Effectiveness of auriculotherapy for anxiety, stress or burnout in health professionals: a network meta-analysis

Authors’ contribution

Study concept and design: Oclaris Lopes Munhoz, Bruna Xavier Morais, Cristiane Cardoso de Paula, Tânia Solange Bosi de Souza Magnago. Obtaining data: Oclaris Lopes Munhoz, Bruna Xavier Morais, Cristiane Cardoso de Paula, Tânia Solange Bosi de Souza Magnago. Data analysis and interpretation: Oclaris Lopes Munhoz, Bruna Xavier Morais, Wendel Mombaque dos Santos, Cristiane Cardoso de Paula, Tânia Solange Bosi de Souza Magnago. Statistical analysis: Oclaris Lopes Munhoz, Bruna Xavier Morais, Wendel Mombaque dos Santos, Cristiane Cardoso de Paula, Tânia Solange Bosi de Souza Magnago. Obtaining financing: Oclaris Lopes Munhoz, Bruna Xavier Morais, Tânia Solange Bosi de Souza Magnago. Drafting the manuscript: Oclaris Lopes Munhoz, Bruna Xavier Morais, Wendel Mombaque dos Santos, Cristiane Cardoso de Paula, Tânia Solange Bosi de Souza Magnago. Critical review of the manuscript as to its relevant intellectual content: Oclaris Lopes Munhoz, Bruna Xavier Morais, Wendel Mombaque dos Santos, Cristiane Cardoso de Paula, Tânia Solange Bosi de Souza Magnago. All authors approved the final version of the text.

Conflict of interest

The authors have declared that there is no conflict of interest.

Information sources	Strategy	References retrieved
MEDLINE (PubMed)	((((“auriculotherapy”[MeSH Terms]) OR (“acupuncture, ear”[MeSH Terms])) OR (“auriculotherapy”[All Fields])) OR (“acupuncture ear”[All Fields])) OR (“nada protocol”[All Fields]) AND (((((((((“anxiety”[MeSH Terms]) OR (“occupational stress”[MeSH Terms])) OR (“stress, physiological”[MeSH Terms])) OR (“burnout, psychological”[MeSH Terms])) OR (“anxiety”[All Fields])) OR (“occupational stress”[All Fields])) OR (“stress physiological”[All Fields])) OR (“burnout psychological”[All Fields])) OR (“stress”[All Fields])) OR (“burnout”[All Fields]) AND (((“health personnel”[MeSH Terms]) OR (“health personnel”[Title/Abstract])) OR (“workers”[Title/Abstract])) OR (“professionals”[Title/Abstract])	12
SCOPUS (Elsevier)	“auriculotherapy” OR “acupuncture, ear” OR “nada protocol” AND “anxiety” OR “occupational stress” OR “stress, physiological” OR “burnout, psychological” OR “stress” OR “burnout” AND “health personnel” OR “professionals” OR “workers” AND (LIMIT-TO (LANGUAGE, “English”) OR LIMIT-TO ( LANGUAGE , “Portuguese”) OR LIMIT-TO ( LANGUAGE, “Spanish”))	106
EMBASE (Elsevier)	‘auricular acupuncture’/exp OR ‘auricular acupuncture’ AND ‘anxiety’/exp OR ‘anxiety’ OR ‘job stress’/exp OR ‘job stress’ OR ‘mental stress’/exp OR ‘mental stress’ OR ‘professional burnout’/exp OR ‘professional burnout’ OR ‘burnout’/exp OR ‘burnout’	123
LILACS	(“auriculoterapia” OR “acupuntura auricular” OR “auriculotherapy” OR “acupuncture, ear” OR “nada protocol”) AND (“ansiedade” OR “estresse ocupacional” OR “estresse psicológico” OR “esgotamento psicológico” OR “estresse” OR “burnout” OR “anxiety” OR “occupational stress” OR “stress, physiological” OR “burnout, psychological” OR “stress” OR “ansiedad” OR “estrés laboral” OR “estrés psicológico” OR “agotamiento psicológico”) AND ( db:(“LILACS” OR “MTYCI”) AND la:(“pt” OR “es” OR “en”))	43
VHL TCIM	(“auriculoterapia” OR “acupuntura auricular” OR “auriculotherapy” OR “acupuncture, ear” OR “nada protocol”) AND (“ansiedade” OR “estresse ocupacional” OR “estresse psicológico” OR “esgotamento psicológico” OR “estresse” OR “burnout” OR “anxiety” OR “occupational stress” OR “stress, physiological” OR “burnout, psychological” OR “stress” OR “ansiedad” OR “estrés laboral” OR “estrés psicológico” OR “agotamiento psicológico”) AND ( db:(“LILACS” OR “MTYCI”) AND la:(“pt” OR “es” OR “en”))	13
Web of Science Core Collection (Clarivate analytics)	TS=(auriculotherapy OR “acupuncture ear” OR nada protocol) AND TS=(anxiety OR “occupational stress” OR “stress physiological” OR “burnout psychological” OR stress OR burnout) AND TS=(“health personnel” OR professionals OR workers) AND TI=(auriculotherapy OR “acupuncture ear” OR “nada protocol”) AND TI=(anxiety OR “occupational stress” OR “stress physiological” OR “burnout psychological” OR stress OR burnout) AND TI=(“health personnel” OR professionals OR workers) AND AB=(auriculotherapy OR “acupuncture ear” OR “nada protocol”) AND AB=(anxiety OR “occupational stress” OR “stress physiological” OR “burnout psychological” OR stress OR burnout) AND AB=(“health personnel” OR professionals OR workers) AND AK=(auriculotherapy OR “acupuncture ear” OR “nada protocol”) AND AK=(anxiety OR “occupational stress” OR “stress physiological” OR “burnout psychological” OR stress OR burnout) AND AK=(“health personnel” OR professionals OR workers) Índices=SCI-EXPANDED, SSCI, A&HCI, CPCI-S, CPCI-SSH, ESCI Tempo estipulado=Todos os anos	9
CINAHL (EBSCO)	TX ( auriculotherapy OR “acupuncture ear” OR “nada protocol” ) AND TX ( anxiety OR “occupational stress” OR “stress physiological” OR “burnout psychological” OR stress OR burnout ) AND TX ( “health personnel” OR professionals OR workers )	47
APA PsycINFO (EBSCO)	“auriculotherapy” OR Any Field: “acupuncture ear” OR Any Field: “nada protocol” AND Any Field: “anxiety” OR Any Field: “occupational stress” OR Any Field: “stress physiological” OR Any Field: “burnout psychological” OR Any Field: “stress” OR Any Field: “burnout” AND Any Field: “health personnel” OR Any Field: “professionals” OR Any Field: “workers”	6
Cochrane Central Register of Controlled Trials (CENTRAL)	“auriculotherapy” OR “acupuncture, ear” OR “nada protocol”	429

