Department of Psychology, Faculty of Environmental & Life Sciences, University of Southampton, Highfield Campus, Southampton, United Kingdom.
Faculty of Medicine, University of Southampton, Highfield Campus, Southampton, United Kingdom.
J Altern Complement Med. 2021 Mar;27(3):238-254. doi: 10.1089/acm.2020.0365. Epub 2020 Dec 17.
Behavioral factors are the leading cause of ill-health worldwide. Diet, physical activity, smoking, and alcohol consumption are the focus of public health targets on promotion of healthy behavior. The science of behavior change is rapidly growing and has largely evolved within mainstream health care treatments. Traditional Chinese Medicine includes self-care practices that encourage healthy behavior alongside treatments such as acupuncture. Exploring behavior change within traditional acupuncture could potentially highlight new techniques and approaches, and contribute to developing models of behavior change. In this review, the authors aimed to critically appraise research exploring health behavior change within traditional acupuncture, to highlight gaps in the field, identify questions, and enable theory development. The authors were guided by a critical interpretive synthesis (CIS) method to explore a diverse mixture of research including qualitative and quantitative articles. Eight databases were searched up to October 2017 for articles published in English. Eleven thousand four hundred eighty-eight articles were identified (7,149 after deduplication). Titles and abstracts were screened by one reviewer (10% by a second reviewer). Eligible articles were selected using a Population, Intervention, Comparison, Outcome framework. CIS methods, including purposive sampling of eligible articles and a reflexive, dialectic process of critiquing evidence and theory, were used to synthesize the evidence. Several articles examined the prevalence and patterns of behavior change and support for change, although methods varied and reliability of results was limited. There was more evidence concerning diet/exercise than alcohol/smoking. Aspects of acupuncturists' work identified as potential key elements for promoting behavior change included: ; ; ; ; and . A logic model of the process of behavior change was developed, proposing that , , and may facilitate change. Possible moderators included: ; ; ; ; ; and . These findings suggest behavior change work is a significant part of traditional acupuncture practice, although more reliable evidence is needed to understand the effectiveness, prevalence, and patterns of this work (in particular the patterns suggesting acupuncturists are more likely to work on changes to diet and physical activity than alcohol and smoking behaviors, and more likely to support changes in long-term compared with acute conditions). The proposed model of behavior change should be developed and tested with a view to refining the model and elaborating the suggested links with a wider theory of behavior and behavior change. This review was preregistered with PROSPERO as "Health behaviour change in traditional acupuncture treatment: a protocol for a critical interpretive synthesis": CRD42018099766.
行为因素是全球范围内导致健康不良的主要原因。饮食、身体活动、吸烟和饮酒是促进健康行为的公共卫生目标的重点。行为改变科学正在迅速发展，并在很大程度上已融入主流医疗保健治疗中。中医包括自我保健实践，鼓励健康行为以及针灸等治疗方法。探索传统针灸中的行为改变可能会突出新的技术和方法，并有助于发展行为改变模型。在这项综述中，作者旨在批判性地评估探索传统针灸中健康行为改变的研究，以突出该领域的差距，确定问题，并促进理论发展。作者遵循关键解释性综合（CIS）方法，以探索包括定性和定量文章在内的各种研究。从 2017 年 10 月开始，在 8 个数据库中搜索发表在英文中的文章，共确定了 11488 篇文章（重复后为 7149 篇）。由一名评审员（另一名评审员为 10%）筛选标题和摘要。使用人群、干预、比较、结果框架选择符合条件的文章。CIS 方法，包括有针对性地选择符合条件的文章和对证据和理论进行反思性、辩证的批判过程，用于综合证据。有几篇文章检查了行为改变和改变支持的流行率和模式，尽管方法不同，结果的可靠性有限。关于饮食/运动的证据比关于酒精/吸烟的证据更多。被确定为促进行为改变的针灸师工作的潜在关键要素包括：; ; ; ; 和 。提出了行为改变过程的逻辑模型，提出 、 、 和 可能有助于改变。可能的调节剂包括：; ; ; ; ; 和 。这些发现表明行为改变工作是传统针灸实践的重要组成部分，尽管需要更可靠的证据来了解这种工作的有效性、流行率和模式（特别是表明针灸师更有可能致力于改变饮食和身体活动而不是饮酒和吸烟行为的模式，并且更有可能支持长期而非急性条件下的变化）。应该制定和测试提出的行为改变模型，以期完善该模型并详细阐述与更广泛的行为和行为改变理论的建议联系。该综述已在 PROSPERO 上预先注册，标题为“传统针灸治疗中的健康行为改变：批判性解释性综合方案”：CRD42018099766。
