OHSU School of Medicine, Portland, OR, USA.
OHSU Division of General Internal Medicine and Geriatrics, Portland, OR, USA.
J Altern Complement Med. 2021 Sep;27(9):760-770. doi: 10.1089/acm.2021.0028. Epub 2021 Jun 15.
Acupuncture is an effective and low-risk therapy for a wide spectrum of medical conditions. In the hospice setting, where comfort is the top priority, acupuncture could play a vital role in reducing symptom burden at the end of life. This state-wide survey study explored perceived barriers to acupuncture use in the hospice setting from acupuncturist and hospice staff perspectives. Specific barriers addressed included insurance coverage/funding for acupuncture, lack of knowledge of acupuncture as a therapeutic modality, and perceived insufficient evidence base for acupuncture. Acupuncturists and hospice staff in Oregon were recruited by e-mail and/or telephone to complete their survey. Among acupuncturists, a response rate of 50% was obtained. The response rate of hospice staff could not be obtained. There were a total of 270 providers and hospice staff (102 acupuncturists, 16 hospice doctors, 14 hospice directors, 93 hospice nurses, 30 hospice social workers, and 15 hospice chaplains). The majority of acupuncturists (76% and 89%, respectively) and hospice staff (59% and 82%, respectively) strongly agreed or somewhat agreed that insurance coverage/funding for acupuncture and lack of knowledge of acupuncture as a therapeutic modality are important barriers. With respect to the perceived evidence base for acupuncture, the majority of acupuncturists (91%) and hospice staff (69%) strongly agreed or somewhat agreed that acupuncture can help provide a higher quality of life for hospice patients, although knowledge of specific conditions amenable to acupuncture among acupuncturists and hospice staff varied. From the acupuncturist and hospice staff perspectives, insurance coverage/funding for acupuncture, lack of knowledge of acupuncture as a therapeutic modality, and perceived insufficient evidence base for acupuncture are primary barriers to the use of acupuncture in hospice care. Increased awareness/education about acupuncture in the hospice setting, as well as improved funding structures, is critical.
针灸是一种有效且低风险的治疗方法，适用于广泛的医疗条件。在临终关怀环境中，以舒适为首要任务，针灸可以在减轻生命末期的症状负担方面发挥重要作用。这项全州范围的调查研究从针灸师和临终关怀工作人员的角度探讨了在临终关怀环境中使用针灸的感知障碍。具体涉及的障碍包括针灸的保险覆盖/资金、缺乏对针灸作为治疗方式的了解，以及对针灸证据基础不足的看法。俄勒冈州的针灸师和临终关怀工作人员通过电子邮件和/或电话被招募来完成他们的调查。在针灸师中，获得了 50%的回复率。无法获得临终关怀工作人员的回复率。共有 270 名提供者和临终关怀工作人员（102 名针灸师、16 名临终关怀医生、14 名临终关怀主任、93 名临终关怀护士、30 名临终关怀社会工作者和 15 名临终关怀牧师）。大多数针灸师（分别为 76%和 89%）和临终关怀工作人员（分别为 59%和 82%）强烈同意或有些同意保险覆盖/资金用于针灸和缺乏对针灸作为治疗方式的了解是重要的障碍。至于对针灸证据基础的看法，大多数针灸师（91%）和临终关怀工作人员（69%）强烈同意或有些同意针灸可以帮助提高临终关怀患者的生活质量，尽管针灸师和临终关怀工作人员对针灸适用的具体情况的了解存在差异。从针灸师和临终关怀工作人员的角度来看，针灸的保险覆盖/资金、缺乏对针灸作为治疗方式的了解以及对针灸证据基础不足的看法是在临终关怀中使用针灸的主要障碍。增加临终关怀环境中对针灸的认识/教育，以及改善资金结构至关重要。
