A Delphi Process to Inform a Clinical Trial Using Acupuncture to Reduce Perceived Stress Levels
- Publication Type:
- Thesis
- Issue Date:
- 2023
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Stress is a common part of modern life. While it provides a positive stimulus for physiological functions, it may still lead to negative effects when featuring high intensity or duration for an individual. As a population facing many specific challenges, students are often subjected to multiple types of stressors. Limited data exists to show acupuncture as an effective stress reduction intervention, but there is little consensus about treatment protocols. This thesis aims to further inform the possible protocols to be used in subsequent clinical trials.
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The project aims to inform possible further study in acupuncture and stress by refining proposed acupuncture protocols for stress via a Delphi process. Expert consensus was sought regarding diagnosis, syndrome differentiation, signs and symptoms, acupuncture point selection and treatment frequency.
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This thesis contains a literature review, a clinical trial protocol and a Delphi process. The literature review highlights the scarcity of acupuncture research specifically about stress. A clinical trial protocol was developed using the literature review results to investigate the impact of acupuncture at different treatment frequencies, focussing on tertiary students as the population group. Finally, a two-round Delphi process seeking expert consensus regarding clinical diagnosis and treatment of stress was undertaken with a threshold level set at 80%.
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The literature review found very little evidence of studies using acupuncture for stress (n=11; RCTs n=8, UCTs n=3). There was very little cohesiveness between studies regarding acupuncture dosage (treatment frequency or number of treatments total), acupuncture points used or diagnosis.
The Delphi process showed expert consensus on zangfu relevant to stress diagnoses (Heart and Liver), syndromes relevant to stress diagnoses (qi stasis and zangfu disharmony) and acupuncture points relevant to stress treatment (Liver 3, Pericardium 6, Heart 7 and Yin Tang). There was no consensus on frequency of treatments or number of treatments preferred.
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The clinical trial acupuncture point protocol is valid for future use according to expert consensus. Further research is needed to determine satisfactory acupuncture dosage for use in clinical trials across a range of variables including treatment frequency and total number of treatments.
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