Chen Shu Cheng, Zhang Xuan, Yu Juan, Lin Shuang Lan, Ding Fei Fei, Shou Jia Wen, Ren Ge, Pang Lok Yi, Yeung Wing Fai
School of Nursing, The Hong Kong Polytechnic University, 11 Yuk Choi Road, Hung Hom, Kowloon, Hong Kong, China.
Shandong University of Traditional Chinese Medicine, Jinan, China.
BMC Complement Med Ther. 2025 Jul 12;25(1):260. doi: 10.1186/s12906-025-05000-y.
Pediatric tuina treatment program is an intervention of traditional Chinese medicine that involves specific manual techniques applied to the bodies of infants and children to promote health and treat conditions such as congenital muscular torticollis (CMT). This study was conducted to understand facilitators, barriers, and influencing factors in the implementation of pediatric tuina treatment program based on parents' experiences.
Semi-structured individual interviews were conducted with parents' experience in Shandong province, China. Purposive sampling was applied to recruit 13 parents whose children had received a pediatric tuina training program for at least three months to participate voluntarily. Interviews were audio-recorded, transcribed verbatim, and analyzed using template analysis to identify key themes and subthemes. NVivo 12 software was used to facilitate the organization and coding of the data.
Three themes were identified: (1) facilitators to the use of pediatric tuina treatment program, (2) barriers to the use of pediatric tuina treatment program, and (3) modulating factors of the use of pediatric tuina treatment program. The theme of the facilitators of intervention implementation included the subthemes of (a) merits of pediatric tuina, (b) perceived benefits by patients, and (c) parents' concerns and expectations. The theme of barriers to intervention implementation included the subthemes of (a) perceived problems by patients, (b) limited medical resources, (c) family pressure, and (d) manipulation particularity. Modulating factors included (a) parents' perception, (b) patients' adherence, and (c) parents' mentality.
Perceived beneficial effects on improving children's CMT symptoms and constitutions as well as the conservative nature of pediatric tuina treatment mainly facilitated the treatment. Disease recurrence limited medical resources, long-term family pressure, and noncooperation of children were the dominant barriers to treatment implementation. Parents' adherence, mentality, and perceptions on CMT and intervention selection modulated the effects of the treatment. Further research is needed to confirm these findings and explore additional factors affecting the effectiveness and implementation of pediatric tuina treatment.
小儿推拿治疗方案是一种中医干预方法，涉及对婴幼儿身体运用特定手法以促进健康并治疗诸如先天性肌性斜颈（CMT）等病症。本研究旨在基于家长的经验了解小儿推拿治疗方案实施过程中的促进因素、障碍及影响因素。
在中国山东省对家长的经验进行了半结构化个体访谈。采用目的抽样法招募了13名其子女接受小儿推拿训练方案至少三个月的家长自愿参与。访谈进行了录音，逐字转录，并使用模板分析法进行分析以确定关键主题和子主题。使用NVivo 12软件辅助数据的组织和编码。
确定了三个主题：（1）小儿推拿治疗方案使用的促进因素，（2）小儿推拿治疗方案使用的障碍，（3）小儿推拿治疗方案使用的调节因素。干预实施促进因素主题包括以下子主题：（a）小儿推拿的优点，（b）患者感知到的益处，（c）家长的关注和期望。干预实施障碍主题包括以下子主题：（a）患者感知到的问题，（b）医疗资源有限，（c）家庭压力，（d）手法特殊性。调节因素包括（a）家长的认知，（b）患者的依从性，（c）家长的心态。
对改善儿童CMT症状和体质的有益效果以及小儿推拿治疗的保守性质主要促进了治疗。疾病复发、医疗资源有限、长期家庭压力以及儿童不配合是治疗实施的主要障碍。家长的依从性、心态以及对CMT和干预选择的认知调节了治疗效果。需要进一步研究来证实这些发现并探索影响小儿推拿治疗有效性和实施的其他因素。
