AKiPal: Protocol for a Mixed-Methods Pilot and Feasibility Study of a Nurse-Led Acupressure Intervention in...

Background: Patients receiving palliative and hospice care frequently experience high symptom burden alongside altered body perception due to progressive disease and physical decline. While acupressure has demonstrated beneficial effects on symptoms such as nausea, pain, fatigue, and anxiety, its potential influence on body awareness has not been systematically investigated. Furthermore, evidence regarding the feasibility and implementation of nurse-led acupressure interventions across different palliative and hospice care settings remains limited. This study aims to explore the feasibility, acceptability, and potential effects of acupressure on symptom burden and body awareness in palliative care settings. Methods: This pilot study evaluates a nurse-led acupressure intervention aimed at improving body awareness in patients receiving palliative and hospice care across specialized inpatient and outpatient settings. This study is designed as a prospective, exploratory, mixed-methods pilot and feasibility study using a pre-post design across multiple care settings, including a palliative care unit, specialized palliative home care (SAPV), an inpatient palliative consultation service (PMD), and a hospice. A total of 60-80 adult patients with incurable illnesses will be recruited. The intervention consists of standardised acupressure administered by trained nursing staff, with at least two sessions per participant. Primary outcomes focus on feasibility and acceptability indicators, including recruitment, retention, adherence, intervention documentation, and data completeness. Exploratory clinical outcomes include symptom burden, body awareness, and use of on-demand medication. Quantitative outcomes include symptom burden (MIDOS), body awareness (State Mindfulness Scale-Body subscale), and use of on-demand medication. Qualitative data will be collected through brief patient interviews using the Body Image Assessment (BIA) and semi-structured interviews with patients and healthcare providers after the completed intervention. Data will be analysed using descriptive and exploratory inferential statistics, alongside a linguistic and thematic analysis. Quantitative and qualitative findings will be integrated using a convergent triangulation approach. Discussion: This study will provide first insights into the feasibility and acceptability of acupressure in palliative and hospice care and generate hypotheses regarding its potential effects on symptom relief and body awareness. Findings will inform the design of a future randomized controlled trial and contribute to the implementation of complementary therapies in integrative palliative care.