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Whole systems healthcare: traditional Chinese medicine acupuncture under the microscope

El-Grégorie, S. (2018). Whole systems healthcare: traditional Chinese medicine acupuncture under the microscope. (Unpublished Doctoral thesis, City, University of London)

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Abstract

Aim
The aim of this study was to investigate the efficacy of a specific school of acupuncture, Traditional Chinese Medicine Acupuncture (TCMA), as a whole complex intervention, as it operated in a clinic setting, on a wider representation of users and spectrum of diseases than the typical acupuncture user profile, and to explore potential variations in health outcomes.

Design and Setting
This was a retrospective study that employed a Whole Systems Research (WSR) design that involved outcome evaluation, to determine the efficacy of TCMA, together with process evaluation, to determine patient perceptions of how the intervention worked in practice, with regards to health, wellness, and Quality of Life (QoL). The research focused on a subsidised clinic that was located in a socially deprived area of London.

Methods
The retrospective study period was February 2007 to March 2008. Scores from Measure Yourself Medical Outcome Profile (MYMOP), an outcome measure used to investigate changes in health outcomes over time, were extracted from individual patient files (N=208) that had fulfilled the inclusion criteria of attendance at six consecutive treatment sessions, delivered from baseline treatment, irrespective of outcome or symptom.

MYMOP scores on Symptom, Activity and Wellbeing, that were completed at baseline (treatment 1) follow up (treatment 2), follow up (treatment 3), follow up (treatment 4), follow up (treatment 5) and follow up (treatment 6), were analysed using repeated measures ANOVA to investigate whether a significant difference in QoL, a variable derived from the mean of the nominated MYMOP scores, existed between baseline treatment and outcome for patients over the six week treatment period; statistical analysis was also completed to explore variations in treatment outcomes in relation to patient’s socio-demographic characteristics, age, gender, ethnicity and social grade, and the wide range of health conditions reflected in the sample.

Written patient commentaries (N=117), concerning experiences of TCMA, that were provided on patient discharge forms were extracted and analysed using Thematic Analysis.

Results
Significant differences were found in the direction of better reported MYMOP Symptom, Activity and Wellbeing scores following TCMA treatments and a significant difference in QoL was found between baseline assessment and outcome for TCMA patients over the 6-week course of treatment.

Statistical analysis produced no evidence that the perceived benefits of TCMA treatment were associated with patients’ gender, age, ethnicity, social class, or presenting condition; no evidence was found that either demographics or presenting condition operated as outcome modifiers.

Thematic analysis resulted in the identification of five themes which together provided insight into, and a way of understanding, both the outcomes and the processes that operated within TCMA.

Conclusion
Findings from the present study show that TCMA delivered perceived global and multidimensional beneficial changes in health, wellbeing and QoL; furthermore, the perceived positive treatment outcomes, which were unrelated to illness type or severity at the time of initial treatment, were consistent across socio-demographic subgroups and a wide spectrum of challenging cases of both physical and mental pathology. The study’s findings are important because they have advanced understanding of TCMA treatment efficacy and the workings of this particular style of acupuncture (TCMA) in terms of health, wellness and QoL.

Publication Type: Thesis (Doctoral)
Subjects: B Philosophy. Psychology. Religion > BF Psychology
R Medicine > RZ Other systems of medicine
Departments: Doctoral Theses
Doctoral Theses > School of Health Sciences
School of Health Sciences
URI: http://openaccess.city.ac.uk/id/eprint/20129

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