. (2019). Acupressure on anxiety and sleep quality after cardiac surgery: A randomized controlled trial. Journal of Perianesthesia Nursing, 34(6), 1222–1231. https://doi.org/10.1016/j.jopan.2019.03.014
Ayinde, O., Hayward, R. S., & Ross, J. D. C. (2021). The effect of intramuscular injection technique on injection-associated pain: A systematic review and meta-analysis. PLOS ONE, 16(5), e0250883. https://doi.org/10.1371/journal.pone.0250883
Bani Hani, D. A., Alshraideh, J. A., & Alshraideh, B. (2022). Patients’ experiences in the intensive care unit in Jordan: A cross-sectional study. Nursing Forum, 57(1), 49–55. https://doi.org/10.1111/nuf.12650
Başak, S., Bahcecioglu Turan, G., & Özer, Z. (2025). The effects of self-acupressure on pain and sleep quality in patients with coronary artery disease: A randomized controlled trial. Pain Management Nursing, 26(1), e10–e17. https://doi.org/10.1016/j.pmn.2024.07.013
Bjørnøy, I., Rustøen, T., Mesina, R. J. S., & Hofsø, K. (2023). Anxiety and depression in intensive care patients six months after admission to an intensive care unit: A cohort study. Intensive & Critical Care Nursing, 78, 103473. https://doi.org/10.1016/j.iccn.2023.103473
Bourdiol, A., Legros, V., Vardon-Bounes, F., Rimmele, T., Abraham, P., Hoffmann, C., Dahyot-Fizelier, C., Jonas, M., Bouju, P., Cirenei, C., Launey, Y., Le Gac, G., Boubeche, S., Lamarche, E., Huet, O., Bezu, L., Darrieussecq, J., Szczot, M., Delbove, A., Schmitt, J., … Société Française d’Anesthésie-Réanimation–SFAR Research Network. (2023). Prevalence and risk factors of significant persistent pain symptoms after critical care illness: A prospective multicentric study. Critical Care, 27(1), 199. https://doi.org/10.1186/s13054-023-04491-w

