Patients' preconceptions of acupuncture: a qualitative study exploring the decisions patients make when seeking acupuncture

open access

Research article

Background

Like any other form of healthcare, acupuncture takes place in a particular context which can enhance or diminish treatment outcomes (i.e. can produce contextual effects). Patients' expectations of acupuncture might be an important component of contextual effects, but we know relatively little about the origins and nature of patients' expectations or wider preconceptions about acupuncture. Our aim was to identify the processes the underpin patients' decisions to try acupuncture and thus begin to tease out the origins and nature of patients' preconceptions.

Methods

One-off semi-structured interviews were conducted with a purposive, varied sample of 35 adults who had tried acupuncture for various conditions. Interviews explored people's experiences of acupuncture treatment and techniques from framework and inductive thematic analysis were used to relate the data to the research question.

Results

We identified four distinct processes within participants' accounts of deciding to try acupuncture: establishing a need for treatment, establishing a need for a new treatment, deciding to try acupuncture, and finding an acupuncturist. Family, friends and health care professionals played a role in these processes, providing support, advice, and increasing people's general familiarity with acupuncture. When they came to their first acupuncture appointment, participants had hopes, concerns, and occasionally concrete expectations as to the nature of acupuncture treatment and its likely effects.

Conclusions

Existing theories of how context influences health outcomes could be expanded to better reflect the psychological components identified here, such as hope, desire, optimism and open-mindedness. Future research on the context of acupuncture should consider these elements of the pre-treatment context in addition to more established components such as expectations. There appears to be a need for accessible (i.e. well-disseminated), credible, and individualised, patient-centred materials that can allay people's concerns about the nature of acupuncture treatment and shape realistic hopes and expectations.

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 "....Six men and 29 women aged between 26 and 86 years (median 53 years) volunteered and gave informed consent to take part in an audio-recorded interview. They had experienced acupuncture treatment for various conditions, including: hay fever, rheumatoid arthritis,
anxiety, fertility/IVF, IBS, digestive problems, sinusitis, shoulder/neck pain, tendonitis, smoking, low energy levels, menopause, menstrual problems, fibromyalgia, wheat intolerance, stress, osteoarthritis, headache, good health maintenance, lost voice, flying phobia, joint pain, back pain, tight muscle in thigh, and post-viral syndrome. Five participants had experienced acupuncture in public-sector clinics."

Deciding to try acupuncture
"Having established a need for a different treatment, participants talked about making a specific decision to try acupuncture. Some participants saw acupuncture specifically as an attractive treatment that could offer them something that previous treatments had not provided. For some participants this was based on anecdotal evidence and success stories
from friends and acquaintances, consistent with the role of lay referral networks identified in studies of CAM use in cancer [33,34]..