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Beyond needling--therapeutic processes in acupuncture care: a qualitative study nested within a low-back pain trial.
J Altern Complement Med. 2006 Nov; 12(9):873-80.JA

Abstract

BACKGROUND

In the medical and scientific literature, there is a dearth of reports about how acupuncturists work and deliver care in practice. An informed characterization of the treatment process is needed to support the appropriate design of evaluative studies in acupuncture.

METHODS

The design was that of a nested qualitative study within a pragmatic clinical trial. Six acupuncturists who treated up to 25 patients each were interviewed after the treatment phase of the trial to obtain an account of their experiences of providing acupuncture care to patients with low back pain referred by their GP. Using semistructured interviews and a topic guide, data were collected and analyzed for both a priori and emergent themes. This paper focuses on practitioners' accounts of the goals and processes of care, and describes the strategies employed in addition to needling and other hands-on treatments.

RESULTS

From the interview data, it is clear that a coherent body of theoretical knowledge informed clinical decisions and practice, and that the goals of treatment went beyond the alleviation of immediate pain-related symptoms. Acupuncturists in this study all described a pattern of patient-centered care based on a therapeutic partnership. Study participants confirmed the importance of three processes that characterized acupuncture care in this trial, each contributing to the goal of a positive long-term outcome; building a therapeutic relationship; individualizing care; and facilitating the active engagement of patients in their own recovery. Acupuncturists described elements of care that characterized these processes including establishing rapport, facilitating communication throughout the period of care, using an interactive diagnostic process, matching treatment to the individual patient, and the use of explanatory models from Chinese medicine to aid the development of a shared understanding of the patient's condition and to motivate lifestyle changes that reinforce the potential for a recovery of health. Acupuncturists did not view these therapeutic goals, processes, and strategies as a departure from their usual practice.

CONCLUSIONS

This study suggests that acupuncture care for patients with chronic conditions such as low back pain is likely to be a complex intervention that utilizes a number of patient-centered strategies to elicit longterm therapeutic benefits. Research designed to evaluate the effectiveness of acupuncture as it is practiced in the UK needs to accommodate the full range of therapeutic goals and related treatment processes.

Authors+Show Affiliations

Foundation for Traditional Chinese Medicine, York, UK.No affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

17109578

Citation

MacPherson, Hugh, et al. "Beyond Needling--therapeutic Processes in Acupuncture Care: a Qualitative Study Nested Within a Low-back Pain Trial." Journal of Alternative and Complementary Medicine (New York, N.Y.), vol. 12, no. 9, 2006, pp. 873-80.
MacPherson H, Thorpe L, Thomas K. Beyond needling--therapeutic processes in acupuncture care: a qualitative study nested within a low-back pain trial. J Altern Complement Med. 2006;12(9):873-80.
MacPherson, H., Thorpe, L., & Thomas, K. (2006). Beyond needling--therapeutic processes in acupuncture care: a qualitative study nested within a low-back pain trial. Journal of Alternative and Complementary Medicine (New York, N.Y.), 12(9), 873-80.
MacPherson H, Thorpe L, Thomas K. Beyond Needling--therapeutic Processes in Acupuncture Care: a Qualitative Study Nested Within a Low-back Pain Trial. J Altern Complement Med. 2006;12(9):873-80. PubMed PMID: 17109578.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Beyond needling--therapeutic processes in acupuncture care: a qualitative study nested within a low-back pain trial. AU - MacPherson,Hugh, AU - Thorpe,Lucy, AU - Thomas,Kate, PY - 2006/11/18/pubmed PY - 2007/3/14/medline PY - 2006/11/18/entrez SP - 873 EP - 80 JF - Journal of alternative and complementary medicine (New York, N.Y.) JO - J Altern Complement Med VL - 12 IS - 9 N2 - BACKGROUND: In the medical and scientific literature, there is a dearth of reports about how acupuncturists work and deliver care in practice. An informed characterization of the treatment process is needed to support the appropriate design of evaluative studies in acupuncture. METHODS: The design was that of a nested qualitative study within a pragmatic clinical trial. Six acupuncturists who treated up to 25 patients each were interviewed after the treatment phase of the trial to obtain an account of their experiences of providing acupuncture care to patients with low back pain referred by their GP. Using semistructured interviews and a topic guide, data were collected and analyzed for both a priori and emergent themes. This paper focuses on practitioners' accounts of the goals and processes of care, and describes the strategies employed in addition to needling and other hands-on treatments. RESULTS: From the interview data, it is clear that a coherent body of theoretical knowledge informed clinical decisions and practice, and that the goals of treatment went beyond the alleviation of immediate pain-related symptoms. Acupuncturists in this study all described a pattern of patient-centered care based on a therapeutic partnership. Study participants confirmed the importance of three processes that characterized acupuncture care in this trial, each contributing to the goal of a positive long-term outcome; building a therapeutic relationship; individualizing care; and facilitating the active engagement of patients in their own recovery. Acupuncturists described elements of care that characterized these processes including establishing rapport, facilitating communication throughout the period of care, using an interactive diagnostic process, matching treatment to the individual patient, and the use of explanatory models from Chinese medicine to aid the development of a shared understanding of the patient's condition and to motivate lifestyle changes that reinforce the potential for a recovery of health. Acupuncturists did not view these therapeutic goals, processes, and strategies as a departure from their usual practice. CONCLUSIONS: This study suggests that acupuncture care for patients with chronic conditions such as low back pain is likely to be a complex intervention that utilizes a number of patient-centered strategies to elicit longterm therapeutic benefits. Research designed to evaluate the effectiveness of acupuncture as it is practiced in the UK needs to accommodate the full range of therapeutic goals and related treatment processes. SN - 1075-5535 UR - https://www.unboundmedicine.com/medline/citation/17109578/Beyond_needling__therapeutic_processes_in_acupuncture_care:_a_qualitative_study_nested_within_a_low_back_pain_trial_ L2 - https://www.liebertpub.com/doi/10.1089/acm.2006.12.873?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -