Implementation of Acupuncture in Routine Oncology Care: A Comparison of Physicians’, Nurses’, Physiotherapists’ and Acupuncturists’ Practice and Beliefs

Abstract

Background: It is important to investigate beliefs in acupuncture in professionals because professionals’ expectations may affect treatment outcomes. Aim: To document the type, number, and education of professionals practicing acupuncture. Further, to compare beliefs about the effectiveness of acupuncture for common cancer related symptoms in the different types of professionals. Methods: This cross-sectional study employed a questionnaire on practice and beliefs regarding acupuncture effects for symptoms that commonly occur in patients treated within oncology care settings. The respondents (n = 555) consisted of oncology professionals that is, physicians (n = 133), nurses (n = 172), and physiotherapists (n = 117). Additional respondents consisted of acupuncturists (n = 133), working outside approved health care. Results: Of the respondents, acupuncture was practiced by 4% of the physicians, 6% of the nurses, 58% of the physiotherapists, and 90% of the acupuncturists. The professionals believed acupuncture to be effective for pain (of the physicians, nurses, physiotherapists, and acupuncturists, 94%, 98%, 89%, and 99% respectively believed in the effectiveness), chemotherapy-induced nausea (corresponding figures: 74%, 89%, 89%, and 93%), and vasomotor symptoms (corresponding figures: 71%, 81%, 80%, and 97%). The physicians believed acupuncture to be effective in a mean of 5 symptoms, nurses in 6 symptoms, physiotherapists in 6 symptoms, and acupuncturists in 10 symptoms ( P < .001). Conclusions: Since the professionals varied substantially regarding practice, education and beliefs in acupuncture, oncology clinics may consider delivering patient preferred acupuncture according to evidence-informed guidelines rather than on varying preferences among the professionals, since professionals’ treatment expectations may modify treatment outcomes.

A Randomized Sham-Controlled Mixed Methods Pilot Study of the Feasibility of Acupuncture for Chemotherapy-Induced Neuropathy: Lessons Learned From Patient Experiences in Integrative Cancer Care

“…Preceding this study, the therapist did practice the sham-acupuncture technique during a previous acupuncture study. 34 …”

“…Preceding the first acupuncture treatment session, the patients in writing answered an expectancy question 34 : “Do you believe the treatment to be effective for neuropathy symptoms?” (“No, I do not believe the treatment to be effective” or “Yes, I believe a little”/ “moderately”/“Much”/“Entirely” the treatment to be effective”). The expectancy question presented satisfactory test re-test reliability (Spearman’s correlation coefficient between test and re-test was .85) and satisfactory content validity (Kappa coefficients for agreement to other expectancy scales varied .70-.75).…”

“…The expectancy question presented satisfactory test re-test reliability (Spearman’s correlation coefficient between test and re-test was .85) and satisfactory content validity (Kappa coefficients for agreement to other expectancy scales varied .70-.75). 34 …”

“…Measuring of belief in acupuncture effects. Preceding the first acupuncture treatment session, the patients in writing answered an expectancy question 34 : "Do you believe the treatment to be effective for neuropathy symptoms?" ("No, I do not believe the treatment to be effective" or "Yes, I believe a little"/ "moderately"/"Much"/"Entirely" the treatment to be effective").…”

“…The expectancy question presented satisfactory test re-test reliability (Spearman's correlation coefficient between test and re-test was .85) and satisfactory content validity (Kappa coefficients for agreement to other expectancy scales varied .70-.75). 34 Measuring of side-effects and blinding statement. Previously used weekly written questions covered experience of negative side-effects ("Yes" or "No") close to the acupuncture sessions and the therapist during every acupuncture session documented if the patents experienced any negative sideeffects (bleeding around needles, dizziness, fainting, or other needle-induced unpleasant sensations; yes or no).…”