Effect and safety of acupuncture for Hwa-byung, an anger syndrome: a study protocol of a randomized controlled pilot trial

Acupuncture for Psychosomatic Symptoms of Hwa-byung, an Anger Syndrome: A Feasibility Randomized Controlled Trial

Objectives: Emerging studies found the potential effects of acupuncture for treating chronic pain and mental disorders, namely, depressive and anxiety disorders. Acupuncture is widely used for treating culture-related anger syndrome, Hwa-byung. This pilot trial aimed to investigate the feasibility of a clinical trial testing acupuncture for the psychosomatic symptoms of Hwa-byung.

Methods: A total of 26 patients with Hwa-byung planned to be randomly assigned to the acupuncture or sham acupuncture groups. About 10 treatment sessions were applied over 4 weeks. The 100-mm visual analog scale was used to measure the six major Hwa-byung symptoms: stuffiness in the chest, heat sensations, pushing-up in the chest, feeling a mass in the throat, feelings of unfairness, and hard feelings. The criteria for assessing the success of this pilot trial were defined as improvement in three or more of the six Hwa-byung symptoms after treatment, with an effect size >0.2.

Results: A total of 15 patients were finally included and randomly assigned to the acupuncture group (n = 7) or the sham acupuncture group (n = 8). After 10 treatment sessions, the Cohen's d effect sizes for acupuncture compared to sham acupuncture were >0.2 for each one of the six major Hwa-byung symptoms, which met our a priori criteria for success. Also, the effect size for the somatic symptoms of “stuffiness in the chest” was 0.81 (95% CI −0.40, 2.20), referring to a large effect size.

Conclusions: Our results suggest that acupuncture treatment would be regarded as an acceptable intervention for a full-scale study of psychosomatic symptoms in patients with Hwa-byung.

Trial Registration:cris.nih.go.kr, identifier: KCT0001732.

Development and Validation of the Happiness Scale for Middle-Aged Women Based on Existence, Relation, and Growth Theory

PURPOSE

This study aimed at developing a happiness assessment scale for middle-aged women (HAS-MW) in Korea.

METHODS

Preliminary items for the scale were drafted from the results of literature review and personal interviews and open-ended questions with women in the community. The interviews were based on the theory of existence, relatedness, and growth. After validating a preliminary scale, we analyzed the validity and reliability of the new scale items, and model fit. We surveyed 600 women aged 40 years to 64 years for exploratory factor analysis (EFA) and confirmatory factor analysis (CFA). Valid data were divided into 352 for EFA and 174 for CFA by multiplies of number 1 to 3.

RESULTS

Using exploratory and confirmatory factor analyses, we extracted four primary factors-self-value, positive thinking, self-care, and family relationship-and with a total of 24 items for HAS-MW. The fit of the final model was evaluated as good showing χ²/df = 2.10, goodness of fit index = .80, comparative fit index = .85, root mean square error of approximation = .08, standardized root mean residual = .05. The HAS-MW had a significant positive correlation with the Oxford Happiness scale and showed a significant negative correlation with the Hwa-Byeong Scale. Cronbach's α for the new scale was .91, and the Spearman-Brown half coefficient was .93. The new scale used a five-point Likert scale with higher scores indicating greater happiness.

CONCLUSION

The HAS-MW is a reliable and valid one. It can be used to measure the level of happiness for middle-aged women. In addition, it might be applied to find low women and to evaluate the effect of intervention program related to happiness in woman of middle age.