“我感觉就像上帝的手把针插进去”:对低收入、种族多样化和医疗服务不足的患者群体针灸治疗慢性疼痛的定性分析。

Benjamin Kligler, Michele Buonora, Jonathan Gabison, Emilie Jacobs, Alison Karasz, M Diane McKee
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引用次数: 17

摘要

目的:研究来自低收入、不同种族的医疗服务不足人群的患者接受针灸治疗慢性疼痛的经验。设计:采用对针灸试验参与者访谈的归纳主题分析进行定性分析。环境/地点:纽约布朗克斯的四个社区保健中心。参与者:37名患有慢性颈部或背部疼痛或骨关节炎的成年人,他们参加了以前的针灸试验。干预措施:每周最多14次针灸治疗。结果测量:在原始试验中检查疼痛和生活质量;本研究检验了定性结果。结果:主题自然分为三个领域的针灸经验:决策过程,治疗经验和针灸对健康的影响。关于决策,重要的因素是愿意尝试新事物,即使你不一定“相信”它或有特别积极的期望;一种药物对疼痛不起作用的感觉,药物还会引起严重的副作用,自然疗法可能更可取;还有一种绝望的感觉。费用和可及性是针灸治疗的主要障碍。关于针灸的过程,与针灸师的开放和个人沟通是一个重要因素,针灸的过程与身体内部愈合或纠正的自然过程有关,针灸成功的一部分需要对心灵的力量开放,以产生积极的结果。关于治疗效果,值得注意的方面是参与者在治疗期间报告的深度休息和放松感,以及他们在疼痛以外的条件下体验到的益处。结论:在这个种族多样化的低收入人群中出现的主题与过去十年对其他患者群体针灸体验的定性研究中出现的主题非常相似。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
"I Felt Like It Was God's Hands Putting the Needles In": A Qualitative Analysis of the Experience of Acupuncture for Chronic Pain in a Low-Income, Ethnically Diverse, and Medically Underserved Patient Population.

Objectives: To examine the experience of patients from a low-income, ethnically diverse medically underserved population receiving acupuncture for chronic pain.

Design: Qualitative analysis using inductive thematic analysis of interviews with participants from an acupuncture trial.

Settings/location: Four community health centers in the Bronx, New York.

Participants: Thirty-seven adults with chronic neck or back pain or osteoarthritis who participated in a previous acupuncture trial.

Interventions: Up to 14 weekly acupuncture treatments.

Outcome measures: Pain and quality of life were examined in the original trial; this study examines qualitative outcomes.

Results: The themes grouped naturally into three domains of the acupuncture experience: the decision-making process, the treatment experience, and the effect of acupuncture on health. Regarding decision-making, important factors were a willingness to try something new even if you do not necessarily "believe" in it or have specifically positive expectations; a sense that medications were not working for their pain, that they also caused significant adverse effects, and that natural strategies might be preferable; and a feeling of desperation. Cost and access were significant barriers to acupuncture treatment. Regarding the process of acupuncture, the open and personal communication with the acupuncturist was an important factor, as were the sense that the process of acupuncture related to a natural process of healing or correction within the body and that part of making acupuncture successful required being open to the power of the mind to generate a positive outcome. Regarding the effect of treatment, notable aspects were the deep sense of rest and relaxation participants reported during treatment as well as the benefit they experienced for conditions other than pain.

Conclusions: The themes that emerged in this ethnically diverse, low-income population were very similar to those that have emerged over the past decade of qualitative research on the acupuncture experience in other patient populations.

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