Kligler Benjamin, Buonora Michele, Gabison Jonathan, Jacobs Emilie, Karasz Alison, McKee M Diane
1 Department of Integrative Medicine, Mount Sinai Beth Israel Medical Center , New York, NY.
2 Albert Einstein College of Medicine , Bronx, NY.
J Altern Complement Med. 2015 Nov;21(11):713-9. doi: 10.1089/acm.2014.0376. Epub 2015 Aug 6.
To examine the experience of patients from a low-income, ethnically diverse medically underserved population receiving acupuncture for chronic pain.
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.
Thirty-seven adults with chronic neck or back pain or osteoarthritis who participated in a previous acupuncture trial.
Up to 14 weekly acupuncture treatments.
Pain and quality of life were examined in the original trial; this study examines qualitative outcomes.
The themes grouped naturally into three domains of the acupuncture experience: the decision-making process, the treatment experience, and the effect of acupuncture on health. Regarding decision-making, important factors were a willingness to try something new even if you do not necessarily "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.
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.
考察来自低收入、种族多样且医疗服务不足人群的患者接受针灸治疗慢性疼痛的体验。
采用归纳主题分析法对针灸试验参与者的访谈进行定性分析。
纽约布朗克斯区的四家社区卫生中心。
37名患有慢性颈部或背部疼痛或骨关节炎的成年人，他们参与了之前的针灸试验。
每周最多进行14次针灸治疗。
在原试验中对疼痛和生活质量进行了考察；本研究考察定性结局。
这些主题自然地归为针灸体验的三个领域：决策过程、治疗体验以及针灸对健康的影响。关于决策，重要因素包括即使不一定“相信”或没有特别积极的期望也愿意尝试新事物；感觉药物对其疼痛无效，还会引起严重不良反应，天然疗法可能更可取；以及绝望感。成本和可及性是针灸治疗的重大障碍。关于针灸过程，与针灸师开放且个性化的沟通是一个重要因素，同样重要的是感觉针灸过程与身体内部自然的愈合或矫正过程相关，并且使针灸成功的部分因素是愿意接受心理力量产生积极结果。关于治疗效果，值得注意的方面是参与者在治疗期间报告的深度休息和放松感，以及他们在疼痛以外的病症上所体验到的益处。
在这个种族多样的低收入人群中出现的主题与过去十年对其他患者群体针灸体验的定性研究所呈现的主题非常相似。
