Liu Luping, Zhang Lingyun, Li Sina, Cai Meiling, Han Siyu, Weng Zhiwen, Chen Qianji, Gao Yixuan, Yang Xiaoming, Zhang Yang, Li Duoduo, Liu Changxin, Sun Ya'nan, Wang Xiyou, Yu Changhe
Yongshun Community Health Service Center, Beijing, China.
Tuina and Pain Management Department, Dongzhimen Hospital Beijing University of Chinese Medicine, No. 5, Str., Hai Yun Cang, Dongcheng District, Beijing, China.
BMC Complement Med Ther. 2025 May 28;25(1):191. doi: 10.1186/s12906-025-04926-7.
INTRODUCTION: KOA is a prevalent joint disorder significantly impacting patients' quality of life. Tuina and manual interventions are prioritized in clinical practice within the Chinese healthcare context. Current qualitative studies mostly focus on symptom management and basic disease perceptions, overlooking patient-centered treatment expectations, therapeutic process perceptions, and doctor-patient interaction impacts during manual therapy. This study aims to address these gaps by exploring Chinese KOA patients' experiences, perceptions, and expectations of manual therapy, emphasizing contextual factors affecting therapeutic outcomes and interactions. METHODS: Participants with KOA were sampled using a simple sampling method from a randomized controlled trial of Tuina treatment versus manual physical therapy (MPT). The interviews were conducted by two researchers who have extensive experience interviewing KOA patients, and data were gathered through face-to-face, semi-structured interviews to ensure a high level of information power. Three experienced researchers subsequently analyzed employing thematic analysis to assess patient experiences and outcomes from both treatment modalities. RESULT: The study interviewed a total of 61 participants, thematic saturation was reached when interviewing 42 participants, and seven codes along with 5 sub-themes were utilized to depict potential doctor-patient interactions and influencing factors. This process led to the formation of three themes: Understanding and Impact, Treatment Expectations and Satisfaction, and Treatment Goals and Outcomes, which helped in constructing a model to understand the underlying influences among these themes. CONCLUSION: Our study generated three themes-Understanding and Impact, Treatment Expectations and Satisfaction, and Treatment Goals and Outcomes, and developed a manual therapy model based on these themes. The generated model shows the important factors of doctor-patient interaction in KOA manual therapy management. Future research should expand to multidisciplinary and cross-cultural models to align standardized protocols with individualized patient needs.
引言：膝骨关节炎（KOA）是一种常见的关节疾病，严重影响患者的生活质量。在中国医疗环境中，推拿和手法干预在临床实践中具有优先地位。目前的定性研究大多集中在症状管理和对基本疾病的认知上，忽视了以患者为中心的治疗期望、对治疗过程的认知以及手法治疗期间的医患互动影响。本研究旨在通过探索中国KOA患者对手法治疗的体验、认知和期望来填补这些空白，强调影响治疗效果和互动的背景因素。 方法：从一项推拿治疗与手法物理治疗（MPT）的随机对照试验中，采用简单抽样方法选取KOA患者作为研究对象。访谈由两位在访谈KOA患者方面有丰富经验的研究人员进行，通过面对面的半结构化访谈收集数据，以确保较高的信息获取量。随后，三位经验丰富的研究人员采用主题分析法进行分析，以评估两种治疗方式下患者的体验和结果。 结果：该研究共访谈了61名参与者，在访谈42名参与者时达到了主题饱和，并使用了7个编码和5个子主题来描述潜在的医患互动和影响因素。这一过程导致形成了三个主题：理解与影响、治疗期望与满意度、治疗目标与结果，这有助于构建一个模型来理解这些主题之间的潜在影响。 结论：我们的研究产生了三个主题——理解与影响、治疗期望与满意度、治疗目标与结果，并基于这些主题开发了一个手法治疗模型。所生成的模型显示了KOA手法治疗管理中医患互动的重要因素。未来的研究应扩展到多学科和跨文化模型，以使标准化方案与个体化患者需求相匹配。
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