Authorship of the study, journal and year	Outcomes evaluated	Participants, number and interval between the auriculotherapy sessions and follow-up	Ear points	Material used for the auriculotherapy sessions	Main results
Giaponesi ALL, et al. Rev. Nursing, 2009.²⁴24. Giaponesi ALL, Leão ER. Estresse da equipe de enfermagem em terapia intensiva: a auriculoterapia como intervenção de saúde. Rev Nursing [Internet]. 2009 [cited 2021 Dec 12];12(139):575-9. Available from: https://pesquisa.bvsalud.org/portal/resource/pt/lil-542129 https://pesquisa.bvsalud.org/portal/reso...	- Stress	- 41 Nursing professionals - 8 sessions, with 7-day intervals - No follow-up	- Shen men and brainstem	- This information is not included in the article	The mean for stress (27%) was reduced to 10%, as 17% of the subjects started to show little stress and 35 individuals (85.4%) reported an improvement in their Stress level.
Kurebayashi LFS, et al. Rev. Acta Paulista de Enf, 2012.²⁵25. Kurebayashi LFS, Gnatta JR, Borges TP, Silva MJP. Effectiveness of auriculotherapy for stress, based on experience of the therapist: a clinical trial. Acta Paul Enferm. 2012;25(5):694-700. Doi: 10.1590/S0103-21002012000500008 https://doi.org/10.1590/S0103-2100201200...	- Stress	- 49 Nursing professionals - 8 sessions, with 7-day intervals - Follow-up = 15 days	- Shen men, kidney and brainstem	- Semi-permanent needles	There was a significant difference between the Control Group and Group 3 (more experienced therapists) (p=0.036), between LSS^3/LSS^1 and between LSS^4/LSS^1 during follow-up (p=0.033). Group 2 (less experienced) showed significance for LSS^4/LSS^1 (p=0.059).
Kurebayashi LFS, et al. Rev Esc Enferm USP, 2012.²⁶26. Kurebayashi LFS, Gnatta JR, Borges TP, Belisse G, Coca S, Minami A, et al. The applicability of auriculotherapy with needles or seeds to reduce stress in nursing professionals. Rev Esc Enferm USP. 2012;46(1):89-95. Doi: 10.1590/S0080-62342012000100012 https://doi.org/10.1590/S0080-6234201200... Kurebayashi LFS, et al. Rev. Latino-Am. Nursing, 2012.²⁷27. Kurebayashi LFS, Gnatta JR, Borges TP, Silva MJP. Applicability of auriculotherapy in reducing stress and as a coping strategy in nursing professionals. Rev. Latino-Am. Enfermagem. 2012;20(5). Doi: 10.1590/S0104-11692012000500021 https://doi.org/10.1590/S0104-1169201200... Kurebayashi LFS, et al. Rev. Eletr Enf, 2014.²⁹29. Kurebayashi LFS, Gnatta JR, Borges TP, Silva MJP. Traditional chinese medicine diagnostic evaluation of stress symptoms treated by auriculotherapy: a clinical trial. Rev Eletr Enf. 2014;16(1):68-76. Doi: 10.5216/ree.v16i1.20167 https://doi.org/10.5216/ree.v16i1.20167...	- Stress	- 75 Nursing professionals - 8 sessions, with 7-day intervals - Follow-up = 15 days	- Shen men, kidney and brainstem	- Semi-permanent needles - Mustard seeds	Statistically significant differences were verified when all three groups were compared, at 4 different moments (LSS^1, LSS^2, LSS^3, LSS^4). The significance level between the differences of the results was p=0.020 between LSS^3 and LSS^1 and p=0.003 when LSS^4 and LSS^1 were compared. The seed group did not present statistically significant differences.
Reilly PM, et al. Rev Dimen of Crit Care Nursing, 2014.¹³13. Reilly PM, Buchanan TM, Vafides C, Breakey S, Dykes P. Auricular acupuncture to relieve health care workers' stress and anxiety: impact on caring. Dimens Crit Care Nurs. 2014;33(3):151-9. Doi: 10.1097/DCC.0000000000000039 https://doi.org/10.1097/DCC.000000000000...	- Anxiety - Burnout	- 37 health professionals - 5 sessions, with 7-day intervals - No follow-up	- Shen men, sympathetic, lung, liver and kidney	- Stainless steel ear acupuncture needles	There was a significant reduction in state anxiety (p=0.000) and trait anxiety (p=0.007), and for burnout (p=0.006) in the treated participants when compared to the baseline.
Gagliardi G, et al. Rev. Medical Acupuncture, 2014.²⁸28. Gagliardi G, Meneghetti M, Ceccherelli F, Giommi A, Romoli M. Auricular acupuncture for anxiety in health care volunteers: randomized crossover study comparing real and sham needles. Rev Medical Acupuncture. 2014;26(3). Doi: 10.1089/acu.2014.1036 https://doi.org/10.1089/acu.2014.1036...	- Anxiety	- 20 health professionals - 2 sessions with 2-week intervals - No follow-up	- Points according to the individual evaluation of each participant (without a closed protocol)	- Real needles - Fake needles	There was a significantly higher reduction of anxiety in the real needle group for the NRS^† anxiety (p<0.01) and state anxiety (p<0.005) scores.
Kurebayashi LFS, et al. Rev. Latino-Am. Nursing, 2014.³⁰30. Kurebayashi LFS, Silva MJP. Efficacy of Chinese auriculotherapy for stress in nursing staff: a randomized clinical trial. Rev. Latino-Am. Enfermagem. 2014;22(3):371-8. Doi: 10.1590/0104-1169.3239.2426 https://doi.org/10.1590/0104-1169.3239.2... Kurebayashi LFS, et al. Rev. Bras Enferm, 2015.³¹31. Kurebayashi LFS, Silva MJP. Chinese auriculotherapy to improve quality of life of nursing team. Rev Bras Enferm. 2015;68(1):117-23. Doi: 10.1590/0034-7167.2015680116p https://doi.org/10.1590/0034-7167.201568...	- Stress	- 175 Nursing professionals - 12 sessions, with 7-day intervals - Follow-up = 30 days	- Shen men, brain tem, kidney and liver yang 1 and 2	- Semi-permanent needles	Stress was reduced (p<0.05) in both intervention groups. There were significant differences between the stress mean values in the second evaluation after 12 appointments (LSS^*2) (F=21.92/p=0.000) an in the 30-day follow-up (F=7.59/0=0.001); as well as in the second evaluation between the Control and Intervention groups (p=0.000). In the third evaluation (LSS3), the differences were between the Control group and protocol (p=0.004) and between the Control group and no protocol (p=0.002).
Kurebayashi LFS, et al. Rev. Latino-Am. Nursing, 2017.⁸8. Kurebayashi LFS, Turrini RNT, Souza TPB, Marques CF, Rodrigues RTF, Charlesworth K. Auriculotherapy to reduce anxiety and pain in nursing professionals: a randomized clinical trial. Rev. Latino-Am. Enfermagem. 2017;25:e2843. Doi: 10.1590/1518-8345.1761.2843 https://doi.org/10.1590/1518-8345.1761.2...	- Anxiety	- 133 Nursing professionals - 10 sessions, with 3-day intervals - No follow-up	- Shen men, tranquilizer, thalamus, sympathetic, zero point	- Semi-permanent needles - Mustard seeds	There were significant differences for the reduction of anxiety after 10 sessions. The group with semi-permanent needles reached a large effect and 17% reduction.
Buchanan TM, et al. Rev. Dimensions of Critical Care Nursing, 2018.⁹9. Buchanan TM, Reilly PM, Vafides C, Dykes P. Reducing Anxiety and Improving Engagement in Health Care Providers Through an Auricular Acupuncture Intervention. Dimens Crit Care Nurs. 2018;37(2):87-96. Doi: 10.1097/DCC.0000000000000288 https://doi.org/10.1097/DCC.000000000000...	- Anxiety	- 42 health professionals - 5 sessions, with 7-day intervals - No follow-up	- Shen men, sympathetic, lung, liver and kidney	- Disposable needles	Seven percentiles of state and trait anxiety decreased by approximately 15 points. When comparing the post-intervention scores to the baseline, there is a significant reduction in state anxiety (from 37.64 to 32.6; p=0.0001) and trait anxiety (from 38.14 to 34.64; p=0.0001).
Araújo JS, et al. Rev. Enferm UFPE, 2018.³²32. Araújo JS, Domingos TS, Braga EM. Auriculotherapy for the stress of the nursing team in the medium hospital complexity. Rev Enferm UFPE. 2018;12(2):371-8. Doi: 10.5205/1981-8963-v12i2a25129p25129-25129-2018 https://doi.org/10.5205/1981-8963-v12i2a...	- Stress	- 16 Nursing professionals - 8 sessions, with 7-day intervals - No follow-up	- Shen men and brainstem	- Crystals	The nurses did not have their stress level reduced. At baseline there were five participants (83.3%) in the stress-free phase and one (16.6%) in resistance; at the 8^th application, all nurses were stress-free; and there was a significant reduction in stress (p=0.317). During follow-up, one participant returned to the resistance phase. There was stress reduction in nursing assistants between baseline and follow-up (p=0.034).
Prado JM, et al. Rev Esc Enferm USP, 2018.¹²12. Prado JM, Kurebayashi LFS, Silva MJP. Experimental and placebo auriculotherapy for stressed nurses: randomized controlled trial. Rev Esc Enferm USP. 2018;52:e03334. Doi: 10.1590/S1980-220X2017030403334 https://doi.org/10.1590/S1980-220X201703...	- Stress	- 168 nurses - 12 sessions, with 3-day intervals - Follow-up = 15 days	- Shen men and brainstem (intervention) - External ear and cheek area (placebo)	- The material used is not specified	There were statistical differences in the analysis between all three groups (p=0.000). In the post hoc period there was a difference for the auriculotherapy group between the baseline and the 2^nd evaluation, after eight sessions, remaining in the third evaluation (12 sessions) until follow-up (p=0.000).
Olshan-Perlmutter M, et al. Rev. Applied Nursing Research, 2019.³³33. Olshan-Perlmutter M, Carter K, Marx J. Auricular acupressure reduces anxiety and burnout in behavioral healthcare. Appl Nurs Res. 2019;49:57-63. Doi: 10.1016/j.apnr.2019.05.011 https://doi.org/10.1016/j.apnr.2019.05.0...	- Anxiety - Burnout	- 98 health professionals - 6 sessions, with 7-day intervals - No follow-up	- Shen men	- Magnetic palettes	Group 1 (treatment during the first six weeks) and Group 2 (started treatment at week 7) significantly improved (p<0.05) the anxiety levels after the treatment. When compared to the baseline there was also a significant improvement for burnout in each participant (p<0.05).
Oliveira CMC, et al. Rev. Eletr. Enf, 2021.³⁴34. Oliveira CMC, Assis BB, Mendes PG, Lemos IC, Sousa ALC, Chianca TCM. Auriculotherapy in nursing professionals during the coronavirus pandemic: a multiple case study. Rev Eletr Enferm. 2021;23:65678. Doi: 10.5216/ree.v23.65678 https://doi.org/10.5216/ree.v23.65678...	- Anxiety - Stress	- 41 Nursing professionals - 1 session - Follow-up = 15 days	- Shen men, kidney, sympathetic, joy, anxiety, antidepressant, heart, endocrine, lung and muscle relaxation	- Mustard seeds	The anxiety levels were significantly reduced: medians from six to four (p<0.001). The stress mean values were significantly reduced from 19.37 to 11.95 (p<0.001).

Outcome	Study	Measuring instruments	Intervention Group				Control Group/Placebo/Sham
Outcome	Study	Measuring instruments	Group	Mean (I=Initial; F=Final)	Standard Deviation (I=Initial; F=Final)	Pop^*	Group	Mean (I=Initial; F=Final)	Standard Deviation (I=Initial; F=Final)	Pop^*
Anxiety	Gagliardi G, et al.²⁸28. Gagliardi G, Meneghetti M, Ceccherelli F, Giommi A, Romoli M. Auricular acupuncture for anxiety in health care volunteers: randomized crossover study comparing real and sham needles. Rev Medical Acupuncture. 2014;26(3). Doi: 10.1089/acu.2014.1036 https://doi.org/10.1089/acu.2014.1036...	STAI^† NRS^‡	Real needle	STAI^† I: 45.50 F: 41.00	STAI^† I: 3.38 F: 3.15	20	Fake needle	STAI^† I: 45.10 F: 43.60	STAI^† I: 3.8 F: 2.01	20
		STAI^† NRS^‡	Real needle	NRS^‡ I: 3.1 F: 1.7	NRS^‡ I: 0.76 F: 0.75	20	Fake needle	NRS^‡ I: 3.0 F: 2.3	NRS^‡ I: 0.73 F: 0.86	20
	Reilly PM, et al.¹³13. Reilly PM, Buchanan TM, Vafides C, Breakey S, Dykes P. Auricular acupuncture to relieve health care workers' stress and anxiety: impact on caring. Dimens Crit Care Nurs. 2014;33(3):151-9. Doi: 10.1097/DCC.0000000000000039 https://doi.org/10.1097/DCC.000000000000...	STAI^†	Single group (needle)	Trait I: 37.20 F: 34.20	Trait I: 7.70 F: -^††	37	Does not apply
		STAI^†	Single group (needle)	State I: 38.30 F: 32.30	State I: 7.70 F: -^††	37	Does not apply
	Kurebayashi LFS, et al.⁸8. Kurebayashi LFS, Turrini RNT, Souza TPB, Marques CF, Rodrigues RTF, Charlesworth K. Auriculotherapy to reduce anxiety and pain in nursing professionals: a randomized clinical trial. Rev. Latino-Am. Enfermagem. 2017;25:e2843. Doi: 10.1590/1518-8345.1761.2843 https://doi.org/10.1590/1518-8345.1761.2...	STAI^†	Seeds	I: 49.30 F: 42.80	I: 7.90 F: 10.50	35	No intervention	I: 48.0 F: 46.7	I: 9.3 F: 10.4	31
		STAI^†	Needle	I: 51.60 F: 42.90	I: 9.80 F: 6.30	34	Adhesive tape	I: 49.50 F: 44.10	I: 8.70 F: 8.90	33
	Buchanan TM, et al.³²32. Araújo JS, Domingos TS, Braga EM. Auriculotherapy for the stress of the nursing team in the medium hospital complexity. Rev Enferm UFPE. 2018;12(2):371-8. Doi: 10.5205/1981-8963-v12i2a25129p25129-25129-2018 https://doi.org/10.5205/1981-8963-v12i2a...	STAI^†	Single group (needle)	Trait I: 38.14 F: 34.62	Trait I: 9.28 F: 8.74	42	Does not apply
		STAI^†	Single group (needle)	State I: 37.64 F: 32.60	State I: 9.44 F: 9.34	42	Does not apply
	Olshan-Perlmutter M, et al.³³33. Olshan-Perlmutter M, Carter K, Marx J. Auricular acupressure reduces anxiety and burnout in behavioral healthcare. Appl Nurs Res. 2019;49:57-63. Doi: 10.1016/j.apnr.2019.05.011 https://doi.org/10.1016/j.apnr.2019.05.0...	GAD-7^§	Initial treatment (Magnetic palettes)	I: 6.14 F: 3.65	I: 4.80 F: -^††	51	Waiting list	I: 5.91 F: 5.65	I: 4.9 F: -^††	47
	Oliveira CMC, et al.³⁴34. Oliveira CMC, Assis BB, Mendes PG, Lemos IC, Sousa ALC, Chianca TCM. Auriculotherapy in nursing professionals during the coronavirus pandemic: a multiple case study. Rev Eletr Enferm. 2021;23:65678. Doi: 10.5216/ree.v23.65678 https://doi.org/10.5216/ree.v23.65678...	DASS-21^\|\|	Single group (seeds)	I: 6 (median) F: 4 (median)	I: 4-16 (IQR^‡‡) F: 0-7 (IQR^‡‡)	41	Does not apply
