Thesis (Ph. D.)--University of Kent at Canterbury, 1993. / Aalso available in print.

Chronic pain is common in the United States, with studies suggesting that pain impacts 20% of adults annually. There are many pharmacological agents used to treat pain, including but not limited to opioids, gabapentin, oral analgesics, and antidepressants as analgesics. Acupuncture has been shown to be effective in reducing musculoskeletal pain, headaches, and chemotherapy-induced nausea and vomiting in adults. Children also suffer from chronic pain, but minimal research has examined the use of acupuncture for treatment of pediatric pain. The purpose of this retrospective chart review is to quantify pain reduction in pediatric joint pain treated with acupuncture. The pain scores prior to first and sixth acupuncture treatment for knee pain were compared for 14 pediatric patients. Daily activity and functions scores were obtained from 6 patients. Our results revealed a statistically significant reduction in median pain score (P=0.002). 47% of our sample reported clinically significant pain reduction (> 30% reduction in pain on numerical rating scale (NRS)) and 60% of individuals with baseline moderate-severe pain reported clinically significant pain reduction. The median interference of pain with daily activity was reduced in 5 of 7 daily activities. Our results suggest that acupuncture might be an effective treatment modality for pediatric knee pain and improving quality of life.

No description available.

Objective--Identify patient history intake questions common to four fields of medicine - allopathic, naturopathic, chiropractic and Traditional Chinese Medicine to be included in an Integrated Patient History Intake Tool. Background--The use of complementary and alternative medicine (CAM) is on the rise in the United States. 80% of those who used CAM therapies in 1990 did so in conjunction with allopathic medicine, and 70% of those who used CAM therapies did not tell their conventional practitioner. Lack of awareness of patients' use of CAM therapies may hinder practitioners' ability to provide adequate healthcare. Methods--A three-round modified Delphi technique was utilized to generate consensus among 106 Oregon health care practitioners on the importance of specific patient history intake questions. A panel of faculty members from Oregon Health and Sciences University, the National College of Naturopathic Medicine, the Oregon College of Oriental Medicine, and Western States Chiropractic College identified 321 patient history intake questions, which then were distributed to the Oregon healthcare practitioners. The healthcare practitioners were asked to rate the importance of each question through a series of two surveys over the period of eleven weeks. Suggestions for additional intake questions also were invited. Results--The Delphi process narrowed the 321 initial questions plus 150 additional suggested questions down to a list of 52 intake questions to be included in the Integrated Patient History Intake Tool. There was an overall response rate of 47% with a 64% response rate to SURVEY I, and a 74% response rate for SURVEY II. Discussion--The patient history intake questions have been identified for use in an Integrated Patient History Intake tool. This Delphi study illustrated the differences that are held unique for each paradigm of medicine. Determining unique characteristics of complementary and alternative medicine from allopathic medicine is an important aspect of building collaboration among allopathic and CAM providers within the state of Oregon. The proposed model of an integrated patient history intake form provides a platform from which to build further cooperation and awareness. / Graduation date: 2003

This study aims to explore the factors which affect the technological employees¡¦ utilization of alternative medicine in Taiwan. The research modifies Aday and Anderson model to form the research framework. This reasearch focus on the relationship between predisposition factors, enabling factors , needs factors of technological employees and the utilization of alternative medicine services. 600 copies of questionnaires were conducted in July 2005 to January 2006, with 520 of them returned that makes a response rate of 86.67%. The conclusions of this study are presented as follows: 1. A total of 274(52.7%) of technological employees have ever utilized alternative medicine, 243(46.7%) of technological employees have never utilized alternative medicine and 3(0.6%) of technological employees is the missing data. 2. On average each person has utilized 1.40 alternative medicine service visits and has spent NT$740.73. 3. The alternative medicine used most commonly by technological employees are naprapathy (17.1%), hydropathy (13.6%), feet massage (10.0%), massage (9.7%) and acupuncture (8.9%). 4. Technological employees¡¦ age, occupation, the position of occupation, income, the methods of acquiring alternative medicine, residence,the recommendations of family or friends,and perceived physical health are the factors to affect the utilization of alternative medicine. Technological employees¡¦ religion of Buddhism is the factors to affect the number of visits of alternative medicine. Technological employees¡¦gender of womem and other methods of acquiring alternative medicine are the factors to affect the expenditure of alternative medicine. The suggestions of this study are that Department of Health may help the public to acquire accurate information concerning alternative medicine and plan for having the health insurance coverage of alternative medicine.In addition, hospitals or the alternative medicine providers may increase promotion of alternative medicine, marketing for alternative medicine services bases on the major findings from this study.

<p> This mixed methods study examines the opinions of U.S-based practitioners of Chinese Medicine (CM). This study recruited CM practitioners (n = 96) from U.S professional association networks. The study asked CM practitioners to define the term integrative medicine (IM). They were also asked to reflect on the role of CM within contemporary health care in the United States, the impact this may have on patient care, and the future of CM as a part of IM. </p><p> While some CM practitioners in this study voiced optimism and an interest in working in IM settings, others equated the opportunity for integration with loss of CM traditions, compromise to CM, and professional subordination. While CM practitioners are fully trained to practice a complete system of medicine, acupuncture alone is most frequently the modality that is utilized in IM settings. </p><p> Practitioners were of the opinion that skills, training, knowledge, and experience that are included in patient care remain underutilized in IM settings. They also had concerns about maintaining the distinct philosophy and practices that constitute Chinese medicine as a whole system of care. </p><p> The recommendation from this study is that the current hierarchical structure that exists in many IM settings open up to the possibility that CM can provide a range of treatment options for patients that conventional medicine cannot. The contribution that CM practitioners could bring to the developing field of IM holds great potential. The majority of CM practitioners surveyed agreed that the health care field in the United States is expanding and this offers opportunities for ongoing development of the Chinese medicine profession in the United States.</p>

<p> Historically the relationship between Allopathic and Osteopathic physicians with Chiropractors has been strained at best. Since the Patient Protection and Affordable Care Act specifically list&rsquo;s Chiropractors as part of Accountable Care Organizations this strained relationship will not be in the best interests of patient care. Chiropractors are a small part of the health care puzzle so they will need to integrate into the larger health care arena and work alongside their Allopathic and Osteopathic counterparts. To accomplish this, the attitudes and beliefs of these Allopathic and Osteopathic Physicians were ascertained so that Chiropractors can possess the information required to transition into Accountable Care Organizations as seamlessly as possible. This study, with limitations including small sample size, determined the attitudes and beliefs of Allopathic and Osteopathic physicians towards Chiropractors and then determined the steps that they would suggest to help with Allopathic and Osteopathic collaboration with Chiropractors for future patient care. </p><p> The Survey used to ascertain the attitudes and beliefs of Allopathic and Osteopathic physicians was obtained with permission from Busse et.al. (2009). Three different research questions were analyzed using several different items from the Survey. Overall the Allopath&rsquo;s and Osteopath&rsquo;s had a negative view of Chiropractors including the attitude that Chiropractors should not be involved in Medical Homes or Accountable Care Organizations as stated in the Patient Protection and Affordable Care Act. Additionally there was no statistically significant relationship between Allopathic and Osteopathic attitudes or beliefs and their willingness to collaborate clinically with Chiropractors based on age, gender, Allopathic or Osteopathic education, years in practice, and specialty. In the written response aspect of the survey barriers to collaboration included Chiropractors anti-vaccine stance, non-evidence based treatment, and over treatment of patients. Key Words: Chiropractor, Allopath, Osteopath, Collaboration, Patient Care.</p>

<p>Massage therapy is often used to treat musculoskeletal symptoms and to promote wellness. While evidence regarding its effectiveness is increasing, research related to actual practice and studies seeking to understand the mechanisms of massage therapy are needed. The purpose of this research was to describe the characteristics of massage therapists and their clients and to understand the role of communication in massage therapy outcomes. The first study examined the outcome expectations, expectancies, and behaviors of a random sample of massage therapists in Iowa (n=151) using a cross-sectional survey. The second study used a practice-based research design incorporating two samples of massage therapy clients (n=320 and n=321) to develop and validate a measure of client expectations of massage, the Client Expectations of Massage Scale (CEMS). The third study examined the influence of client expectations and massage therapists' interpersonal attractiveness on pain and satisfaction following massage. Social Cognitive Theory and Expectancy Violation Theory were used as frameworks to demonstrate how health behavior and communication theories can provide insight to massage therapy research. Results indicated that massage therapists had high expectations regarding the benefits of massage therapy and engaged in a variety of behaviors that reflect the clinical, educational, and interpersonal nature of massage therapy. In addition to using a variety of manual therapies, the massage therapists educated their clients in areas such as diet, stress management, and exercise to improve client health. Similarly, clients had positive expectations as measured by the outcome, clinical, educational, and interpersonal subscales of the CEMS. Positive outcome expectations predicted significant improvements in pain and serenity. High interpersonal expectations were related to negative changes in serenity. The third study revealed that high satisfaction was influenced by positive interpersonal attractiveness but more research is needed to understand the influence of client expectations being met on satisfaction. Initially high educational expectations, exceeded educational expectations, violated interpersonal expectations, and positive interpersonal attractiveness were related to less pain following massage. In conclusion, this research demonstrated that client expectations and massage therapist interpersonal attractiveness are important constructs to consider when evaluating the effects of massage therapy.

Thesis (M.S.W.)--Smith College School for Social Work, Northampton, Mass., 2007 / Thesis submitted in partial fulfillment for the degree of Master of Social Work. Includes bibliographical references (leaves 46-49).

Thesis (Ph.D.)--University of California, San Francisco, 2005. / Includes bibliographical references. Also available online.