Acupressure for Agitation, Pain, and Sleep in Mechanically Ventilated ICU Patients

Inclusion Criteria: * Adult patients aged 20 years or older * Admitted to an intensive care unit * Receiving mechanical ventilation via an oral endotracheal tube * Richmond Agitation-Sedation Scale (RASS) score between +2 and +3 * Expected to remain in the ICU for at least 4 consecutive days * Able to receive acupressure intervention as determined by the clinical care team Exclusion Criteria: * planned extubation or ventilator weaning during the study period to ensure a stable clinical condition throughout the intervention period * requirement for deep sedation (e.g., continuous high-dose midazolam or propofol) * severely hemodynamic or respiratory instability (e.g., APACHE II ≥30, heart rate ≥150 beats/min with severe arrhythmia, respiratory rate ≥30 breaths/min, SpO₂ \<90%, or use of high-dose vasopressors with mean arterial pressure ≤50 mmHg) * severe agitation requiring immediate pharmacological restraint * diagnosed delirium, psychiatric disorders, or neurocognitive disorders * bleeding tendency (e.g., platelet count \<20,000/µL) or contraindications to acupressure