Cam Yanik, T., & Altun Ugras, G. (2025). Acupressure on sleep quality and daytime sleepiness of surgical nurses: A randomized, single-blind, sham-controlled trial. Florence Nightingale Journal of Nursing, 33, e24247. https://doi.org/10.5152/FNJN.2025.24247
Canbolat, O., Aktas, A. B. D., & Aydın, B. (2024). Perceptions of adult intensive care unit patients regarding nursing presence and their intensive care experiences: A descriptive-correlational study. Journal of Clinical Nursing, 33(10), 4005–4013. https://doi.org/10.1111/jocn.17064
Cekaite, A., & Goodwin, M. H. (2021). Touch and social interaction. Annual Review of Anthropology, 50(1), 203–218. https://doi.org/10.1146/annurev-anthro-101819-110402
Ceyhan, Ö., Taşcı, S., Elmalı, F., & Doğan, A. (2019). The effect of acupressure on cardiac rhythm and heart rate among patients with atrial fibrillation: The relationship between heart rate and fatigue. Alternative Therapies in Health and Medicine, 25(1), 12–19.
Chen, I. H., Yeh, T. P., Yeh, Y. C., Chi, M. J., Chen, M. W., Chou, K. R., Lien, Y. Y., & Yuan, C. F. (2019). Effects of acupressure on sleep quality and psychological distress in nursing home residents: A randomized controlled trial. Journal of the American Medical Directors Association, 20(7), 822–829. https://doi.org/10.1016/j.jamda.2019.01.003
Chen, J. H., Chao, Y. H., Lu, S. F., Shiung, T. F., & Chao, Y. F. (2012). The effectiveness of valerian acupressure on the sleep of ICU patients: A randomized clinical trial. International Journal of Nursing Studies, 49(8), 913–920. https://doi.org/10.1016/j.ijnurstu.2012.02.012
Chen, S. R., Hou, W. H., Lai, J. N., Kwong, J. S. W., & Lin, P. C. (2022). Effects of acupressure on anxiety: A systematic review and meta-analysis. Journal of Integrative and Complementary Medicine, 28(1), 25–35. https://doi.org/10.1089/jicm.2020.0256
Cheng, H. Y., Carol, S., Wu, B., & Cheng, Y. F. (2020). Effect of acupressure on postpartum low back pain, salivary cortisol, physical limitations, and depression: A randomized controlled pilot study. Journal of Traditional Chinese Medicine, 40(1), 128–136.
Dehghan, M., Hosseini, S. J., Shahrbabaki, P. M., Forouzi, M. A., & Roy, C. (2023). The effect of acupressure and cryotherapy on the pain of patients on hemodialysis during arteriovenous fistula cannulation: A randomized crossover clinical trial. Nephrology Nursing Journal, 50(2), 131–139.
Dincer, B., İnangil, D., İnangil, G., Bahçecik, N., Ayaz, E. Y., Arslanoğlu, A., Keskinler, M. V., Kabuk, A., & Özkan, G. (2022). The effect of acupressure on sleep quality of older people: A systematic review and meta-analysis of randomized controlled trials. Explore, 18(6), 635–645. https://doi.org/10.1016/j.explore.2021.11.010
Durkin, J., Jackson, D., & Usher, K. (2021). The expression and receipt of compassion through touch in a health setting: A qualitative study. Journal of Advanced Nursing, 77(4), 1980–1991. https://doi.org/10.1111/jan.14766
Duymaz, T., & Çulha, Y. (2025). Investigation of environmental stressors and individualized care perceptions of inpatients in the intensive care unit. Nursing in Critical Care, 30(2), e13299. https://doi.org/10.1111/nicc.13299
Erbay Dalli, Ö., & Kelebek Girgin, N. (2025). Sleep quality and disruptive factors in intensive care units: A comparison between mechanically ventilated and spontaneously breathing patients. Nursing in Critical Care, 30(4), e70097. https://doi.org/10.1111/nicc.70097
Gan, T. J., Belani, K. G., Bergese, S., Chung, F., Diemunsch, P., Habib, A. S., Jin, Z., Kovac, A. L., Meyer, T. A., Urman, R. D., Apfel, C. C., Ayad, S., Beagley, L., Candiotti, K., Englesakis, M., Hedrick, T. L., Kranke, P., Lee, S., Lipman, D., Minkowitz, H. S., … Philip, B. K. (2020). Fourth consensus guidelines for the management of postoperative nausea and vomiting. Anesthesia and Analgesia, 131(2), 411–448. https://doi.org/10.1213/ANE.0000000000004833
Gezginci, E., Goktas, S., & Orhan, B. N. (2022). The effects of environmental stressors in intensive care unit on anxiety and depression. Nursing in Critical Care, 27(1), 113–119. https://doi.org/10.1111/nicc.12553
He, Y., Guo, X., May, B. H., Zhang, A. L., Liu, Y., Lu, C., Mao, J. J., Xue, C. C., & Zhang, H. (2020). Clinical evidence for association of acupuncture and acupressure with improved cancer pain: A systematic review and meta-analysis. JAMA Oncology, 6(2), 271–278. https://doi.org/10.1001/jamaoncol.2019.5233
İskender, M. D., & Çalışkan, N. (2020). Konstipasyon yönetiminde akupresür uygulaması ve hemşirenin rolü. Van Tıp Dergisi, 27(1), 103–108.
Jafari, M., Shabani, F., Fathollahi, M. S., Barghi, T. S., Peighambari, S. B., & Zargaz, S. E. H. (2025). Effect of acupressure on pain and sleep quality of patients with cancer after undergoing surgery admitted to the intensive care unit: A single-blind randomized clinical trial. Iranian Journal of Nursing and Midwifery Research, 30(4), 531–537. https://doi.org/10.4103/ijnmr.ijnmr_368_23
