| Objective: Fatigue-predominant subhealth(FPSH)is one of the most common types of subhealth.Fatigue is its most prominent symptom.Taking active measures to relieve fatigue effectively intervene the occurrence and development of FPSH.Therefore,the purpose of this study was to investigate the effects of self-acupressure based on selfregulated learning(SRL)theory on young and middle-aged people with FPSH,with the aim of presenting a foundation for exploring a home care model suitable for the middleaged and young adults to relieve fatigue.Methods: This study was a three-arms,parallel randomized controlled trial.Participants were extensively recruited at a physical examination center in Changchun,China.Based on the inclusion and exclusion criteria,sixty-nine participants were identified.Eligible participants were randomized into the intervention group 1(acupressure based on SRL theory intervention and health education),the intervention group 2(acupressure),and the control group(health education),with 23 participants in each group.And Baihui(DU20),Jianjing(GB21),Zusanli(ST36),Sanyinjiao(SP6),and Taichong(LR3)were selected for acupoints.Every acupoint was pressed for three minutes per time,once a day,5 days a week for 4 weeks.Data were collected at baseline(T0),after 2 weeks of intervention(T1),and after 4 weeks of intervention(T2).Outcomes included fatigue symptoms,self-efficacy,compliance,subhealth status,and psychological status.The assessment tools included the general data questionnaire,Fatigue Scale-14(FS-14),Checklist Individual Strength(CIS),General Self-Efficacy Scale(GSES),Sub-health Measurement Scale Version 1.0(SHMS V1.0)and Depression Anxiety Stress Scale-21(DASS-21).The SPSS 26.0 software was used for statistical analysis.Results:1.The baseline assessment: At baseline,there were no significant differences in the demographic characteristics,FS-14 scale scores,CIS scale scores,SHMS V1.0 scale scores,and DASS-21 scale scores among the three groups(P >0.05).In addition,there was no statistical difference in GESE scores between the intervention two groups at baseline(P>0.05).2.Analysis of fatigue symptoms: The results of repeated measures analysis of variance(ANOVA)showed that there were significant interaction effects of group and time for total FS-14 scores,physical fatigue scores,mental fatigue scores,total CIS scores,and subjective experience of fatigue scores(P<0.05).At T1,compared with the control group,the total FS-14 score,mental fatigue score,and subjective fatigue experience scores were significantly decreased in the intervention group 1(P<0.05).At T2,compared with the control group,the total FS-14 scores,physical fatigue scores,and mental fatigue scores in the intervention groups 1 and 2 were significantly decreased(P<0.05),but there were no statistical changes between the two intervention groups.Compared with the control group and the intervention group 2,the total CIS scores in the intervention group 1 were significantly decreased(P<0.05).Compared with the control group,the subjective fatigue experience scores in the intervention groups 1 and 2 were significantly decreased(P<0.05),but there was no statistical significance between the two intervention groups(P>0.05).3.Analysis of self-efficacy: The results of repeated measures ANOVA showed that GSES scores had significant group and time interaction effects.At T1 and T2,GSES scores in the intervention group 1 were significantly increased than those in the intervention group 2(P<0.05).4.Analysis of acupressure compliance: The acupressure compliance in the intervention group 1 was significantly increased than that of intervention group 2(P<0.05).5.Analysis of subhealth status: The results of repeated measures ANOVA showed there were significant interaction effects of group and time for the total SHMS V1.0 scores and social subhealth scores.The results of the generalized estimating equation(GEE)indicated that the interaction effects of group and time on social subhealth scores andmental subhealth scores were significantly different(P<0.05).At T2,compared with the control group,total SHMS V1.0 scores and physical subhealth scores were significantly increased in the intervention groups 1 and 2,mental subhealth scores in the intervention group 1 were significantly increased(P<0.05).Compared to T0,participants in the intervention groups 1 and 2 experienced a significant increase in the total SHMS V1.0 scores,physical subhealth scores,and mental subhealth scores at T1 and T2,and social subhealth scores in the intervention group 1 were significantly increased at T2(P<0.05)。6.Analysis of psychological status: The results of repeated measures ANOVA indicated that anxiety score had significant group and time interaction effects,stress score had a significant main effect of time.The results of GEE showed that the main effect of time in the depression scores were significantly differed.At T2,compared with the control group,anxiety scores in the two intervention groups were significantly decreased(P<0.05).7.Analysis of adverse events: No adverse events occurred during the intervention period.8.Analysis of the results of sensitivity analysis: Sensitivity analysis showed that there was significant difference in the FS-14 scores between the participants who did not complete the intervention and those who completed the intervention(P<0.05).Conclusions:1.Compared with the health education group,acupressure and acupressure based on SRL theory could significantly improve fatigue symptoms and physical subhealth,and reduce anxiety levels in the middle-aged and young people with FPSH.2.Compared with the health education group,acupressure based on SRL theory could significantly improve mental subhealth in the middle-aged and young people with FPSH.3.Compared with the acupressure group,acupressure based on SRL theory could significantly improve subjects’ self-efficacy,compliance,and fatigue symptoms(CIS total score)in the middle-aged and young people with FPSH.4.Acupressure based on SRL theory is safe,effective and feasible,which is suitable forthe current middle-aged and young people with FPSH. |
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