25. Perceptions Of Acupuncture Acupressure

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25. Perceptions Of Acupuncture Acupressure

 

 

CATEGORY:Alternative Medicines 300 Courses

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Syllabus

List of Tables ……………………………………………………………………………………………………… xii
List of Figures……………………………………………………………………………………………………… xiv
Abstract………………………………………………………………………………………………………………. xv
Chapter One: The Problem……………………………………………………………………………………….1
Introduction …………………………………………………………………………………………………1
Background of the Problem……………………………………………………………………………3
Statement of the Problem ………………………………………………………………………………3
Purpose of the Study……………………………………………………………………………………..5
Introduction to Theoretical Foundation……………………………………………………………6
Summary of Methods……………………………………………………………………………………7
Significance of the Study……………………………………………………………………………….8
Definition of Terms………………………………………………………………………………………9
Summary………………………………………………………………………………………………….. 10
Chapter Two: Review of Related Literature ……………………………………………………………. 12
Overview …………………………………………………………………………………………………. 12
Complementary and Alternative Medicine …………………………………………………… 12
Oriental Medicine……………………………………………………………………………………… 14
History of Acupuncture ……………………………………………………………………………… 15
China…………………………………………………………………………………………….. 15
India……………………………………………………………………………………………… 16
Japan …………………………………………………………………………………………….. 16
France …………………………………………………………………………………………… 16
Modern Acupuncture History……………………………………………………………………… 17
International history………………………………………………………………………… 17
U.S. history……………………………………………………………………………………. 17
Evidence-Based Support in the Context of Anesthesia Practice ………………………. 18
Preoperative Management……………………………………………………………….. 18
International literature…………………………………………………………. 18
U.S. literature ……………………………………………………………………… 19
Intraoperative Management……………………………………………………………… 19
International literature…………………………………………………………. 19
U.S. literature ……………………………………………………………………… 21
Postoperative Management ……………………………………………………………… 22
Postoperative nausea and vomiting………………………………………… 22
International literature………………………………………………. 23
U.S. literature …………………………………………………………… 23
Postoperative pain management ……………………………………………. 23
International Literature……………………………………………… 23
U.S. literature …………………………………………………………… 25
Acute and Chronic Pain Management……………………………………………….. 25
International literature…………………………………………………………. 25
U.S. literature ……………………………………………………………………… 26
Controversy ………………………………………………………………………… 27

Placebo acupuncture ……………………………………………………………. 28
Acupuncture and Acupressure in the Academic Literature…………………… 29
International and Domestic CAM Use by Health-Care Providers ……………………. 29
International…………………………………………………………………………………… 29
Veterinary medicine ……………………………………………………………………….. 30
United States………………………………………………………………………………….. 30
Government ………………………………………………………………………… 30
Nursing ………………………………………………………………………………. 30
Physician ……………………………………………………………………………. 31
Economic Implications………………………………………………………………………………. 31
Theoretical Framework ……………………………………………………………………………… 32
Diffusion of innovations………………………………………………………………….. 32
Summary……………………………………………………………………………………….. 37
Chapter Three: Methodology ………………………………………………………………………………… 38
Overview …………………………………………………………………………………………………. 38
Research Design ……………………………………………………………………………………….. 38
Variables……………………………………………………………………………………….. 39
Population and Sample Description …………………………………………………………….. 40
Data sources…………………………………………………………………………………… 40
Target population……………………………………………………………………………. 41
Sample ………………………………………………………………………………………….. 43
Inclusion criteria …………………………………………………………………. 43
Exclusion criteria ………………………………………………………………… 43