Jiang-Siebert, Q., Wieteck, P., & Kraus, S. (2025). Acupressure, a promising intervention for fatigue, within the European nursing care pathways (ENP): An integrative review. International Nursing Review, 72(1), e12989. https://doi.org/10.1111/inr.12989
Kakar, E., Priester, M., Wessels, P., Slooter, A. J. C., Louter, M., & van der Jagt, M. (2022). Sleep assessment in critically ill adults: A systematic review and meta-analysis. Journal of Critical Care, 71, 154102. https://doi.org/10.1016/j.jcrc.2022.154102
Kalyoncuo, S. (2024). Koroner anjiografi (KAG) uygulanan hastaların ağrı yönetiminde akupresür ve hemşirelik. Avrasya Sağlık Bilimleri Dergisi, 7(3), 233–240.
Khan-Mohammadi, F., Jafari, H., Bagheri-Nesami, M., Moosazadeh, M., Kamali, M., Esmaeili-Ahangarkelai, N., & Quds, K. (2023). Effects of acupressure on intestinal function in patients with coronary artery bypass graft surgery: A randomized clinical trial. Gastroenterology and Hepatology from Bed to Bench, 16(3), 282–291. https://doi.org/10.22037/ghfbb.v16i2.2720
Kürtüncü, M., Kurt, A., & Arslan, N. (2023). The experiences of COVID-19 patients in intensive care units: A qualitative study. Omega, 87(2), 504–518. https://doi.org/10.1177/00302228211024120
Lange, S., Mędrzycka-Dąbrowska, W., Friganovic, A., Oomen, B., & Krupa, S. (2022). Non-pharmacological nursing interventions to prevent delirium in ICU patients: An umbrella review with implications for evidence-based practice. Journal of Personalized Medicine, 12(5), 760. https://doi.org/10.3390/jpm12050760
Lee, A., Zhang, J. Z., Xie, J., Cheng, V., Wong, M. K. H., & Yau, D. K. W. (2025). Stimulation of the wrist acupuncture point PC6 for preventing postoperative nausea and vomiting: A network meta-analysis. Cochrane Database of Systematic Reviews, 9, CD003281. https://doi.org/10.1002/14651858.CD003281.pub5
Lehmkuhl, L., Munck, M. S., Rothmann, M. J., & Sorknaes, A. D. (2024). Exploring critically ill patients’ and their relatives’ experiences of intensive care unit during COVID-19: A qualitative study. Nursing in Critical Care, 29(2), 427–437. https://doi.org/10.1111/nicc.13011
Li, Q. Q., Shi, G. X., Xu, Q., Wang, J., Liu, C. Z., & Wang, L. P. (2013). Acupuncture effect and central autonomic regulation. Evidence-Based Complementary and Alternative Medicine, 2013, 267959. https://doi.org/10.1155/2013/267959
Li, Z. Q., Jiang, M. Y., Liu, X. H., Cai, Y. Q., Wang, C. L., Cao, F., & Liu, J. P. (2024). Research trends of acupressure from 2004 to 2024: A bibliometric and visualization analysis. Heliyon, 10(21), e38675. https://doi.org/10.1016/j.heliyon.2024.e38675
Ling, W., Yang, C., Ho, M. H., & Lee, J. J. (2025). Effectiveness of acupressure on sleep quality among inpatients: A systematic review and meta-analysis. Nursing & Health Sciences, 27(1), e70075. https://doi.org/10.1111/nhs.70075
Liu, M., Tong, Y., Chai, L., Chen, S., Xue, Z., Chen, Y., & Li, X. (2021). Effects of auricular point acupressure on pain relief: A systematic review. Pain Management Nursing, 22(3), 268–280. https://doi.org/10.1016/j.pmn.2020.07.007
Lu, H. B., Ma, R. C., Yin, Y. Y., Song, C. Y., Yang, T. T., & Xie, J. (2022). Auricular acupressure for improving sleep quality in patients with lung cancer: A systematic review and meta-analysis. Holistic Nursing Practice, 36(4), E27–E37. https://doi.org/10.1097/HNP.0000000000000532
Ma, Y., Yang, X., Wang, C., Li, Y., Zhang, Y., Wang, L., Hu, R., & Li, X. (2024). Comparative efficacy of non-pharmacological interventions for anxiety in adult intensive care unit patients: A systematic review and network meta-analysis. Nursing in Critical Care, 29(6), 1334–1345. https://doi.org/10.1111/nicc.13156
Medrzycka-Dabrowska, W., Lewandowska, K., Kwiecień-Jaguś, K., & Czyż-Szypenbajl, K. (2018). Sleep deprivation in intensive care unit: Systematic review. Open Medicine, 13, 384–393. https://doi.org/10.1515/med-2018-0057
Mota, M., Santos, E., Cunha, M., Abrantes, T., Caldes, P., & Santos, M. R. (2021). Non-pharmacological interventions for acute pain management in adult trauma victims: A scoping review. JBI Evidence Synthesis, 19(7), 1555–1582. https://doi.org/10.11124/JBIES-20-00189
Mucuk, S., & Ceyhan, Ö. (2015). Akupres. In M. Başer & S. Taşçı (Eds.), Kanıta dayalı rehberleriyle tamamlayıcı ve destekleyici uygulamalar (1. baskı, ss. 205–245). Akademisyen Tıp Kitabevi.
Nieh, H. C., Chang, W. C., Chen, C. J., & Tsai, Y. F. (2023). Effect of acupressure on alleviating constipation among hospitalized patients: A randomized controlled trial. Complementary Therapies in Clinical Practice, 53,101801. https://doi.org/10.1016/j.ctcp.2023.101801
Nielsen, A., Dusek, J. A., Taylor-Swanson, L., & Tick, H. (2022). Acupuncture therapy as an evidence-based nonpharmacologic strategy for comprehensive acute pain care: The Academic Consortium Pain Task Force white paper update. Pain Medicine, 23(9), 1582–1612. https://doi.org/10.1093/pm/pnac056
