Acupuncture as a Complex Intervention: A Holistic Model

MRC Health Services Research Collaboration, Department of Social Medicine, University of Bristol, Bristol B58 2PR, UK.
The Journal of Alternative and Complementary Medicine (Impact Factor: 1.59). 11/2004; 10(5):791-801. DOI: 10.1089/acm.2004.10.791
Source: PubMed


Our understanding of acupuncture and Chinese medicine is limited by a lack of inquiry into the dynamics of the process. We used a longitudinal research design to investigate how the experience, and the effects, of a course of acupuncture evolved over time.
This was a longitudinal qualitative study, using a constant comparative method, informed by grounded theory. Each person was interviewed three times over 6 months. Semistructured interviews explored people's experiences of illness and treatment. Across-case and within-case analysis resulted in themes and individual vignettes.
Eight (8) professional acupuncturists in seven different settings informed their patients about the study. We interviewed a consecutive sample of 23 people with chronic illness, who were having acupuncture for the first time.
People described their experience of acupuncture in terms of the acupuncturist's diagnostic and needling skills; the therapeutic relationship; and a new understanding of the body and self as a whole being. All three of these components were imbued with holistic ideology. Treatment effects were perceived as changes in symptoms, changes in energy, and changes in personal and social identity. The vignettes showed the complexity and the individuality of the experience of acupuncture treatment. The process and outcome components were distinct but not divisible, because they were linked by complex connections. The paper depicts these results as a diagrammatic model that illustrates the components and their interconnections and the cyclical reinforcement, both positive and negative, that can occur over time.
The holistic model of acupuncture treatment, in which "the whole being greater than the sum of the parts," has implications for service provision and for research trial design. Research trials that evaluate the needling technique, isolated from other aspects of process, will interfere with treatment outcomes. The model requires testing in different service and research settings.

22 Reads
  • Source
    • "needling sensation) and the therapeutic model of patient care. A number of studies have reported acupuncturists' views about research participation [10] [11] [12] [13] [14] [15]. Common themes in these studies expressed by practitioners included: the importance of individualised treatment; valued features of the therapeutic relationship as the basis for establishing trust and rapport; empowering and educating patients and reflections on conflicts and benefits of research participation including constraints imposed by treatment protocols. "
    [Show abstract] [Hide abstract]
    ABSTRACT: Acupuncture is now emerging as a complementary medicine used in conjunction with in vitro fertilisation (IVF). The aim of this study was to examine participation in a randomised controlled trial of acupuncture as an adjunct to IVF from the perspective of women and study acupuncturists.
    Full-text · Article · Oct 2015 · European Journal of Integrative Medicine
    • "Traditional Chinese Medicine does not follow the strict principle of a specifi c diagnosis and targeted treatment. It rather takes into consideration the various aspects of lifestyle, eff ect of disease on body and mind and provides a holistic treatment , which not only treats the underlying disease but also improves self-confi dence, self-help and empowerment (Paterson and Britten 2004). "
    [Show abstract] [Hide abstract]
    ABSTRACT: Women's choice to delay fertility due to various reasons is making subfertility a growing problem and increased use of IVF as a last resort. Despite advances in the technology, IVF success remains low, especially in older women. Hence, many of these women need to undergo several cycles of IVF and are faced with unprecedented anxiety and frustration. In desperation, they resort to anything that might increase the success of their IVF treatment. Acupuncture has gained popularity among the various complementary medicines available and many go privately to have acupuncture while undergoing IVF. Since 1999, in spite of multiple trials and systematic reviews, the beneficial effect of acupuncture in improving the success of IVF remains unproven and debatable. As clinicians, we face the dilemma of what to suggest to our patients when asked about having acupuncture during IVF, given that different meta-analyses have come to different conclusions. Hence, this review is conducted with the aim to summarise the available literature and provide a better insight into this complex and controversial topic.
    No preview · Article · Jun 2014 · Journal of Obstetrics and Gynaecology
  • Source
    • "The speed along with the disorientating shock of diagnosis and initial treatment may induce additional problems alongside the common " side-effects " already known to arise from surgery and chemotherapy. There is thus considerable potential for a complementary therapy, such as traditional acupuncture (TA) with its whole-person approach [4], to help modify these effects and to potentially induce other patient benefits, for example, improvement in well-being [4] [5] and cancer-related fatigue [6]. Given the complex combination of factors, it is pertinent to uncover the needs and concerns of women and perceived benefits of TA, so as to be able to offer additional acceptable and meaningful support at this time. "
    [Show abstract] [Hide abstract]
    ABSTRACT: Women diagnosed with breast cancer experience symptom clusters in addition to existential issues from a life-threatening diagnosis during chemotherapy. A complementary therapy, such as traditional acupuncture (TA) with its whole-person orientation, may help to modify these effects, alongside inducing other patient benefits. Exploring the needs and concerns of women and perceived benefits of TA would add to knowledge about its integrative treatment potential. Methods. A longitudinal qualitative study recruited fourteen women to receive up to ten sessions of TA during chemotherapy. They were interviewed before, during, and after chemotherapy. Two practitioners of TA delivered treatment and were interviewed before and after the study, and kept treatment logs and diaries. Interviews were recorded and transcribed, and the data were analysed using grounded theory. Findings. Both broad and specific benefits were reported by the women; a highly valued outcome was enabling coping through the alleviation of symptoms and increased well-being. Practitioners dealt with the presented symptom clusters facilitating outcome patterns, including and beyond individual symptom changes. Further research on TA as a flexible intervention able to respond to the changing needs and concerns of woman during chemotherapy along with the measure of such outcome patterns is warranted.
    Full-text · Article · Sep 2013 · Evidence-based Complementary and Alternative Medicine
Show more