Stress	Kurebayashi LFS, et al.²⁷27. Kurebayashi LFS, Gnatta JR, Borges TP, Silva MJP. Applicability of auriculotherapy in reducing stress and as a coping strategy in nursing professionals. Rev. Latino-Am. Enfermagem. 2012;20(5). Doi: 10.1590/S0104-11692012000500021 https://doi.org/10.1590/S0104-1169201200... Kurebayashi LFS, et al.²⁹29. Kurebayashi LFS, Gnatta JR, Borges TP, Silva MJP. Traditional chinese medicine diagnostic evaluation of stress symptoms treated by auriculotherapy: a clinical trial. Rev Eletr Enf. 2014;16(1):68-76. Doi: 10.5216/ree.v16i1.20167 https://doi.org/10.5216/ree.v16i1.20167...	LSS^¶	Needles	I: 66.82 F: 48.48	I: 18.56 F: 27.35	27	No intervention	I: 54.36 F: 55.77	I: 15.90 F: 30.98	22
		LSS^¶	Seeds	I: 63.27 F: 53.36	I: 26.05 F: 32.72	26	No intervention	I: 54.36 F: 55.77	I: 15.90 F: 30.98	22
	Kurebayashi LFS, et al.³⁰30. Kurebayashi LFS, Silva MJP. Efficacy of Chinese auriculotherapy for stress in nursing staff: a randomized clinical trial. Rev. Latino-Am. Enfermagem. 2014;22(3):371-8. Doi: 10.1590/0104-1169.3239.2426 https://doi.org/10.1590/0104-1169.3239.2... Kurebayashi LFS, et al.³¹31. Kurebayashi LFS, Silva MJP. Chinese auriculotherapy to improve quality of life of nursing team. Rev Bras Enferm. 2015;68(1):117-23. Doi: 10.1590/0034-7167.2015680116p https://doi.org/10.1590/0034-7167.201568...	LSS^¶	With protocol (needles)	I: 62.26 F: 48.50	I: 21.50 F: 22.90	58	No intervention	I: 57.76 F: 63.21	I: 17.64 F: 26.85	58
		LSS^¶	No protocol (needles)	I: 65.00 F: 47.22	I: 22.62 F: 23.87	59	No intervention	I: 57.76 F: 63.21	I: 17.64 F: 26.85	58
	Prado JM, et al.¹²12. Prado JM, Kurebayashi LFS, Silva MJP. Experimental and placebo auriculotherapy for stressed nurses: randomized controlled trial. Rev Esc Enferm USP. 2018;52:e03334. Doi: 10.1590/S1980-220X2017030403334 https://doi.org/10.1590/S1980-220X201703...	LSS^¶	Points indicated for stress	I: 72.40 F: 41.30	I: 17.90 F: 16.40	43	No intervention	I: 69.30 F: 66.80	I: 17.80 F: 27.60	43
		LSS^¶	Points indicated for stress	I: 72.40 F: 41.30	I: 17.90 F: 16.40	43	Sham points	I: 66.70 F: 51.80	I: 17.30 F: 27.00	47
	Oliveira CMC, et al.³⁴34. Oliveira CMC, Assis BB, Mendes PG, Lemos IC, Sousa ALC, Chianca TCM. Auriculotherapy in nursing professionals during the coronavirus pandemic: a multiple case study. Rev Eletr Enferm. 2021;23:65678. Doi: 10.5216/ree.v23.65678 https://doi.org/10.5216/ree.v23.65678...	DASS-21^\|\|	Single group (seeds)	I: 19.37 F: 11.95	I: 10.61 F: 8.51	41	Does not apply
Burnout	Olshan-Perlmutter M, et al.³³33. Olshan-Perlmutter M, Carter K, Marx J. Auricular acupressure reduces anxiety and burnout in behavioral healthcare. Appl Nurs Res. 2019;49:57-63. Doi: 10.1016/j.apnr.2019.05.011 https://doi.org/10.1016/j.apnr.2019.05.0...	PQOL^**	Initial treatment (Magnetic palettes)	I: 22.30 F: 20.42	I: 5.11 F: -^††	51	Waiting list	I: 20.08 F: 21.56	I: 5.25 F: -^††	47
Burnout	Reilly PM, et al.¹³13. Reilly PM, Buchanan TM, Vafides C, Breakey S, Dykes P. Auricular acupuncture to relieve health care workers' stress and anxiety: impact on caring. Dimens Crit Care Nurs. 2014;33(3):151-9. Doi: 10.1097/DCC.0000000000000039 https://doi.org/10.1097/DCC.000000000000...	PQOL^**	Single group (needle)	I: 22.90 F: 21.30	I: 5.40 F: 6.00	37	Does not apply

ANXIETY
Semi-permanent needles	-0.49 (-1.12, 0.14)	-2.72 (-3.25, -2.20)	-1.92 (-2.86, -1.02)	-7.14 (-8.18, -6.10)
	Magnetic palettes	-2.23 (-2.58, -1.88)	-1.45 (-2.45, -0.45)	-6.65 (-7.76, -5.54)
		Placebo	0.78 (-0.15, 1.72)	-4.42 (-5.47, -3.36)
			Seeds	-5.20 (-6.35, -4.05)
				No intervention
STRESS
Semi-permanent needles	-16.01 (-33.47, 1.46)	-4.12 (-17.29, 9.05)	-0.46 (-17.90, 16,984)	-24.05 (-37.21, -10.88)
	Placebo	11.88 (-0.97, 24.74)	15.55 (-1.66, 32.76)	-8.04 (-20.91, 4.83)
		Seeds	3,663 (-9.16, 16.49)	-19.92 (-28.14, -11.70)
			Semi-permanent needle (without a closed protocol)	-23.59 (-36.42, -10.76)
				No intervention

[1] Corresponding author
Tania Solange Bosi de Souza Magnago. E-mail: magnago.tania@gmail.com

Brasil

Brasil

Effectiveness of auriculotherapy for anxiety, stress or burnout in health professionals: a network meta-analysis

Abstract

Objective:

Method:

Results:

Conclusion: