"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

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 necessary "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.