Acupressure for Managing Agitation in People with Dementia: Design of a Protocol Using the Delphi Technique

Abstract

Background: Preliminary studies support the effect of acupressure in managing agitation in people with dementia (PWD). However, procedures for the selection of intervention ingredients and specifications of the implementation techniques are lacking. This lack of information hinders further studies on the effect of acupressure and its subsequent clinical uses. The aim of this study was to develop an acupressure protocol and to identify its specifications. Methods: This study employed the Delphi technique, an approach to gain consensus on intervention ingredient selection to formulate the acupressure protocol through rounds of consultation among a panel of experts. Consensus of the protocol is considered when agreements on each ingredient reach and exceed 80%. Results: We invited 6 eligible traditional Chinese medicine (TCM) practitioners into the expert panel. An acupressure protocol with 100% agreement was developed in 3 rounds of consultation. Five acupoints and seven implementation specifications were identified. Conclusions: This study identifies the key intervention ingredients of acupressure and displays their procedures. The results support the notion that identification of acupressure ingredients for managing agitation in PWD by the Delphi technique is feasible. This study also identifies some intervention implementation specifications that have not been reported earlier, although the dosage (i.e. the frequency and duration) could not be well justified by the experts based on their clinical experience and the TCM theory. The study results suggest that further studies should focus on identifying the ideal dosage to be used and subsequently examine the effect of this standardized acupressure protocol as implemented by lay caregivers in randomized controlled trials.