Olsen, B. F., Valeberg, B. T., Jacobsen, M., Småstuen, M. C., Puntillo, K., & Rustøen, T. (2020). Pain in intensive care unit patients: A longitudinal study. Nursing Open, 8(1), 224–231. https://doi.org/10.1002/nop2.621
Parpucu, Ü. M., Küçük, O., & Aydemir, S. (2024). Factors influencing morbidity and mortality rates in tertiary intensive care units in Turkey: A retrospective cross-sectional study. Healthcare, 12(6), 689. https://doi.org/10.3390/healthcare12060689
Peng, Z., Zheng, Y., Yang, Z., Zhang, H., Li, Z., Xu, M., Cui, S., & Lin, R. (2024). Acupressure: A possible therapeutic strategy for anxiety related to COVID-19: A meta-analysis of randomized controlled trials. Frontiers in Medicine, 11, 1341072. https://doi.org/10.3389/fmed.2024.1341072
Pepito, J. A. T., Babate, F. J. G., & Dator, W. L. T. (2023). The nurses’ touch: An irreplaceable component of caring. Nursing Open, 10(9), 5838–5842. https://doi.org/10.1002/nop2.1860
Pota, V., Coppolino, F., Barbarisi, A., Passavanti, M. B., Aurilio, C., Sansone, P., & Pace, M. C. (2022). Pain in intensive care: A narrative review. Pain and Therapy, 11(2), 359–367. https://doi.org/10.1007/s40122-022-00366-0
Ropero Peláez, F. J., & Taniguchi, S. (2016). The gate theory of pain revisited: Modeling different pain conditions with a parsimonious neurocomputational model. Neural Plasticity, 2016, 4131395. https://doi.org/10.1155/2016/4131395
Sharafi, S., Sedighi, L., Sanaei, N., Sanaei, N., & Nasiri, M. (2025). Investigating the impact of nature music and acupressure on the pain intensity of conscious patients hospitalized in ICU. Archives of Anesthesiology and Critical Care, 11(4), 442–447. https://doi.org/10.18502/aacc.v11i4.19353
Shdaifat, S. A., & Al Qadire, M. (2022). Anxiety and depression among patients admitted to intensive care. Nursing in Critical Care, 27(1), 106–112. https://doi.org/10.1111/nicc.12536
Shih, C. Y., Wang, A. Y., Chang, K. M., Yang, C. C., Tsai, Y. C., Fan, C. C., Chuang, H. J., Thi Phuc, N., & Chiu, H. Y. (2023). Dynamic prevalence of sleep disturbance among critically ill patients in intensive care units and after hospitalisation: A systematic review and meta-analysis. Intensive and Critical Care Nursing, 75, 103349. https://doi.org/10.1016/j.iccn.2022.103349
Snyder, M., & Tracy, M. F. (2014). Complementary and alternative therapies in nursing (7th ed.). Springer.
Suclupe, S., Efrain Pantoja Bustillos, P., Bracchiglione, J., Requeijo, C., Salas-Gama, K., Solà, I., Merchán-Galvis, A., Uya Muntaña, J., Robleda, G., & Martinez-Zapata, M. J. (2023). Effectiveness of nonpharmacological interventions to prevent adverse events in the intensive care unit: A review of systematic reviews. Australian Critical Care, 36(5), 902–914. https://doi.org/10.1016/j.aucc.2022.11.003
Wagner, J. (2015). CE: Incorporating acupressure into nursing practice. American Journal of Nursing, 115(12),40–47. https://doi.org/10.1097/01.NAJ.0000475290.20362.77
Wang, Z., Hu, X., Su, J., Gao, X., Xu, N., Xing, Y., & Zhuang, L. (2017). The efficacy and safety of stimulating a single acu-point shenmen (HT7) for managing insomnia: A systematic review of randomized controlled trials. European Journal of Integrative Medicine, 15, 17–22. https://doi.org/10.1016/j.eujim.2017.08.010
World Health Organization. (2000). General guidelines for methodologies on research and evaluation of traditional medicine.
Williams, H., Gow, J., Rana, R., Rouse, A., Chinthamuneedi, M., Beccaria, G., & Ralph, N. (2021). Measuring the intensive care experience: A cross-sectional survey of patient and family experiences of critical care. Journal of Clinical Nursing, 30(23–24), 3623–3633. https://doi.org/10.1111/jocn.15884
Yao, C., Zeng, X., Zhang, S., Xiao, B., Sun, P., Kong, L., Tao, J., & Fang, M. (2025). Acupoint massage: A comprehensive descriptive review of its forms, applications, and underlying mechanisms. Chinese Medicine, 20(1), 54. https://doi.org/10.1186/s13020-025-01105-1
Yoshida, T., Uchino, S., & Sasabuchi, Y. (2022). Epidemiology of constipation in critically ill patients and its impact on in-hospital mortality: A retrospective observational study. Journal of Anesthesia, 36(3), 349–358. https://doi.org/10.1007/s00540-022-03050-x
Zhang, J., Qin, Z., So, T. H., Chang, T. Y., Yang, S., Chen, H., Yeung, W. F., Chung, K. F., Chan, P. Y., Huang, Y., Xu, S., Chiang, C. Y., Lao, L., & Zhang, Z. J. (2023). Acupuncture for chemotherapy-associated insomnia in breast cancer patients: An assessor-participant blinded, randomized, sham-controlled trial. Breast Cancer Research, 25(1), 49. https://doi.org/10.1186/s13058-023-01645-0
Zhao, F. Y., Kennedy, G. A., Cleary, S., Conduit, R., Zhang, W. J., Fu, Q. Q., & Zheng, Z. (2022). Knowledge about, attitude toward, and practice of complementary and alternative medicine among nursing students: A systematic review of cross-sectional studies. Frontiers in Public Health, 10, 946874. https://doi.org/10.3389/fpubh.2022.946874

Details

Primary Language

English

Subjects

Health Care Administration

Journal Section

Review

Authors

Ayşe Buket Doğan ^*
0000-0002-7370-6229
Türkiye

Özlem Canbolat
0000-0002-4222-4577
Türkiye

Publication Date

April 30, 2026

Submission Date

December 8, 2025

Acceptance Date

April 2, 2026

Published in Issue

Year 2026 Volume: 8 Number: 1

DOI

https://doi.org/10.59124/guhes.1837039

IZ

https://izlik.org/JA74NS88KL

Cite

RIS / Bibtex

APA

Doğan, A. B., & Canbolat, Ö. (2026). A Non-Pharmacological Approach to Symptom Management in Intensive Care Patients: Acupressure. Journal of Gazi University Health Sciences Institute, 8(1), 11-21. https://doi.org/10.59124/guhes.1837039

AMA

1.Doğan AB, Canbolat Ö. A Non-Pharmacological Approach to Symptom Management in Intensive Care Patients: Acupressure. GUHES. 2026;8(1):11-21. doi:10.59124/guhes.1837039

Chicago

Doğan, Ayşe Buket, and Özlem Canbolat. 2026. “A Non-Pharmacological Approach to Symptom Management in Intensive Care Patients: Acupressure”. Journal of Gazi University Health Sciences Institute 8 (1): 11-21. https://doi.org/10.59124/guhes.1837039.

EndNote

Doğan AB, Canbolat Ö (April 1, 2026) A Non-Pharmacological Approach to Symptom Management in Intensive Care Patients: Acupressure. Journal of Gazi University Health Sciences Institute 8 1 11–21.

IEEE

[1]A. B. Doğan and Ö. Canbolat, “A Non-Pharmacological Approach to Symptom Management in Intensive Care Patients: Acupressure”, GUHES, vol. 8, no. 1, pp. 11–21, Apr. 2026, doi: 10.59124/guhes.1837039.

ISNAD

Doğan, Ayşe Buket - Canbolat, Özlem. “A Non-Pharmacological Approach to Symptom Management in Intensive Care Patients: Acupressure”. Journal of Gazi University Health Sciences Institute 8/1 (April 1, 2026): 11-21. https://doi.org/10.59124/guhes.1837039.

JAMA

1.Doğan AB, Canbolat Ö. A Non-Pharmacological Approach to Symptom Management in Intensive Care Patients: Acupressure. GUHES. 2026;8:11–21.

MLA

Doğan, Ayşe Buket, and Özlem Canbolat. “A Non-Pharmacological Approach to Symptom Management in Intensive Care Patients: Acupressure”. Journal of Gazi University Health Sciences Institute, vol. 8, no. 1, Apr. 2026, pp. 11-21, doi:10.59124/guhes.1837039.

Vancouver

1.Ayşe Buket Doğan, Özlem Canbolat. A Non-Pharmacological Approach to Symptom Management in Intensive Care Patients: Acupressure. GUHES. 2026 Apr. 1;8(1):11-2. doi:10.59124/guhes.1837039