Acupuncture Effects on the Stress Level in Administrative Workers

Research Article

Ann Yoga Phys Ther. 2017; 2(3): 1028.

Acupuncture Effects on the Stress Level in Administrative Workers

Silveira AF¹, Rodrigues VRMC¹, Nascimento LCG¹, Bittar CML¹, Zaia JE² and Quemelo PRV³*

¹Department of Health Promotion, University of Franca, Brazil

²Department of Biological Sciences, Minas Gerais State University (UEMG), Brazil

³Department of Physiotherapy, Sao Camilo University Center, Brazil

*Corresponding author: Paulo Roberto Veiga Quemelo, Department of Physiotherapy, Sao Camilo University Center, Sao Paulo, Sao Paulo – Brazil

Received: May 03, 2017; Accepted: June 02, 2017; Published: June 14, 2017


Introduction: Acupuncture has been growing in clinical practice with the aim of reducing the stress. However, there is a lack of studies proving their benefits.

Objective: To evaluate the effects of auricular acupuncture on stress levels in administrative workers.

Materials and Methods: Participated in the study, 58 administrative sector workers of a public hospital. The participants were randomly separated into two groups: control group (n=30) which received no intervention; and the experimental group (n=28), which was applied to auricular acupuncture for eight weeks. Perceived Stress Scale (PSS-10) measured the stress level.

Results: The stress level reduced in experimental group of high to moderate. The stress level reduced to 21.0 points to 18.5 points in the experimental group (p=0.001).

Conclusion: The implementation of eight weeks of auricular acupuncture showed an effective strategy for reducing stress. Acupuncture is a method that offers a low cost and easy application, being a practical and effective method for stress management in administrative workers.

Keywords: Stress; Occupational health; Burnout; Health promotion; Acupuncture therapy


CNS: Central Nervous System; PSS – 10: Perceived Stress Scale 10; 5–HT: 5-Hydroxytryptamine receptors; PNPIC: National Policy on Integrative and Complementary Practices; SUS: Unified Health System


Stress is the body’s reaction that involves physical and psychological components that cause changes in the homeostasis [1]. Muscle tension, excessive sweating, dry mouth and perception of constant alertness are common symptoms caused by stress. These symptoms may occur through the coping of stressful situations on people, regardless of age, sex, social class or occupation [2]. Intellectual work, shift work and work pressure are conditions that can lead to stress conditions [3,4]. Occupational stress influences the health of workers, absenteeism and performance at work. Some disorders like insomnia, depression, anxiety, musculoskeletal disorders and burnout syndrome are common in stressed workers [3,5,6-8]. This situation brings economic impact with high cost for companies and government [7].

Given the impact that stress can have on workers it is important to think about interventions to reduce this condition. Acupuncture, meditation and yoga are alternative therapies frequently offered to mind and body practices [8]. Acupuncture has been widespread in the last decade in western countries as a treatment for many diseases [9-11]. Acupuncture can be applied systemically in the body or in the ear. The auricular acupuncture therapy is based on an inverted fetus, in which the organs, viscera, central and peripheral nervous system are represented in the ear [12,13]. General mechanisms, including placebo effects, stress reduction, improved mood and sleep are mentioned by acupuncture therapy effects [10,11]. It was demonstrated a significant positive effect of acupuncture on cognitive impairment through modulation of signaling pathways involved in neuronal survival and functioning ‘animal’ studies, but the exact mechanism remains unclear [14]. Theoretically, acupuncture is believed to have the ability to regulate various biological functions through the autonomic nervous system and reduce the symptoms of musculoskeletal pain. However, there are few studies about acupuncture focused on the worker’s health [15,16]. Specifically, about stress and workers, we did not find any studies about acupuncture effects. Since the use of acupuncture has grown in clinical practice and as a form of intervention in the workplace to reduce anxiety and stress it is important to further to investigate the benefits of acupuncture to improve the worker’s health. Thus, the aim of this study was to evaluate the effects of auricular acupuncture on the stress levels of administrative workers.

Materials and Methods

The study was conducted in the administrative sector of a public hospital complex in São Paulo State, Brazil. The study was approved by the Research Ethics Committee (CAAE: 39306314.6.3001.5438). Data collection and intervention were made from April to July 2015.


Fifty-eight female workers of the administrative sector of a public hospital complex were invited to participate in this study. The inclusion criteria were: female workers from the administrative sector (receptionist workers) that worked in the public hospital for more than one year and being at least 18 years old. The exclusion criterion was: workers on vacation or pregnancy period. The receptionist works directly with patients and people all the time. The activities include patient/person attendance; computer task; telephone service; note taking and medical scheduling (writing paper). Additionally, the receptionists are exposed to physical risks (static and repetitive activities) and mental overload (stress). The subjects (n=60) were separated into two groups at random procedure: 30 workers with 30.5 ± 10.5 years old were included in control group and 30 workers with 35.0 ±11.2 years old were included in experimental group. Two (n=2) subjects of the experimental group dropped out of the study during the interventional period.

Auricular acupuncture intervention

The acupuncturist performed asepsis of the ear with cotton and alcohol 70%. After this procedure, the points in the ear were identified and semi-permanent needles (Dux Acupuncture – size: 0.30 x 0.50 mm) were applied and fixed with Micropore tape (3M Micropore). The points used for intervention were: Shenmen, Zero, Kidney and Brain Stem [12]. Participants were instructed to stimulate the needles once a day with moderate pressure. After seven days, the needles were removed; discarded and new needles were reapplied. The needles were changed every week during eight weeks. Each week the same application procedure was performed on the contralateral ear to avoid fatigue on acupuncture points [17]. Participants of the control group did not receive any intervention during these eight weeks.

Instrument and data collection

The Perceived Stress Scale (PSS-10) consists of a self-report instrument for general assessment of stress levels based on the responses to 10 items [18,19]. Each item has five possible answers based on frequency of symptoms. The final perceived stress score ranges from 0 to 40, with higher scores meaning higher stress levels. The perceived stress scores were classified as low: 0 to 10, moderate: 10 to 20, high: 20 to 30 and very high: 30 to 40. The Portuguese PSS- 10 has high internal consistency (Cronbach’s alpha = 0.87) and high test-retest reliability (Intraclass Correlation Coefficient = 0.86) [19].

All participants of both groups (control and experimental) answered the PPS-10 questionnaire before the auricular acupuncture intervention (pre-intervention) and eight weeks after intervention (post intervention). We explained to the workers how to complete the questionnaire each employee responded to the questionnaire individually, but the researcher was available to clarify any doubts, if necessary. The questionnaire was placed in an envelope with preestablished numbers to avoid identification and any embarrassment in answering the questions.

Statistical analysis

Data were tabulated on an Excel spreadsheet, and the results were presented in a descriptive way, including mean, standard deviation and median. The analyses of the data were submitted to normality test (Kolmogorov-Smirnov). The Mann-Whitney and Wilcoxon tests were used to compare the control and experimental groups at pre and post intervention moments. Data were processed using the Statistica 7.0 software (StatSoft, Inc. 1984-2004) and the level of significance was set at p <0.05 in all the analyses.


There was no significant difference between the control and experimental groups for demographics data and time in the current study (Table 1).

Citation:Silveira AF, Rodrigues VRMC, Nascimento LCG, Bittar CML, Zaia JE and Quemelo PRV. Acupuncture Effects on the Stress Level in Administrative Workers. Ann Yoga Phys Ther. 2017; 2(3): 1028.