Australian Research Centre for Complementary and Integrative Medicine (ARCCIM), Faculty of Health, School of Public Health, University of Technology Sydney, Sydney, Australia.
Office of Research, Endeavour College of Natural Health, Brisbane, Australia.
J Integr Complement Med. 2023 Jun-Jul;29(6-7):430-438. doi: 10.1089/jicm.2022.0657. Epub 2023 Apr 18.
Marginalized populations experience health inequities and are often underserved within existing health systems. Australian marginalized populations and their use of complementary medicine, including acupuncture, lack investigation. We have collected information on the health-seeking behaviors of marginalized individuals who utilize an acupuncture service within a community-based integrative health setting. A secondary analysis of pre-existing data involving the linking of three datasets. Information was collected across four domains: health characteristics, socio-demographics, health services utilization, and vulnerability markers. Bivariate analysis using Fisher's exact and chi-square tests additional to logistic regression analysis were conducted to determine the characteristics of the study population. All data once analyzed were then presented as a cumulative statistic. Study participants ( = 42) included 28% of individuals with reported histories of homelessness ( = 12) and 32% with a history of psychological trauma ( = 13). Eighty-three percent ( = 31) of the population sought acupuncture to manage pain and 91% ( = 36) for musculoskeletal conditions. Sixty-three percent ( = 24) reported a mental health diagnosis, most commonly depression ( = 18). Participants were most likely to engage with three other health services within the study setting, in addition to acupuncture. Participants with an illicit substance abuse problem were 12 times more likely to seek a greater number of acupuncture treatments, and individuals with trauma histories were twice as likely to attend the acupuncture clinic eight or more times. Our study findings suggest a robust level of engagement with acupuncture treatment among the target population and a willingness to engage with integrative health services when barriers to uptake such as accessibility and affordability are removed. Findings support current evidence pertaining to acupuncture's use as an adjunct to managing pain in marginalized populations as well as a perceived acceptability and feasibility of the integration of acupuncture within conventional health settings. There is the further observation that acupuncture in a group setting is suitable for a marginalized population and an interest in commitment to treatment among individuals with substance abuse problems.
边缘化群体在现有卫生系统中存在健康不平等问题，服务往往得不到满足。澳大利亚的边缘化群体及其对补充医学的使用，包括针灸，缺乏调查。我们已经收集了在社区为基础的综合健康环境中使用针灸服务的边缘化个体的健康寻求行为的信息。对涉及三个数据集链接的现有数据进行二次分析。信息是在四个领域收集的：健康特征、社会人口统计学、卫生服务利用和脆弱性指标。使用 Fisher 精确检验和卡方检验以及逻辑回归分析进行了单变量分析，以确定研究人群的特征。分析后所有数据都以累积统计数据呈现。研究参与者（ = 42）包括 28%（ = 12）有报告无家可归史的个体和 32%（ = 13）有心理创伤史的个体。83%（ = 31）的人寻求针灸治疗以缓解疼痛，91%（ = 36）的人则因肌肉骨骼疾病寻求针灸治疗。63%（ = 24）报告有心理健康诊断，最常见的是抑郁症（ = 18）。参与者最有可能在研究环境中除了针灸治疗之外，还会使用另外三种健康服务。有非法药物滥用问题的参与者接受更多次针灸治疗的可能性是其他参与者的 12 倍，有创伤史的个体接受八次或更多次针灸治疗的可能性是其他参与者的两倍。我们的研究结果表明，目标人群对针灸治疗有很强的接受程度，并且愿意在获得针灸治疗等服务的障碍（如可及性和可负担性）被消除时，接受综合健康服务。研究结果支持当前关于在边缘化人群中使用针灸作为辅助治疗疼痛的证据，以及针灸在常规健康环境中整合的可接受性和可行性。进一步观察到，群体环境中的针灸治疗适合边缘化人群，并且有药物滥用问题的个体对治疗的承诺感。
