Traditional acupuncture for people with medically unexplained symptoms: a longitudinal qualitative study of patients’ experiences

Rugg, Sue; Paterson, Charlotte; Britten, Nicky; Bridges, Jackie; Griffiths, Peter

doi:10.3399/bjgp11x577972

Cited by 46 publications

(50 citation statements)

References 41 publications

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“…This is consistent with qualitative work by Rugg et al 25 on patients with complex and medically unexplained symptoms that ''acupuncture, initially accepted as 'just another referral'-one like many others that had been tried and proved unsuccessful-was valued for the amount of time allotted with a caring practitioner who listened and responded, as well as for the interactive and holistic nature of the sessions.'' Patients in that study, as in the current one, reported ''changes in their health that spanned physical, psychological, and social dimensions.as well as feelings of greater personal control, calmness, and relaxation.…”

Section: Discussionsupporting

confidence: 79%

“I Felt Like It Was God's Hands Putting the Needles In”: A Qualitative Analysis of the Experience of Acupuncture for Chronic Pain in a Low-Income, Ethnically Diverse, and Medically Underserved Patient Population

Kligler¹,

Buonora

Gabison

et al. 2015

The Journal of Alternative and Complementary Medicine

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Objectives: To examine the experience of patients from a low-income, ethnically diverse medically underserved population receiving acupuncture for chronic pain. Design: Qualitative analysis using inductive thematic analysis of interviews with participants from an acupuncture trial. Settings/Location: Four community health centers in the Bronx, New York. Participants: Thirty-seven adults with chronic neck or back pain or osteoarthritis who participated in a previous acupuncture trial. Interventions: Up to 14 weekly acupuncture treatments. Outcome measures: Pain and quality of life were examined in the original trial; this study examines qualitative outcomes. Results: The themes grouped naturally into three domains of the acupuncture experience: the decisionmaking process, the treatment experience, and the effect of acupuncture on health. Regarding decisionmaking, important factors were a willingness to try something new even if you do not necessary ''believe'' in it or have specifically positive expectations; a sense that medications were not working for their pain, that they also caused significant adverse effects, and that natural strategies might be preferable; and a feeling of desperation. Cost and access were significant barriers to acupuncture treatment. Regarding the process of acupuncture, the open and personal communication with the acupuncturist was an important factor, as were the sense that the process of acupuncture related to a natural process of healing or correction within the body and that part of making acupuncture successful required being open to the power of the mind to generate a positive outcome. Regarding the effect of treatment, notable aspects were the deep sense of rest and relaxation participants reported during treatment as well as the benefit they experienced for conditions other than pain. Conclusions: The themes that emerged in this ethnically diverse, low-income population were very similar to those that have emerged over the past decade of qualitative research on the acupuncture experience in other patient populations.

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Section: Discussionsupporting

confidence: 79%

“I Felt Like It Was God's Hands Putting the Needles In”: A Qualitative Analysis of the Experience of Acupuncture for Chronic Pain in a Low-Income, Ethnically Diverse, and Medically Underserved Patient Population

Kligler¹,

Buonora

Gabison

et al. 2015

The Journal of Alternative and Complementary Medicine

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“…The written qualitative data also confirm previous reviews 23,24 concerning the value of participation and its link to selfefficacy -themes that are also evident in the interview data to be reported elsewhere. 56 The lack of serious adverse effects in this study is in accordance with data from large-scale surveys of acupuncture, which demonstrate its safety. 55,59 Implications for research and practice This study has begun the process of developing an evidence base for traditional acupuncture as an additional treatment option for these 'difficult-to-help' patients, and also provides generalisable data on outcomes and baseline resource use on which to base a longer term costeffectiveness trial.…”

Section: Strengths and Limitationssupporting

confidence: 73%

Acupuncture for ‘frequent attenders’ with medically unexplained symptoms: a randomised controlled trial (CACTUS study)

Paterson¹,

Taylor²,

Griffiths³

et al. 2011

Br J Gen Pract

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BackgroundMedically unexplained physical symptoms (MUPS) are common and difficult to treat. AimTo investigate the effectiveness of adding fiveelement acupuncture to usual care in 'frequent attenders' with MUPS. Design and settingRandomised controlled trial in four London general practices. MethodParticipants were 80 adults with MUPS, consulting GPs ≥8 times/year. The intervention was individualised five-element acupuncture, ≥12 sessions, immediately (acupuncture group) and after 26 weeks (control group). The primary outcome was 26-week Measure Yourself Medical Outcome Profile (MYMOP); secondary outcomes were wellbeing (W-BQ12), EQ-5D, and GP consultation rate. Intention-to-treat analysis was used, adjusting for baseline outcomes. ResultsParticipants (80% female, mean age 50 years, mixed ethnicity) had high health-resource use. Problems were 59% musculoskeletal; 65% >1 year duration. The 26-week questionnaire response rate was 89%. Compared to baseline, the mean 26-week MYMOP improved by 1.0 (95% confidence interval [CI] = 0.4 to 1.5) in the acupuncture group and 0.6 (95% CI = 0.3 to 0.9) in the control group (adjusted mean difference: acupuncture versus control -0.6 [95% CI = -1.1 to 0] P = 0.05). Other between-group adjusted mean differences were: W-BQ12 4.4 (95% CI = 1.6 to 7.2) P = 0.002; EQ-5D index 0.03 (95% CI = -0.11 to 0.16) P = 0.70; consultation rate ratio 0.90 (95% CI = 0.70 to 1.15) P = 0.4; and number of medications 0.56 (95% CI = 0.47 to 1.6) P = 0.28. All differences favoured the acupuncture group. Imputation for missing values reduced the MYMOP adjusted mean difference to -0.4 (95% CI = -0.9 to 0.1) P = 0.12. Improvements in MYMOP and W-BQ12 were maintained at 52 weeks. ConclusionThe addition of 12 sessions of five-element acupuncture to usual care resulted in improved health status and wellbeing that was sustained for 12 months.

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“…[8][9][10][11] In our case, a massive impairment in physical status occurred at a period of her life when physical health is naturally assumed and important in the context of the physical and emotional changes of adolescence. This can generate profound mental, emotional and physical stress.…”

Section: Well-being Self-assessmentmentioning

confidence: 99%

Use of Nada Ear Acupuncture in An Adolescent Patient with Phantom Limb Pain after Surgery for Osteosarcoma

et al. 2015

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Traditional acupuncture for people with medically unexplained symptoms: a longitudinal qualitative study of patients’ experiences

Cited by 46 publications

References 41 publications

“I Felt Like It Was God's Hands Putting the Needles In”: A Qualitative Analysis of the Experience of Acupuncture for Chronic Pain in a Low-Income, Ethnically Diverse, and Medically Underserved Patient Population

“I Felt Like It Was God's Hands Putting the Needles In”: A Qualitative Analysis of the Experience of Acupuncture for Chronic Pain in a Low-Income, Ethnically Diverse, and Medically Underserved Patient Population

Acupuncture for ‘frequent attenders’ with medically unexplained symptoms: a randomised controlled trial (CACTUS study)

Use of Nada Ear Acupuncture in An Adolescent Patient with Phantom Limb Pain after Surgery for Osteosarcoma

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