Patients' experiences of Western-style acupuncture: the influence of acupuncture 'dose', self-care strategies and integration.
ABSTRACT To investigate patients' perspectives of the process and outcome of Western-style acupuncture for chronic health problems. To use these results to inform the provision of acupuncture in health services in the UK.
A purposive sample of 18 patients who were having Western-style acupuncture, for the first time, for a health problem of at least three months duration, were interviewed twice over a four-month period using semi-structured interviews. Using a constant comparative method, the data were analysed across cases and within cases.
The interviewees complained of chronic pain and moderate or severe disability which was resistant to conventional treatment. Their experience of acupuncture was diverse and varied according to the 'dosage' of acupuncture received, the inclusion of self-care strategies, and their relationship with the practitioner. These three factors were interlinked and constituted individual styles of practice for each practitioner. The majority of patients benefited in terms of complete or partial relief of pain and disability, and reduction in conventional medication. However, some patients were disappointed by the treatment, distressed about 'wasting people's time', and about the lack of continuity of care. People who benefited most had good general health and a single problem.
Patients showed discerning judgement regarding the 'dosage' of acupuncture they required, and combined acupuncture with exercises to good effect. Publicly funded health services should provide an acupuncture service that provides the optimal 'dosage' and uses pain relief to promote self-care. Further research to investigate the benefits of a service that combines Western-style and traditional acupuncture is planned.
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ABSTRACT: The purpose of this study was to observe the response to Western acupuncture performed in a National Health Service (NHS) general practice. Outcomes, patient experience, impact on conventional therapies, and appropriateness of acupuncture in general practice were assessed. An explanatory letter and questionnaire were sent to every patient in a 3-partner rural general practice regarding the acupuncture treatment they had received from the author over a period of 3 years. Completed questionnaires were returned anonymously to the Practice Manager to be collated. There were 194 surveys were posted; 71% were completed and returned to the Practice Manager. Demographics of patients treated with acupuncture demonstrate that it was administered to patients of all age groups, with the majority on the 40-80-year age span, and female-to-male ratio of 64%:36%, respectively. Following the course of acupuncture, 75% of patients surveyed noted an improvement in their presenting condition; 24% noted no change. Those who benefited from the treatment reported the improvement as complete (26%) or major (38%). Seventy-two percent (72%) of patients judged their "quality of life" to be improved. Sixty-nine percent (69%) of patients stated a reduction or cessation of painkillers and/or anti-inflammatory drugs. Fifty-seven percent (57%) thought that referral to hospital specialist or physiotherapist was avoided as a result of the acupuncture treatment. Twenty-three percent (23%) of patients found acupuncture to be painful; of those, 60% said the pain was only mild. Seventy-two percent (72%) of patients were treated within 1 week of being seen by the general practitioner (GP); the majority (81%) of patients had between one and three treatments. Patient opinion on interval time between GP consultation and treatment, as well as appropriateness of acupuncture in the general practice setting, was extremely favorable. This survey demonstrates the application of Western acupuncture within a NHS general practice administered by an individual GP. The patients' response scores from an anonymized questionnaire showed beneficial outcomes from acupuncture; patients also perceived that the treatment negated secondary care referral and reduction or cessation of pain-relieving medication.Journal of alternative and complementary medicine (New York, N.Y.) 06/2012; 18(6):555-60. DOI:10.1089/acm.2010.0398 · 1.52 Impact Factor
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ABSTRACT: Nested qualitative studies within clinical trials provide data on patients' experiences of receiving trial interventions and can inform and improve trial designs. The present study explored patients' experiences of participating in a randomised controlled trial of acupressure wristbands for chemotherapy related nausea. A randomised three-group sham-controlled trial was carried out to evaluate the effectiveness of acupressure wristbands in the management of chemotherapy-related nausea. A convenience sample of 26 patients volunteered to participate in a qualitative study to explore their experiences of using acupressure wristbands, and taking part in the clinical trial. Participants were recruited from each of the three UK geographical sites from which the trial was conducted: Manchester, Liverpool and Plymouth. In-depth semi-structured interviews were conducted with the participants in their own homes or other location convenient for participating patients. Interviews were audio-taped, transcribed verbatim and analysed using Framework methodology. The main motivational factors influencing participants to take part in the trial were a desire to 'give something back' and limit their own experience of nausea. Participants were largely satisfied with the organisation and running of the acupressure wristband trial. Many participants experienced positive outcomes as a result of taking part in the trial. Lapses in memory, or poor health as a result of their chemotherapy treatment, led to some participants failing to complete trial paperwork on designated days. Two sham wristband participants reported wearing the bands inappropriately resulting in pressure being applied to the acupoint. Almost all of the participants interviewed had only experienced mild nausea or vomiting during the trial. Participants were pragmatic on the extent to which the wristbands were responsible for this lack of nausea and vomiting during the trial. However, many participants, including some patients receiving sham acupressure, believed the wristbands to have had a positive impact on their nausea and vomiting; there was a perception that the wristbands were, at least in part, responsible for the lack of nausea and vomiting they had experienced. Participants perceive acupressure wristbands as reducing the level of nausea and vomiting experienced during chemotherapy treatment. Reports that some participants wore wristbands inappropriately, and/or delayed completion of trial paperwork could represent confounding variables and have implications for the trial results, and the design of clinical trials within the field of cancer.BMC Complementary and Alternative Medicine 10/2013; 13(1):260. DOI:10.1186/1472-6882-13-260 · 1.88 Impact Factor
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ABSTRACT: To examine the effect of acupuncture and the relaxation response (RR) for treating gastrointestinal (GI) symptoms in HIV patients who are using highly active antiretroviral therapy (HAART). The authors conducted a 4-arm 2×2 double-blind randomised controlled trial in an acupuncture clinic in the USA. Sham acupuncture and health education were used as the control conditions of real acupuncture and RR elicitation, respectively. Enrolled patients were randomised to real acupuncture+RR (AR), sham acupuncture+RR (SR), real acupuncture+health education (AE) or sham acupuncture+health education (SE) study arm. Participants listened to CDs with RR-eliciting instructions or health education while receiving acupuncture intervention. Interventions were provided twice weekly for 4 weeks and once weekly for another 4 weeks. Participants used daily diaries to record GI symptom severity ratings (0-10). The authors estimated the intervention effect as the changes in symptom rating per intervention session increase using a mixed-effects regression model. A total of 130 people with HIV/AIDS who were on HAART and had persistent GI symptoms were enrolled and 115 started the study intervention. The AR group had greater intervention effects for loose stools symptoms than the other three groups (β=-0.149, -0.151 and -0.144, p value=0.013, 0.013 and 0.018 comparing AR to AE, SR and SE, respectively). The AR group also had significant intervention effects on reducing nausea symptoms when the intervention was given twice per week (β=-0.218, p=0.001). Our trial provided preliminary data demonstrating the potential synergistic effects of acupuncture and RR for treating GI symptoms in HIV patients on HAART.Acupuncture in Medicine 06/2011; 29(3):180-7. DOI:10.1136/acupmed-2011-010026 · 1.68 Impact Factor