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Traditional acupuncture for people with medically unexplained symptoms: a longitudinal qualitative study of patients’ experiences

    Sue Rugg, MSc, PhD, DipCOT, research fellow,
    Charlotte Paterson, PhD,MRCGP, senior research fellow and
    Nicky Britten, PhD, FRCGP (Hon), professor of applied health care

    Jackie Bridges, PhD,MSN BNurs(Hons), RN, senior research fellow

    Peter Griffiths, PhD, RN, professor of health services research

+ Author Affiliations

    Institute of Health Service Research, University of Exeter, Exeter
    School of Community and Health Sciences, City University, London
    School of Health Science, University of Southampton, Southampton, on behalf of the CACTUS study team

    Address for correspondence
    Dr Charlotte Paterson, Institute of Health Service Research, Peninsula Medical School, University of Exeter, Veysey Building, Salmon Pool Lane, Exeter EX2 4SG. E-mail: charlotte.paterson@pms.ac.uk

Abstract

Background  -   People with medically unexplained physical symptoms (MUPS) are helped by interventions that combine physical and psychological explanations and treatment. Traditional acupuncture may offer such a perspective, but its use for these patients has not been investigated.

Aim  -   To ascertain how patients with MUPS perceive and experience five-element acupuncture treatment.

Design and setting   -  A longitudinal qualitative interview study, nested in a randomised controlled trial was carried out in four general practices in socioeconomically diverse areas of London.

Method   -  A purposive sample of 20 trial participants was interviewed twice, at the start and the end of 6 months of acupuncture treatment. Semi-structured interviews were transcribed, coded, and analysed thematically, summarising both across-case as themes and within-case individual vignettes.

Results   -   Acupuncture, initially accepted as ‘just another referral’ — one like many others that had been tried and proved unsuccessful — was valued for the amount of time allotted with a caring practitioner who listened and responded, as well as for the interactive and holistic nature of the sessions. These attributes encouraged many patients to take an active role in their treatment, including making cognitive or behavioural lifestyle changes. Interviewees cited a wide range of changes in their health that spanned physical, psychological, and social dimensions. These were largely positive and included an increase in physical and/or mental energy, as well as feelings of greater personal control, calmness, and relaxation. Three interviewees reported worsening health but did not ascribe this to acupuncture.

Conclusion  -   Many patients who were treated with five-element acupuncture perceived a range of positive effects and appeared to take on a more active role in consultations and self-care.