Sample size …………………………………………………………………………. 43
Sample Recruitment ……………………………………………………………………….. 44
Survey……………………………………………………………………………………………………… 45
Development………………………………………………………………………………….. 45
Administration……………………………………………………………………………….. 46
Survey Design ………………………………………………………………………………………….. 47
Pretesting ………………………………………………………………………………………. 47
Reliability ……………………………………………………………………………………… 47
Measurement Validity …………………………………………………………………….. 49
Face validity ……………………………………………………………………….. 48
Content validity …………………………………………………………………… 49
Construct validity ………………………………………………………………… 49
Survey Scoring ………………………………………………………………………………. 50
Data Collection…………………………………………………………………………………………. 50
Mixed-Mode ………………………………………………………………………………….. 50
Social exchange principles………………………………………………………………. 51
Procedure………………………………………………………………………………………. 51
Incentive ……………………………………………………………………………………….. 52
Ethical considerations……………………………………………………………………… 53
Data Analysis ………………………………………………………………………………………….. 54
Coding and storing …………………………………………………………………………. 54
Statistical analysis ………………………………………………………………………….. 54
Summary………………………………………………………………………………………………….. 56

Chapter Four: Results ………………………………………………………………………………………….. 58
Data Collection Review……………………………………………………………………………… 58
Methodology Review ………………………………………………………………………………… 58
Data preparation and cleaning ………………………………………………………….. 59
Respondent Demographic Profile………………………………………………………………… 59
Education………………………………………………………………………………………. 60
Years of practice…………………………………………………………………………….. 61
Institution………………………………………………………………………………………. 62
Patient population focus………………………………………………………………….. 63
Country of pre-anesthesia training ……………………………………………………. 63
Descriptive Statistics Related to the Research Questions ……………………………….. 64
Research question 1………………………………………………………………………… 65
Personal use ……………………………………………………………………….. 65
Acupuncture……………………………………………………………… 65
Acupressure ……………………………………………………………… 66
Significance testing……………………………………………………. 66
Age………………………………………………………………………….. 68
Gender…………………………………………………………………….. 68
Anesthesia provider type ……………………………………………. 68
Institution…………………………………………………………………. 68
Pre-anesthesia training ……………………………………………… 71
Worldview…………………………………………………………………………… 72
Acupuncture and acupressure approaches in clinical practice ….. 72

Education……………………………………………………………………………. 73
Acupuncture education desired …………………………………… 73
Acupressure education desired……………………………………. 74
Evidence for use ………………………………………………………………….. 75
Research question 2………………………………………………………………………… 75
Research question 3………………………………………………………………………… 77
Acupuncture………………………………………………………………………… 80
Acupressure ………………………………………………………………………… 82
Research question 4………………………………………………………………………… 84
Alternative vs. mainstream practices ……………………………………… 84
Effects of acupuncture and acupressure………………………………….. 84
General attitudes…………………………………………………………………. 85
Spirituality ………………………………………………………………………….. 86
Chapter Five: Discussion………………………………………………………………………………………. 89
Purpose of the Study………………………………………………………………………………….. 89
Respondent Demographic Profile………………………………………………………………… 89
Summary Findings of Research Questions……………………………………………………. 90
Research question 1………………………………………………………………………… 90
Personal use ……………………………………………………………………….. 90
Worldview…………………………………………………………………………… 91
Acupuncture and acupressure approaches in clinical practice ….. 91
Education……………………………………………………………………………. 91
Evidence for use ………………………………………………………………….. 92

Research question 2………………………………………………………………………… 92
Research question 3………………………………………………………………………… 95
Research question 4………………………………………………………………………… 96
Alternative vs. mainstream ……………………………………………………. 96
Effects of acupuncture and acupressure………………………………….. 96
General attitudes and spirituality…………………………………………… 97
Limitations……………………………………………………………………………………………….. 98
Applications ………………………………………………………………………………………….. 99
Application to theory………………………………………………………………………. 99
Application to the literature……………………………………………………………… 99
Implications……………………………………………………………………………………………. 100
Theoretical…………………………………………………………………………………… 100
Practical ………………………………………………………………………………………. 100
Recommendations for Future Research………………………………………………………. 101
Conclusion……………………………………………………………………………………………… 102
References ………………………………………………………………………………………………………… 105
Appendix A. Acupuncture and Acupressure Survey……………………………………………….. 123
Appendix B. Permission From Authors to Use Surveys………………………………………….. 135
Appendix C. Introductory Letter Sent to the Department Chairs………………………………. 138
Appendix D. List Anesthesiology Departments Contacted………………………………………. 140
Appendix E. Draft of Initial E-mail Sent to the Chairs……………………………………………. 145
Vita …………………………………………………………………………………………………………………. 147

List of Tables

Table Page
1: Review of Preoperative Anxiety Literature…………………………………………………………. 20
2: Review of Intraoperative Acupuncture Literature………………………………………………… 22
3: Review of PONV Literature……………………………………………………………………………… 24
4: Review of Postoperative Pain Literature…………………………………………………………….. 26
5: Review of Acute and Chronic Pain Literature …………………………………………………….. 27
6: Variables and Their Operational Definitions ………………………………………………………. 40
7: Content and Construct Validity: Aligning the Survey Questions With the
Research Questions …………………………………………………………………………………………. 49
8: Relationship Between Research Questions, Constructs, Survey Questions, and
Statistical Measurements………………………………………………………………………………….. 56
9: Age of Anesthesia Providers…………………………………………………………………………….. 60
10: Educational Profile of Anesthesia Providers………………………………………………………. 61
11: Years of Practice ……………………………………………………………………………………………. 61
12: Institution Type ……………………………………………………………………………………………… 62
13: Patient Population Focus…………………………………………………………………………………. 63
14: “Other” Anesthesia Practice Areas……………………………………………………………………. 64
15: Personal Use ………………………………………………………………………………………………….. 65
16: Acupuncture Cross-Tabulation: Age (Personal Use)…………………………………………… 69

Table Page

17: Acupuncture Cross-Tabulation: Gender (Personal Use)………………………………………. 70
18: Acupuncture Cross-Tabulation: Pre-anesthesia Training (Personal Use)……………….. 71
19: Personal Use by Pain Management Specialists…………………………………………………… 72
20: Acupuncture and Acupressure Approaches to Clinical Practice……………………………. 73
21: Acupuncture and Acupressure Education Received…………………………………………….. 74
22: Evidence of Use……………………………………………………………………………………………… 76
23: Reasons Why Acupuncture and Acupressure May Not Work in Western
Medical Settings……………………………………………………………………………………………. 77
24: “Other” Reasons Why Acupuncture and Acupressure May Not Work in
Western Medical Settings……………………………………………………………………………….. 78
25: Acupuncture Cross-Tabulation: U.S. Region (Personal Use)……………………………….. 81
26: Spearman’s Correlation—Acupuncture (U.S. Region)………………………………………… 82
27: Acupressure Cross-Tabulation—U.S. Region (Personal Use)………………………………. 83
28: Alternative vs. Mainstream Practices………………………………………………………………… 84
29: Acupuncture’s Effects on Decreasing ……………………………………………………………….. 85
30: Acupressure’s Effects on Decreasing………………………………………………………………… 86
31: General Attitudes……………………………………………………………………………………………. 87

List of Figures

Figure Page
1: The Four Main Elements of the DOI Theory ………………………………………………………. 33
2: A 5-Stage Model of Rodgers (2003) Innovation-Decision Process………………………… 34
3: Application of DOI Constructs to Bacharach Theoretical Framework……………………. 35
4: Anesthesiology Department Sample—Stratified by Geographic Region and
Institution Type ……………………………………………………………………………………………… 42
5: Study Procedure ……………………………………………………………………………………………… 53
6: Anesthesia Provider Type ………………………………………………………………………………… 60
7: Histogram of Institution Type …………………………………………………………………………… 62
8: Histogram of Personal Acupuncture Use ……………………………………………………………. 66
9: Histogram of Personal Acupressure Use…………………………………………………………….. 67
10: Acupuncture Education Desired……………………………………………………………………….. 74
11: Acupressure Education Desired ……………………………………………………………………….. 75
12: U.S. Geographic Regions Represented by Study Participants………………………………. 81
13: Spirituality’s Influence Over Attitude Toward Acupuncture and Acupressure ……….. 88

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