Focus on Alternative and Complementary Therapies
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Focus Alternat Complement Ther©2005 Pharmaceutical Press
Focus Altern Complement Ther 2003; 8: 143
To identify intended therapeutic effect of acupuncture treatment for RA, explore the impact of practitioner training and affiliation on intended therapeutic effect and compare intended therapeutic effect of acupuncture treatment with attributes typically detected by standard outcome measures of RA.
Qualitative study using a phenomenological approach; grounded theory method was employed. Acupuncturists were chosen via purposive sampling. In-depth semi-structured interviews were conducted with acupuncturists; interviews tape-recorded and transcribed and field notes taken. Thematic analysis performed and bracketing and reflexivity employed. Interviews are ongoing until data saturation or completion of 25 interviews.
Twelve acupuncturists interviewed to date. Treatment delivered by acupuncturists was multifaceted, incorporating more than just the insertion of acupuncture needles. Acupuncturists were identified as attempting to elicit a wide range of improvements in patients with RA (RA symptoms; non-RA symptoms; general physical/mental health; emotional well-being; lifestyle changes). The training and affiliation of acupuncturists impacts on all aspects of treatment. Current categories and themes will be developed and expanded through subsequent interviews.
Clinical trials of acupuncture in RA may have failed to administer a treatment that reflects that administered in clinical practice. Outcome measures employed in clinical trials of acupuncture in RA and established outcome indices for use in assessing improvement in RA appear to lack sufficient breadth to detect effects acupuncturists hope to elicit. A new patient-centred outcome measure may need developing. The training and affiliation of acupuncturists has serious implications for the practice and research of acupuncture.
